CPF-D(1) Application to Withdraw Deceased Member`s CPF This

Application to Withdraw Deceased Member’s CPF
This form may take you 10 minutes to complete.
CPF-D(1)
IMPORTANT: PLEASE PRINT THIS FORM ON BOTH SIDES OF THE PAPER AND READ PAGE 3 BEFORE COMPLETING IT.
It is an offence to make any false statement or to produce any document which is false for any purpose in connection with the Central
Provident Fund Act (Cap. 36). Please sign against any amendment made. Use of correction fluid/tape may render the application void.
PART 1
PARTICULARS OF DECEASED MEMBER
Name: ______________________________________________________________
PART 2
NRIC or CPF Account Number
*S/T
DECLARATION BY NOMINEE
I, (Name of Nominee, as shown on identification document) ___________________________________________________
of (Address, only required for non-NRIC holder) ____________________________________________________________
___________________________________________________________________________________________________
holder of (*NRIC No. / Malaysian IC No. / Foreign Passport) ___________________________ hereby declare that I am the
(Relationship) ___________________________ of the above named deceased and that I am the person nominated by the
deceased to receive a portion of the deceased’s money with the Central Provident Fund (the “Fund”) and the shares in an
approved corporation designated under section 26(1) of the Central Provident Fund Act (Chapter 36) belonging to the
deceased. I hereby apply to withdraw my entitlement of the deceased’s money with the Fund and the proceeds of the sale
of any shares by the deceased (“the deceased’s legacy”).
I declare that I *am / am not an undischarged bankrupt and that the deceased did not, to the best of my knowledge, at any
time from (date of nomination) __________________ to (date of death) __________________, contract any marriage in
Singapore or elsewhere.
I authorise the Central Provident Fund Board (the “Board”) to obtain verification of information relating to me and to my
bank account from the bank, and the bank to disclose any information whatsoever relating to me and to the account for the
purpose of account validation. My authorisation here shall survive the termination of any of the account with the bank and
may be relied on and enforced as fully and effectively by the bank as if it is addressed to the bank.
In consideration of the Board paying to me the deceased’s legacy, I hereby covenant that I will fully indemnify the Board
against any action, claim, demands, damages, costs, expenses and losses incurred or suffered by the Board, including
legal expenses for the recovery of payment from me, in connection with the payment of the deceased’s legacy to me. I
further covenant that if any amount paid to me as the deceased’s legacy is not due to me, I shall refund the amount on
demand being made by the Board.
PART 3
DECEASED’S DISCOUNTED SINGTEL SHARES
(Please complete this part if the deceased has discounted Singtel shares)
I hereby instruct the Board to (please tick only one option):
1.
Sell the deceased’s discounted Singtel shares due to me.
I acknowledge that there will be brokerage charges deducted from the sale proceeds due to me.
2.
Transfer** the deceased’s discounted Singtel shares due to me to my *individual / joint Central Depository Pte
Limited (CDP) Securities Account as indicated below:
1 6 8 1
(Please submit a copy of the CDP statement if this is a joint account)
I consent to the Board disclosing my identity as the appointed nominee of the above named deceased to CDP for
the purpose of transferring the deceased’s discounted Singtel shares to my CDP securities account
I authorise the Board to deduct the CDP transfer fee of $5.35 from the deceased’s CPF monies due to me.
*Delete whichever is inapplicable.
** If you do not have a CDP Securities Account, you may approach the Central Depository to open one. For more information, please contact CDP at
6535 7511 or visit their website www.sgx.com.
(04/2016)
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PART 4
For Bank’s Certification Only
BANK DETAILS OF NOMINEE
(i) Bank Account Number : __________________________________________ The Bank hereby certifies that the bank
(Bank account must not be a trust account or jointly held with the deceased) account, name and identification / passport
number on this form belong to the nominee.
Name of Bank
: __________________________________________
(ii) To be completed for payment via Telegraphic Transfer only:
SWIFT Code
: ________________ (Can be obtained from the bank)
Bank Address
: ___________________________________________
___________________________________________
..................................................
