Form D0563a - Request For Information - Comsuper Defined Benefit Income Stream Schedule
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1
2IMPORTANT
FACSIMILE
To:
Fax:
Company:
Phone:
From:
Fax:
Location:
Phone:
Date:
Pages:
REQUEST FOR INFORMATION
Notice under Section 128 of the Veterans’ Entitlements Act 1986
ComSuper Defined Benefit Income Stream Schedule
for Veterans’ Affairs assessment purposes
DVA Reference Number:
Regarding:
Address:
Date of Birth:
Product Name:
Product Reference:
This Department is currently reviewing the pension entitlements of
who is in receipt of a ComSuper defined benefit income stream.
As a person to whom the Secretary of this Department has delegated his powers under s.128 of the VEA,
I require you to complete the attached ‘ComSuper Defined Benefit Income Stream Schedule’ with respect to
whose details are supplied above.
Once you have completed the schedule, kindly fax it to my attention on
I require you to provide the completed schedule to me within 14 days of your receipt of this notice.
Should you have any enquiries regarding this matter, please contact me directly on
Yours sincerely
Delegate of the Secretary
Warning: the contents of this fax (including attachments) may be confidential and personal. You should only deal with the material in this fax if you are
authorised to do so. If you are not the addressee, please do not read, copy, re-transmit, store or act in reliance on this fax. Please notify us by telephone
immediately and then destroy all copies.
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