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GEPF USE ONLY - GEPF STAMPS Government Employees Pension Fund GEPF BAR CODE CHOICE FORM RESIGNATION/DISCHARGE Private Bag x63 Pretoria SOUTH AFRICA Tel No 27 0 12 319 1911 Fax No 27 0 12 326 2507 Call Centre 27 0 12 319 1000 E-mail enquiries gepf.co. Za WebSite www. gepf.co. za 34 Hamilton Street Arcadia CHOICE FORM FOR PENSION BENEFIT UPON RESIGNATION/DISCHARGE To enable the GEPF to successfully process the request for withdrawal from the Fund as a result of i Voluntary Resignation ii Discharge due to Misconduct or iii Discharge due to Ill-Health occasioned by own doing the member must select an option before teminating service by completing this form. A PERSONAL PARTICULARS OF MEMBER Pension Number Surname First Name Title Initials ID No D. O. B Salary No Income Tax No B OPTIONS FOR PENSION BENEFIT PAYABLE Applicable Rules of GEPF Law Rule 14. O. B Salary No Income Tax No B OPTIONS FOR PENSION BENEFIT PAYABLE Applicable Rules of GEPF Law Rule 14. 4. 1 14. 4. 2 and 12. 3 A single choice must be made between option a or option b. The benefit is taxable and tax may be deducted subject to instructions from SARS* Option a Members who want a once-off gratuity payment in own right Rule 14. 4. 1 a COMPULSORY ATTACHMENT FOR OPTION a Z894 ACB BANK PARTICULARS This implies A gratuity calculated at 7. 5 of his or her final salary multiplied with the period of his or her pensionable service and increased by ten percentage points for each full year of pensionable service between 5 and 15 years OR Retirement fund Rule 14. 4. 1 b. FUND. N*B. Please familiarize yourself with the contents of section D of the Z1525 form The FULL amount of the benefit is to be transferred to an approved external retirement fund. No benefit will be paid to the member. If the member is above the age of 55 but has not yet reached the normal retirement age his/her benefits shall be reduced by 0. 3 one third of one percent for each complete month between the member s actual retirement date and the normal retirement date. D CERTIFICATION BY MEMBER AND EMPLOYER REPRESENTATIVE I the undersigned declare that I understand the options offered and that I agree that the choice made by me is irrevocable after the date of terminating my service. behalf of the Employer that I have provided the member with explanatory guidelines with regards to his / her withdrawal option* Signature OR Thumbprint of Member A Thumbprint of the member is acceptable in the case where the member cannot read or write. O. B Salary No Income Tax No B OPTIONS FOR PENSION BENEFIT PAYABLE Applicable Rules of GEPF Law Rule 14. 4. 1 14. 4. 2 and 12. 3 A single choice must be made between option a or option b. The benefit is taxable and tax may be deducted subject to instructions from SARS* Option a Members who want a once-off gratuity payment in own right Rule 14. 4. 1 14. 4. 2 and 12. 3 A single choice must be made between option a or option b. The benefit is taxable and tax may be deducted subject to instructions from SARS* Option a Members who want a once-off gratuity payment in own right Rule 14. 4. 1 a COMPULSORY ATTACHMENT FOR OPTION a Z894 ACB BANK PARTICULARS This implies A gratuity calculated at 7.