Bank Officer’s Name, Signature,
Bank’s Stamp & Date
For Witness’ Certification Only#
SIGNATURE / RIGHT THUMBPRINT OF NOMINEE
(for applications completed outside Singapore)
I hereby certify that the nominee had signed
the form in my presence.
_______________________________
Signature / Right Thumbprint
___________________________
Contact Number
_________________
Date
___________________________
Email Address
.....................................................
Witness’ Name, Signature, Official
Seal / Stamp & Date
FOR OFFICIAL USE ONLY
(i) Receipt of Application by CPF Officer
PT
Accepted and Checked by: __________________________________
Officer’s Name, Stamp, Signature & Date
Revised Mode of Payment (if any): * IBG / TT / CHQ
Refer to WSD78A dated: ______________________
SN
MN
Nominee Bankrupt?
Date checked _____
* Yes / No
Exempted?
Date received
(ii) Discounted Singtel shares
No. of shares: _____________
Sale
Transfer
____________________
Checked by / Date
Use CPF for transfer fee: * Yes / No
____________________
Certified by / Date
____________________
Verified by / Date
(iii) Nominee(s) under 18 years
Name
Age
Date of Birth
NRIC / BC No.
%
No. of shares
Informant / Guardian’s Name: _______________________________________________________________________
NRIC / Foreign Passport No.: _______________________ Relationship: ____________________________________
Address: _______________________________________________________________________________________
Remarks: _______________________________________________________________________________________
________________________
Authorised By
____________________
Date of Processing
Keyed By: ___________________
____________________
Code
Verified By: ___________________
*Delete whichever is inapplicable.
# The witness must be either a Notary Public or an official from the Singapore High Commission / the Embassy of the Republic of Singapore with his
official seal / stamp duly affixed.
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IMPORTANT : An incomplete form and / or incomplete supporting documents will delay the processing of
your application.
PROCEDURES FOR CPF WITHDRAWAL
1.
You may post your application and supporting documents (if applicable) to CPF Board, Withdrawal Schemes
Department, 238B Thomson Road, #08-00, Tower B, Novena Square, Singapore 307685. Alternatively, you
may visit our website at www.cpf.gov.sg and log on via SingPass to “my cpf Online Services – My Requests –
Withdrawal on Non-Retirement Grounds” to make an online application.
2. If your application is completed outside Singapore^, your application and all supporting documents must be
witnessed / certified true by either a Notary Public or an official from the Singapore High Commission / the
Embassy of the Republic of Singapore with his official seal / stamp duly affixed. Certifications by a Justice of
Peace or Commissioner for Oaths are not acceptable.
^ Including applications with a non-Singapore address or if applicants have an overseas address in our records.
This does not apply if the form is completed at our CPF Service Centre.
PAYMENT
1. Payment will be credited into your bank account as stated in this application via:
i.
Interbank GIRO for a Singapore bank account.
ii.
Telegraphic Transfer for an overseas bank account.
You will need to provide us the SWIFT code and bank address, and ensure that the bank accepts
payment in Singapore dollars. Please note that you will have to bear all bank charges.
Please get your bank to certify your bank account information on Part 4 of the form or mail us your original bank
statement for verification. Online bank statements are not acceptable. Bank certification is not required for a
Singapore POSB (excluding DBS), OCBC or UOB bank account maintained under your Singapore NRIC.
The Board has the discretion to decide whether or not to perform verification of information relating to you and your
account with the bank.
2. If your bank account information is not provided or is incomplete, we will issue you a cheque in Singapore Dollars.
(Note: For overseas bank clearance of the cheque, you will need to bear all bank charges.)
PROCESSING TIME
Upon receipt of your application and supporting documents, payment will be made according to the service standards
below:
•
•
Interbank GIRO (IBG)
Non-IBG
15 working days
20 working days
An additional 7 working days are required if the deceased member held discounted Singtel shares.
The processing time excludes time taken for transmission of funds, estimated as follows:
1. IBG – 2 working days
2. Telegraphic Transfer – 5 to 12 working days
3. Cheque – It will be sent within 5 working days after processing.
YOU MAY RETAIN THIS PAGE FOR REFERENCE
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