• Your investment
  • Your information
  • Your partner's information
  • Financial adviser details
  • Your agreement
  • Complete

1. Calculate your insured income for life

Between $10,000 and $1,000,000; rounded to the nearest dollar.
Between 60 and 90 years.
Optional, if you have an affiliate or promotion code please enter it here.

Your net insured income

Based on the information you entered above, your minimum net insured income is:

2. Your investment

3. Your information

For assistance, please visit www.ird.govt.nz/toii/pir/workout
You must notify us of any changes to your tax residency or US citizenship within 30 days of the change.

4. Your partner's information

For assistance, please visit www.ird.govt.nz/toii/pir/workout
You must notify us of any changes to your tax residency or US citizenship within 30 days of the change.

5. Authorised financial adviser details

Adviser service fees (optional)

I authorise the Manager to pay a one-off Adviser Service Fee (ASF) of:

Maximum 1%

to the financial adviser whose details are listed above.

I understand the one-off ASF will be deducted from my account balance. I understand it will be calculated on my current account balance.

I authorise the Manager to pay an ongoing ASF of:

Maximum 0.5%

to the financial adviser whose details are listed above.

I understand the ongoing ASF will be deducted from my account balance in the Fund each month. I understand it will be calculated on my current account balance.

6. Your agreement

By signing this application form, you confirm that you have received and read the Lifetime Income Fund Product Disclosure Statement and that you agree to be bound by the Lifetime Income Fund’s terms and conditions. These are set out in the Product Disclosure Statement, online register entry, application form, and governing document.

Partner's agreement

By signing this application form, you confirm that you have received and read the Lifetime Income Fund Product Disclosure Statement and that you agree to be bound by the Lifetime Income Fund’s terms and conditions. These are set out in the Product Disclosure Statement, online register entry, application form, and governing document.