Document ID: chunk:federal_register_of_legislation:F2019L00646:body:0:p18
Version: federal_register_of_legislation:F2019L00646
Segment Type: other
Provision Reference: 
Character Range: 46013–49595

of approved benefit fund rules under section 16Q(2) of the Act.

    4.             Contact person

    Please provide the contact details for the person to whom enquiries relating to this application should be directed.

    Name

    Position title

    Phone

    Email address

    5.             Address for correspondence

    Please provide the address to which correspondence relating to this application should be mailed.

    6.             Signatures

    This form must be signed by:

       (a)          the principal executive officer of the friendly society; or

       (b)          an officer of the friendly society who has been authorised for that purpose by the principal executive officer, if the principal executive officer has notified APRA in writing of the authorisation.

    Name               Position title

    Signature       Date

Please send completed form and accompanying documents to your responsible supervisor.

Form 4: Approval of consequential amendments of a company's constitution as required by APRA

     1. Name and Australian business number of friendly society

    2.             Contact person

    Please provide the contact details for the person to whom enquiries relating to this application should be directed.

    Name

    Position title

    Phone

    Email address

    3.             Address for correspondence

    Please provide the address to which correspondence relating to this application should be mailed.

    4.             Certification

    By signing this form, the signatory certifies that the proposed consequential amendments rectify the deficiency referred to in the APRA notice given under section 16V(2) of the Life Insurance Act 1995.

    5.             Signatures

    This form must be signed by:

       (a)          the principal executive officer of the friendly society; or

       (b)          an officer of the friendly society who has been authorised for that purpose by the principal executive officer, if the principal executive officer has notified APRA in writing of the authorisation.

    Name               Position title

    Signature       Date

Please send completed form and accompanying documents to your responsible supervisor.
Form 5: Restructure of approved benefit funds

     1. Name and Australian business number of friendly society

    2.             Date from which the restructure is proposed to have effect

    3.             Required documentation

    By indicating 'Yes' below, the signatory to this form confirms that the documents mentioned in Schedule 1 to this form have been attached.

        Yes      No

    4.             Contact person

    Please provide the contact details for the person to whom enquiries relating to this application should be directed.

    Name

    Position title

    Phone

    Email address

    5.             Address for correspondence

    Please provide the address to which correspondence relating to this application should be mailed.

    6.             Signatures

    This form must be signed by:

       (a)          the principal executive officer of the friendly society; or

       (b)          an officer of the friendly society who has been authorised for that purpose by the principal executive officer, if the principal executive officer has notified APRA in writing of the authorisation.

    Name               Position title

    Signature       Date

Please send completed form and accompanying