Part A: Contact Details

Please provide your contact details below, which we will use to communicate with you.

Given Name:


Are you the Fund's Trustee?

Business Name:

Business ABN: Lookup your ABN here.

Address Line 1:

Address Line 2:



Post Code:

Contact Phone:

Contact Email:

Alternate Email:

Your Reference:

Invoice Addressee:

Part B: Fund Information

Please provide the following details about the Fund.

Full Name of Fund:

Fund ABN: Lookup your Fund's ABN here. For funds without an ABN, please call us on 1800 978 328.

Tax Year:

Members: Member 1 Member 2 Member 3 Member 4

Member Given Name:

Member Surname:

Member Date of Birth*:

Date Joined (if in year)*:

Date Exited (if in year)*:

* Please enter dates in dd/mm/yyyy format.

Type of Trustee:

Name of Trustee 1:

Name of Trustee 2:

Name of Trustee 3:

Name of Trustee 4:

Did the Fund commence
during the year?

Did the Fund wind-up
during the year?

Are any Fund assets
Does the Fund have
any TRIS's?
Disregarded small
fund assets?
Use deemed

Part C: Financial Data

Please fill out the required financial information below.

1. Account Balances as at 1 July:

Member 1 Member 2 Member 3 Member 4 Reserve

Non-Retirement Phase:

Retirement Phase:

2. Fund Transactions:
No financial transactions are currently loaded. Please use the input fields below to load in new financial data.

Once you have entered the data, click on the Load Transaction Inputs button.

Input New Transactions Data:
Transaction Date Transaction Type Member 1 Member 2 Member 3 Member 4 Reserve

Verus Tip: The "Pymt (Non-Ret)" transaction type refers to amounts withdrawn from non-retirement phase balances only. Amounts paid from retirement phase balances should be entered using the "Pymt (Ret Phase)" transaction type.

3. Pension Commencements and Cessations:
No pension commencements or cessations are currently loaded. If any retirement phase pensions were commenced or ceased during the year, please use the input fields below to provide this information.

Once you have entered the data, click on the Load Pension Inputs button.

Input New Pensions Data:
Date Commence/Cease Member 1 Member 2 Member 3 Member 4

4. Deemed Segregation:
No deemed segregation periods are currently loaded. For the 2017/18 and subsequent tax years, if there have been any period(s) during which the fund was entirely in retirement phase and you are required (or have elected) to treat the fund as deemed to be segregated, please enter data for these periods below.

Once you have entered the data, click on the Load Segregation Periods button.

Click the (?) button on the top-right of this section for more information.

Input New Deemed Segregation Periods:
Start Date End Date

Verus Tip: The start date is the date on which the Fund starts being entirely in retirement phase. The end date is the last complete day in the period during which the Fund is entirely in retirement phase. Multiple periods should not overlap. Click the (?) button on the top-right of this section for more information.

5. Other Net Income and Closing Balance:

Closing Balance:
(as at 30 June)
This should match the closing balance in the Fund's financial statements.

Other Net Income: This is the net balancing amount (including income, expenses and other adjustments) implied by the transactions and balances provided. You should check that the calculated amount is reasonable.

6. Financial Data Summary (Optional):

The reconciliation below can be used to summarise the transactions that have been entered. Note that this summary is not required for the request submission but may be helpful in ensuring all data has been entered correctly.
Whole Fund Member 1 Member 2 Member 3 Member 4 Reserve
Given Name
Non-Retirement Bal. 0 0 0 0 0 0
Retirement Bal. 0 0 0 0 0
Opening Balance 0 0 0 0 0 0
Concessional 0 0 0 0 0 0
Non-Concessional 0 0 0 0 0 0
Rollovers-In 0 0 0 0 0 0
Benefit Payments
Pymts (Non-Ret) 0 0 0 0 0 0
Pymts (Ret Phase) 0 0 0 0 0 0
Rollovers-Out 0 0 0 0 0 0
Other Net Income 0
Closing Balance 0

Part D: Comments and Request Submission

1. Additional Comments:
Please provide any other information relevant to this Fund (e.g. details of unusual features, assets segregated during the year, and/or any member deaths during the year, etc):

2. Draft Tax Exempt Percentages (Optional):

A draft estimate of the Tax Exempt Percentages (TEPs) and Taxable Percentages (TPs) for the Fund, including a breakdown between the Fund's members, can be calculated below.
Whole Fund Member 1 Member 2 Member 3 Member 4 Reserve
Given Name
Draft TEP - - - - - -
Draft TP - - - - - -

3. Request Submission:

Once you have ensured all data inputs have been entered correctly, please submit the request for processing by using the button below.
Note that the user(s) of the email address(es) provided, and the entity associated with the business ABN indicated, will be granted full access to all information pertaining to this request, including the resulting actuarial certificate. Please ensure that the email address(es) and business ABN provided are appropriate for this purpose. By submitting this request to Verus SMSF Actuaries, you confirm that the data provided is complete and correct to the best of your knowledge, and that the minimum pension payment standards have been met for any pension(s) in payment during the tax year.