Form 6—Declaration to accompany applicatForm 6—Declaration to accompany application to trustee for information about a superannuation interest

Form 6—Declaration to accompany application to trustee for information about a superannuation interest

(regulation 62)

Family Law Act 1975 subsection 90XZB(2) or 90YZR(2)

DECLARATION BY APPLICANT FOR INFORMATION ABOUT A SUPERANNUATION INTEREST

I, [name], of [postal address], born on [date of birth], make the following declaration in support of my application to the trustee of [name of eligible superannuation plan from which information is sought] (the plan) for information about:

\*(a) my superannuation interest.
\*(b) a superannuation interest of \[full name of member\], born on \[date of birth of member\], who is a member of the plan.

1. I am: *(a) a member of the plan. *(b) the spouse of [name], who is a member of the plan. *(c) intending to enter into a superannuation agreement under [Part VIIIB/Part VIIIC] of the Family Law Act 1975 with [name], who is a member of the plan.
2. I require the information to: *(a) assist me to properly negotiate a superannuation agreement. *(b) assist me in connection with the operation of [Part VIIIB/Part VIIIC] of the Family Law Act 1975.

DATED:

[signature of person making declaration]

* Omit if not applicable