BT Super for Life application

All information with an asterisk is mandatory.

Your personal details

Tax file number:

Your current home address (not a PO box)

Mailing address (if applicable)

(required)Is the mailing address for your
BT Super for Life account the same as your current home address?: Yes     No

(required)My mailing address is a:ChoosePost boxStreetPropertyOther

(required)Postal type: Post office box Poste restante Community mail agent Community mail bag Community postal agent General post office box Locked mail bag service Mail service Private mail bag service Roadside delivery Roadside mail box Rodeside mail service

(required)Box Number:

Unit number:

Floor/ level:

(required)Property name:

(required)Address line 1:

Address line 2:

Street number:

Street name:

Street type:ChooseRoadStreetAlleyArcadeAvenueBoulevardCircleCircuitCloseCourtCrescentDriveEsplanadeGardenGardensGroveHighwayLaneMewsParadeParkwayPlacePlazaPromenadeSquareTerraceWayAccessAlleywayAmbleAnchorageApproachArteryBasinBeachBendBlockBraceBraeBreakBridgeBroadwayBrowBypassBywayCausewayCentreCentrewayChaseCircletCircusColonnadeCommonConcourseCopseCornerCorsoCourtyardCoveCrestCrossCrossingCrossroadCrosswayCruisewayCul-de-sacCuttingDaleDellDeviationDipDistributorDrivewayEdgeElbowEndEntranceEstateExpresswayExtensionFairwayFire trackFiretrailFlatFollowFootwayForeshoreFormationFreewayFrontFrontageGapGateGatesGladeGlenGrangeGreenGroundGullyHeightsHighroadHillInterchangeIntersectionJunctionKeyLandingLanewayLeesLineLinkLittleLookoutLoopLowerMallMeanderMewMotorwayMountNookOutlookParkParklandsPartPassPathPathwayPiazzaPlateauPocketPointPortQuadQuadrangleQuadrantQuayQuaysRambleRampRangeReachReserveRestRetreatRideRidgeRidgewayRight of wayRingRiseRiverRiverwayRivieraRoadsRoadsideRoadwayRondeRosebowlRotaryRoundRouteRowRueRunService waySidingSlopeSoundSpurStairsState highwayStepsStrandStripSubwayTarnThoroughfareTollwayTopTorTowersTrackTrailTrailerTriangleTrunkwayTurnUnderpassUpperValeViaductViewVillasVistaWadeWalkWalkwayWharfWyndYard

(required)City, town or suburb:

(required)State:ChooseNSWNTQLDSATASVICWA

(required)Postcode

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All information with an asterisk is mandatory.

Tell us how you want your money invested

Tell us how you want your money invested. You can change your selection later via Westpac Online.

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Please check that the details of your application are correct.

Your details

Investment choice

Insurance

Within 48 hours of submitting your BT Super for Life application, you will receive a call from BT Customer Relations to set up your internet banking with Westpac Online. You will then be able to view your new BT Super for Life account online.

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All information with an asterisk is mandatory.

By clicking the 'submit' button below, you:

• Acknowledge that BT Super for Life is a part of Retirement Wrap (ABN 39 827 542 991, RSE R1001327)
• Acknowledge that investments with BT Super for Life do not represent deposits or other liabilities of Westpac Banking Corporation ("WBC") or other companies in the Westpac Group; that the investments can be subject to investment risk, including possible delays in repayment and loss of income and principal invested; and that neither WBC nor its related entities in any way stand behind the capital value and/ or performance of the investment.
• Agree to be bound by all the provisions in the current Product Disclosure Statement ("PDS"), (and any superseding, supplementary or replacement PDS, as appropriate), the Trust Deed (as amended from time to time) and the terms and conditions of any insurance policy in relation to this product to the extent that they are intended to be binding.
• Agree that access to your BT Super for Life account will be given to any person who uses your PIN or password or complies with any other security procedure from time to time. Any action by that person will be taken to be by you.
• Agree to appoint us as your agent so that we can carry out a transaction in relation to BT Super for Life on your behalf, for example, over the telephone.
• To the extent permitted under law, release and indemnify us and other members of the Westpac group from and against all liabilities which may be suffered by you or brought against us (or Westpac group members) in respect of your or your representatives' act or omission in relation to this product.
• Consent to telephone conversations being recorded and listened to for record keeping, security and training purposes.
• Consent to us or a related party (including the administrator) receiving payment or commission as disclosed to you from time to time (eg. in the PDS).
• Agree to be bound by all the terms and conditions of the Westpac and BT websites, and acknowledge that we may vary those terms and conditions (including suspending or cancelling your ability to transact) with or without a notice.
• Acknowledge and confirm that you have read and understood all the relevant terms and conditions in the application process, as well as the PDS and our Financial Services Guide (including the Privacy section).
• Acknowledge and confirm that you have voluntarily provided your tax file number to us, although you are not obliged to do so.
• Agree to receive all correspondences including annual reports, annual account holder statements, transaction confirmations, and any PDS for investment options, as disclosed to you from time to time (eg. in the PDS).
• Consent to us continuing to act as the trustee notwithstanding any conflict of interest, to the extent permitted by law.

Legal Disclosure

Please check the box to confirm that you make the above declarations