CFS Appoint Adviser Form

Attention

Colonial First State

Reply Paid 27
Sydney NSW 2001

Dear CFS Adviser Services Team,

Adviser Nomination

I wish to advise that I have appointed Paul Melling Retirement Planning to act as my in connection with my policies with your company.
Full Client Name:
Account Number:
ALL ACCOUNTS HELD WITH CFS
Date of Birth:

DayMonthYear
2 digit day, 2 digit month, 4 digit year
Address:

I wish to advise that I have appointed Paul Melling Retirement Planning to act as may representative in obtaining any information or forms they may request in connection with my policies with your company.

Company/Adviser/Administration:	Melling Retirement Planning,
	Steve Melling, Chrissy Jones, Kirsty Rae, Larissa Stratton, Dean Hayes, Nimali Barfoot, Genevive Santiago, Ellie Pacete

Address:	Suite 1 486 Lower Heidelberg Road
	Heidelberg Vic 3084

Phone:	03 9450 5000

CFS Dealer Code:	0062
CFS Adviser Code:	0306

Dealer Group:	Paul Melling & Associates Pty Limited
ABN:	99 006 425 092

AFS Licence:	231247

ADVISER NOMINATION
- I/we, declare that I/we have read the current Product Disclosure Statement (PDS) for each AIL and/or CFSIL account(s) identified and:
  - authorise the financial adviser nominated to be servicing adviser for my/our AIL and/or CFSIL account(s) identified, and
  - authorise AIL and/or CFSIL to provide my/our nominated financial adviser with details of my investments for each AIL and/or CFSIL account(s) identified, and
  - authorise the financial adviser nominated to update my personal details, and
  - remain bound by the terms and conditions contained in the PDS(s) (as updated from time to time) and the relevant Constitution(s)/Trust Deed(s) applicable to my/our AIL and/or CFSIL account(s).
- understand that as a consequence of this authorisation, if applicable, any existing:
  - Adviser Online Transaction Authority I/we have granted to any previous adviser for my/our AIL and/or CFSIL account(s) will cease to operate
  - agree this adviser nomination will continue to operate until I/we notify AIL and/or CFSIL in writing that the adviser nominated in this form is no longer my/our servicing adviser.
Your assistance on this matter would be highly appreciated. Should you require any further information please do not hesitate to contact Paul Melling Retirement Planning on 03 9450 5000.

Thank you.

Yours Sincerely,
Date Signed:

DayMonthYear
2 digit day, 2 digit month, 4 digit year
Should be Empty: