Challenger CarePlus PDS · residential care CarePlus Annuity CarePlus Insurance Product Disclosure Statement (PDS) Dated 19 August 2016 Issuer Challenger Life Company Limited (ABN

Challenger CarePlus

For individualsin home orresidential care

CarePlus AnnuityCarePlus Insurance

Product Disclosure Statement (PDS)Dated 19 August 2016

IssuerChallenger Life Company Limited(ABN 44 072 486 938)(AFSL 234670)

2 Challenger CarePlus

About this Product Disclosure Statement (PDS) This PDS is dated 19 August 2016 and relates to two separate financial products:

• CarePlus Annuity; and

• CarePlus Insurance

The two separate financial products are collectively referred to as CarePlus (CarePlus).

This PDS provides information to help investors and their advisers assess the benefits of buying the products and to compare the products with other investment opportunities on offer. We strongly encourage you to read this document in full before making an investment decision. In preparing this PDS, we did not take into account your particular investment objectives, financial situation or needs. As every person’s needs and aspirations are different, you should consider whether investing in CarePlus is appropriate for you in light of your particular circumstances. You may also wish to get independent advice, particularly about taxation, retirement planning and investment risk tolerance.

The information in this PDS is current as at the date of the document. However, some information can change from time to time. If a change is considered materially adverse, we will issue a supplementary or replacement PDS. If a change is considered not materially adverse, we will update the information in the PDS as described below. We may also provide updates to you electronically with your agreement. For updated information about CarePlus, please consult your financial adviser, or call our Investor Services team on 13 35 66 or visit Challenger.com.au. We will send you an updated copy of any updated information free of charge on request.

Important noticesCarePlus is issued by Challenger Life Company Limited (ABN 44 072 486 938) (AFSL 234670) (Challenger, also referred to as we, us, or our), which is also the issuer of this PDS. Challenger’s ultimate parent is Challenger Limited (ABN 85 106 842 371). Neither Challenger Limited nor any other company within the Challenger group of companies guarantees the performance of Challenger Life Company Limited’s obligations to customers, or assumes any liability to customers in connection with CarePlus. Challenger is regulated under the Life Insurance Act 1995 (Cth) (Life Act), which governs the provision of annuities and life insurance in Australia. Challenger is authorised by the Australian Prudential Regulation Authority (APRA) to operate a life insurance business in Australia. All references to guarantees refer to payments we promise to pay under the Policy Documents. CarePlus will be issued only when an application in the form approved by Challenger is received, and the money used to buy CarePlus has cleared. The invitation to buy CarePlus under this PDS is only available to persons receiving this PDS in Australia and is subject to the terms and conditions described in this PDS and the CarePlus Annuity and CarePlus Insurance Policy Documents (Policy Documents) (see pages 19 to 21). You should read these documents before applying for CarePlus. We reserve the right to withdraw the invitation to buy CarePlus and withdraw this PDS. In the event of any inconsistency between the terms of the Policy Documents and the terms of this PDS, the terms of the Policy Documents prevail.

Challenger CarePlus 1

Challenger CarePlus

Table of contentsAbout Challenger CarePlus 3

CarePlus Annuity 4Benefits of the Annuity 4Risks of the Annuity 5How we invest 5 Voluntary withdrawal 6Your Annuity on death 6How the Annuity is taxed 6

CarePlus Insurance 7Benefits of the Insurance 7Risks of the Insurance 7Voluntary termination 8 Calculating the termination value 8 Cancelling your Insurance 8Your Insurance on death 8Estate planning options 8How the Insurance is taxed 9

Fees and other costs 10No Challenger fees 10Adviser service fees 10Stamp duty 11

Starting and managing CarePlus 12Starting your CarePlus 12How to buy CarePlus 12Managing your CarePlus 13

Other information 14Social security 14Cooling-off rights 14Changes to terms and conditions 14Incomplete or rejected application forms 14Customer identification program 15Non-resident account holder reporting/requirements 15Your duty of disclosure 15 Privacy and personal information 16 Complaints 17

Policy Documents 19CarePlus Annuity 19 CarePlus Insurance 21

Application forms 23



Challenger CarePlus

ChallengerCarePlus

Challenger CarePlus is designed for people who have been assessed as being eligible to receive Government-subsidised aged care services.

It provides regular payments that last for your lifetime while allowing you to leave your estate or your nominated beneficiaries a lump sum when you die.


Challenger CarePlus

1About Challenger CarePlusChallenger CarePlus is designed for people who have been assessed as being eligible to receive Government-subsidised aged care services. It provides regular payments that last for your lifetime while allowing you to leave your estate or your nominated beneficiaries a lump sum when you die.

CarePlus is comprised of two products:

• CarePlus Annuity (see page 4)

CarePlus Annuity (Annuity) provides regular payments for your lifetime in exchange for a capital investment (the money you use to buy the Annuity).

• CarePlus Insurance (see page 7)

CarePlus Insurance (Insurance) pays your estate or your nominated beneficiaries a lump sum (called the sum insured) when you die. There is a single premium for lifetime insurance cover. The Insurance can only be purchased if you are also purchasing a CarePlus Annuity.

You can only invest in both an Annuity and Insurance.

You should read this PDS and the Policy Documents before deciding to buy CarePlus. You should also get a quote. Contact your financial adviser for an obligation-free quote. Your quote will show you the Annuity purchase price and Insurance premium payable for the amount you are investing into CarePlus. The regular payments we offer and insurance premiums are reviewed and updated regularly to reflect market conditions.

About Challenger CarePlus


Challenger CarePlus

2CarePlus AnnuityCarePlus Annuity (Annuity) provides regular payments for your lifetime in exchange for a capital investment (the money you use to buy the Annuity).

The amount of your regular payments is established at the time you buy the Annuity, and will depend on the options you choose, your age, your sex and prevailing market rates. Challenger will make those regular payments for your lifetime.

The Annuity does not have a withdrawal value.

Features at a glance

What type of investment is this? An immediate lifetime annuity

Who can buy an Annuity? You can only buy the Annuity if you are over 18 and:

• have Aged Care Assessment Team (ACAT)1 approval that specifies you as being eligible to receive Government-subsidised aged care services (including home care); or

• live in an approved residential aged care facility.

Investment term Your lifetime

Minimum investment amount $10,000 (combined total with CarePlus Insurance premium)

Payment indexation Not available. Regular payments remain fixed for your lifetime.

Regular payment frequency You can choose to receive payments monthly, quarterly, half-yearly or yearly.

Additional investments You cannot add to your CarePlus once it starts; however, you can buy a new CarePlus.

Voluntary withdrawals The Annuity does not have a voluntary withdrawal value (see page 6).

On death Upon death, regular payments stop and no lump sum amount is payable (see page 6).

Benefits of the AnnuityThe benefits of the Annuity are set out below. The benefits must be considered along with the risks, which are shown on the next page.

Regular payments The Annuity provides regular payments that last for your lifetime. The dollar value of your regular payments will not change over time.

Longevity and market protection The Annuity can provide you with the comfort of knowing that you will receive regular payments for your lifetime, regardless of how long you live or how investment markets perform. You will not bear any market risk in relation to how your capital is invested. Challenger bears the market risk, as it guarantees to make regular payments for life.

Competitive ratesThe Annuity uses competitive rates to determine the dollar amount of your regular payments.

You pay no fees to ChallengerOur costs are taken into account when we determine the regular payments you will receive over the life of the Annuity, and various assumptions are made regarding your longevity, potential investment return, and our own income. This means that you do not pay Challenger any fees or charges. For more information about how Challenger derives income from providing the Annuity, see ‘How we invest’ on page 5.

You can agree to the payment of fees for financial advice and other services. For more information, see ‘Fees and other costs’ on page 10.

1 In Victoria, the equivalent body is the Aged Care Assessment Service (ACAS). References in this PDS to ACAT include references to ACAS or any other relevant successor organisation.


Challenger CarePlus

Challenger may also be required to withhold tax on behalf of the Australian Taxation Office (ATO). For more information, see ‘How the Annuity is taxed’ on page 6.

Risks of the AnnuityAll investments carry some risk. The appropriate level of risk for you will depend on factors such as your age, financial goals, investment timeframe, where other parts of your wealth are invested, and your risk tolerance. Listed below are the key risks that you should take into account when deciding whether to buy an Annuity.

Risk of early deathThe Annuity has no amount payable upon death. There is a risk of dying before receiving all or any part of your Annuity investment. To manage this risk, the Insurance pays a lump sum upon your death (see page 7).

Liquidity riskOnce your Annuity commences, there is no withdrawal value. You cannot withdraw from your Annuity at any time, even if your circumstances change.

Counterparty riskThis is the risk that we become unable to meet our commitments to you. However, we are subject to detailed legislative and regulatory requirements designed to ensure that this does not occur.

Challenger is regulated under the Life Act (which governs the provision of annuities in Australia) and the prudential standards made under it, which prescribe minimum capital and solvency requirements, for Challenger as well as for the annuity business it writes. The Australian Prudential Regulation Authority (APRA) actively supervises Challenger’s compliance with these requirements, which are designed to ensure that we are able to meet our obligations to investors. For example, Challenger is required to hold enough capital to withstand a 1 in 200-year shock event.

Even so, unforeseen and extreme circumstances that might impact our ability to make payments to you can never be completely ruled out.

For more information, see ‘How we invest’ below.

Inflation riskThis is the risk that the real value of your regular payments may reduce over time as a result of inflation.

How we investWhen you buy an Annuity, your capital investment goes into a fund along with capital received from other Annuity investors. Challenger also adds to this fund from its own money. This is known as a statutory fund and is regulated under the Life Act.

All regular payments are made from the statutory fund, even if the fund suffers poor investment returns. If the fund falls below the minimum level needed to make all current and future payments, Challenger can be required to top up the fund with its own money. APRA actively supervises this requirement and has extensive powers to intervene that are designed to ensure that payments can be met despite volatile or adverse movements in the broader financial markets.

If the statutory fund receives additional investment returns above the amount necessary to make all guaranteed payments, then Challenger can take some surplus income from it; however, we are only legally permitted to do so after we have made sure that there are sufficient funds to meet the current and future regular payments for all investors. You do not share in any surplus generated by the statutory fund.

Annuity investors can take comfort in knowing that their investment is in a statutory fund and:

• unlike many other investments where investors incur the risk and impact of any market falls, the Annuity makes regular payments for life, even if market returns are lower;

• Challenger invests its own money to provide a buffer for investors;

• the statutory fund is prudently invested, with the aim of ensuring that investment returns are sufficient to cover all payments due to investors;

• there are strict rules in place that are designed to ensure that investors receive the full benefit of their Annuity, even during periods of market volatility.

Challenger will invest the statutory fund, subject to investment restrictions in the Life Act. Generally, the fund will be invested in cash, shares, corporate bonds, convertible notes, debt instruments, geared and ungeared property investments, infrastructure investments and other assets. The investment objectives for the fund include to achieve consistent returns on investment and to match the cash flow in from investment returns with cash flow out to investors so that all present and future guaranteed payments can be made to all investors.

The name of Challenger’s statutory fund that your money will go to when you buy an Annuity is Challenger’s Statutory Fund No. 2. All references to guarantees refer to payments Challenger promises to pay under the Policy Documents.


Challenger CarePlus

Challenger is a signatory to the United Nations Principles of Responsible Investment (UNPRI) and aims to be a responsible investor by considering environmental, social and governance (ESG) factors when investing the assets of the statutory fund. In signing up to UNPRI, Challenger has committed to extending ESG integration activities across our investments, as we recognise that such factors are important factors impacting investment performance over the longer term.

Whilst Challenger takes into account ESG considerations when investing the assets of the statutory fund, we do not adhere to any particular set of standards and have no predetermined view as to what constitutes such considerations, or the extent to which they will be taken into account in our investment management practices.

Voluntary withdrawalOutside of the cooling-off period (see page 14), your Annuity does not have a withdrawal value.

Your Annuity on deathUpon death, your Annuity stops. No further payments will be made from the date of your death, and no lump sum amount is payable (although 100% of the amount invested into CarePlus is payable as a death benefit under CarePlus Insurance see page 8).

We will not make any part-payment in respect of the period that has elapsed between the last regular payment we guarantee to make and the date of death. We will seek to recover any payments made after the date of death that we had not guaranteed to make under the terms of the Annuity, and may deduct any overpayments from another policy held by you. It is therefore important that we are notified promptly of a death.

How the Annuity is taxedThe tax information contained in this PDS sets out our understanding of current tax legislation as at the date of this document. The legislation and its interpretation could change in the future. We recommend that you seek the advice of a tax adviser before investing.

The tax information contained in this PDS only applies to individual Australian tax resident investors who are either an Australian citizen or a permanent visa holder. If you are investing as a non-resident investor or a temporary visa holder, you should seek tax advice.

When you buy an AnnuityThere is no tax payable (at the time of purchase) when you buy the Annuity.

How regular payments are taxed

Part of your regular payments will be included in your assessable income and subject to pay-as-you-go (PAYG) tax. Like an employer, we are required to withhold an amount from certain payments we make to you and remit it to the ATO. Note that PAYG tax is not a final tax, and a greater or lesser amount of tax may apply on assessment of your annual income tax return. By completing a Tax File Number (TFN) Declaration, the PAYG tax deducted from your regular payments may be reduced. The TFN Declaration also allows you to apply for a tax-free threshold. You should consult your financial adviser or tax adviser to ascertain whether the tax-free threshold applies to you.

At the end of each financial year, we will send you a PAYG payment summary and tax information with details to assist you with preparing your income tax return. The assessable income is reduced by an amount called the ‘deductible amount’. The deductible amount will be the amount of each regular payment which is considered for tax purposes to represent the return of your capital. If regular payments are less than the deductible amount applicable to your Annuity, no tax is payable. The deductible amount for your Annuity will be outlined in your quote.

Senior Australians and Pensioners Tax OffsetYou might be eligible to claim the Senior Australians and Pensioners Tax Offset. The amount of the Senior Australians and Pensioners Tax Offset you will get will depend on your personal circumstances. If you are eligible and wish to claim the offset, please complete the TFN Declaration and the Withholding Declaration in the back of this PDS. You can only claim the Senior Australians and Pensioners Tax Offset if you have answered ‘Yes’ to Question 9 of the TFN Declaration.

Tax File NumberBefore you provide your TFN to us, we are required to tell you the following:

• The collection of TFNs is authorised by the taxation and privacy laws. Your TFN will be used for legal purposes only, including providing information to the ATO so that your tax can be properly assessed. These purposes may change in the future.

• It is not an offence not to quote your TFN, but if you choose not to quote it, tax may need to be deducted at the highest marginal rate (plus applicable Government levies). These consequences may change in the future.


Challenger CarePlus

3CarePlus InsuranceCarePlus Insurance (Insurance) pays your estate or your nominated beneficiaries a lump sum (called the sum insured) when you die. You pay a single premium for lifetime insurance cover.

The amount of your sum insured equals your total CarePlus investment amount.

Features at a glance

What type of insurance is this? A life risk insurance policy

Who can buy Insurance? Any person who is purchasing an Annuity (see page 4)

Insurance term Your lifetime

Minimum premium amount $10,000 (combined total with the Annuity investment)

Level of cover 100%2 of the total amount invested into CarePlus

Estate planning options You can select who receives the lump sum benefit payable upon death (see page 8).

Voluntary termination You can cancel the Insurance at any time and receive a termination value (see page 8).

On death Upon death, a lump sum amount is payable (see page 8).

Benefits of the InsuranceThe benefits of the Insurance are set out below. The benefits must be considered along with the risks, which are also set out below.

Lifetime protection The insurance can provide you with the comfort of knowing that, upon your death, your beneficiaries or estate will receive a lump sum.

Immediate coverThere are no medical examinations required. Once your application is accepted by us (see page 12), you are covered immediately. We will pay the sum insured upon death, even if you die after one day.

Effective estate planningYou choose who receives the lump sum payment upon your death.

Risks of the InsuranceThe appropriate level of risk for you will depend on factors such as your age, financial goals, investment timeframe, where other parts of your wealth are invested, and your risk tolerance. Listed below are the key risks that you should take into account when deciding whether to purchase Insurance.

Risk of underinsurance This is the risk that the sum insured you have chosen might be inadequate for your circumstances.

Inflation riskThis is the risk that the real value of your sum insured may reduce over time as a result of inflation.

Counterparty riskThis is the risk that we become unable to meet our commitments to you. However, we are subject to detailed legislative and regulatory requirements designed to ensure that this does not occur.

Challenger is regulated under the Life Act (which governs the provision of life insurance in Australia) and the prudential standards made under it, which prescribe minimum capital and solvency requirements, for Challenger as well as for the life insurance business it writes. The Australian Prudential Regulation Authority (APRA) actively supervises Challenger’s compliance with these requirements, which are designed to ensure that we are able to meet our obligations to investors. For example, Challenger is required to hold enough capital to withstand a 1 in 200-year shock event.

Even so, unforeseen and extreme circumstances that might impact our ability to make payments to you can never be completely ruled out. For more information on how we invest, see page 5.

2 If you reside in South Australia, stamp duty (currently 1.5% of the Insurance premium) will be deducted from the sum insured before it is distributed to beneficiaries (see page 11).


Challenger CarePlus

Voluntary terminationYou can cancel your Insurance at any time. The termination value we pay you is subject to a minimum prescribed under the Life Act and prudential standards enforced by APRA. We will always provide a termination value equal to the minimum level.

Note that if you reside in South Australia, stamp duty (currently 1.5% of the Insurance premium) will be deducted from the termination value before it is paid to you (see page 11).

Calculating the termination valueTo calculate the termination value, we will work out the discounted value of the sum insured based on the future probabilities of death at the time of calculation. This can involve a significant discount in some circumstances, and often results in the termination value being less than the premium you paid for the Insurance.

The calculation method of the present value is impacted by changes in the 10-year Australian Government Bond rate, which means it is only possible to determine the termination value at the time of termination. We set out an example below, which is only for illustrative purposes.

Withdrawal example:

An 85 year old female paid an insurance premium of $87,000 for a sum insured of $100,000.

Estimated termination value

10-yr Government bond rate

Upon turning age 90

Upon turning age 95

2% $ 80,589 $84,734

3% $78,312 $83,096

4% $76,148 $81,520

5% $74,091 $80,003

Cancelling your InsuranceIf you want to cancel your Insurance, contact your financial adviser for your termination value. If requested, we will send you a letter with your termination value as at the date of that request, along with a withdrawal form for you to complete and return to us. When you return that form, you will also need to send us your original Policy Document and Investor Certificate.

The termination value on the day we make the payment may vary from the termination value stated in the letter we send you. To minimise any variation, we will generally pay the termination value within five business days of receiving all required documentation.

We will only make a payment to your nominated bank account. We will not make payments to any third party.

Your Insurance on deathUpon death, the sum insured3 is payable to your nominated beneficiary (or beneficiaries). Where a valid nomination has not been made, we will pay the sum insured to your estate. Challenger has the right to deduct any amount owing to Challenger from the sum insured before it is paid, including any overpaid Annuity payments.

To make a claim, please contact your financial adviser or call the number listed on the inside back cover.

Estate planning optionsYou can select who receives the sum insured payable upon death. You can nominate multiple beneficiaries (in specified or equal proportions).

The nomination of a beneficiary or beneficiaries can be changed at any time.

If you do not nominate a beneficiary, or they die before you, or your nomination is invalid, the sum insured will be paid to your estate. If you nominate multiple beneficiaries and one dies before you, their proportion of the sum insured will go to the remaining beneficiaries.

Important information when a beneficiary nomination is made under power of attorneyAn attorney nominating themselves as a beneficiary must have the legal authority under the power of attorney to give themselves the benefit. The applicable power of attorney legislation is different in each State and Territory and particular legal restrictions apply to the granting of benefits to attorneys in some States and Territories, such as New South Wales, the Australian Capital Territory and Tasmania.

The validity of the nomination under the applicable State or Territory laws will be assessed at the time of claim. If the nomination is invalid we will pay the benefit (or that part of the benefit which is invalid) to the life insured’s estate.

3 If you reside in South Australia, stamp duty (currently 1.5% of the Insurance premium) will be deducted from the sum insured before it is distributed to beneficiaries (see page 11).


Challenger CarePlus

How the Insurance is taxedThe tax information contained in this PDS sets out our understanding of current tax legislation as at the date of this document. The legislation and its interpretation could change in the future. We recommend that you seek the advice of a tax adviser before investing.

The tax information contained in this PDS only applies to individual Australian tax resident investors who are either an Australian citizen or a permanent visa holder. If you are investing as a non-resident investor or a temporary visa holder, you should seek tax advice.

Generally, the premium paid to purchase the Insurance is not tax deductible. We do not deduct tax from claim payments, unless required to by law.

If you cancel your Insurance, any amount you receive will not be assessed as income for taxation purposes.


Challenger CarePlus

4Fees and other costsThere are no fees or charges payable to us, although you can agree to the payment of fees for financial advice and other services; see below.

We may provide benefits to financial services intermediaries where the law permits us to do so. If we do, we will do so using our own money. We maintain a register of these benefits in accordance with relevant regulatory requirements. If you would like to review this register, please contact us.

No Challenger feesChallenger takes the costs of providing CarePlus (including payments to a third party administrator), into account when

setting the amount of the Annuity regular payments and Insurance premium, and we also make various assumptions about your longevity, potential investment return and our own income.

Adviser service feesYou can authorise us to pay fees for services provided to you by your financial adviser and, in the case of the upfront adviser service fee, for facilitating the issue of CarePlus on behalf of Challenger. Where you authorise that, we will pay those fees to the Australian Financial Services Licensee responsible for supervising your financial adviser (or your financial adviser directly if they are the licensee). You do not have to authorise or consent to the payment of these fees if you choose not to. You can instruct us to pay fees (if any) as outlined in the table below.

4 Calculated in accordance with Australian Government Actuary life expectancy tables and may therefore be different from what we estimate your life expectancy to be.

Upfront adviser service fee

You can agree to the payment of an upfront adviser service fee of up to 0.55% (including GST) of your total CarePlus investment multiplied by your life expectancy4, up to a maximum of 2.2% (including GST). The upfront adviser service fee can only be paid by us with your authorisation.

For example, if you invest $10,000 at a time when your life expectancy is 10 years, you can agree to the payment of an upfront adviser service fee of up to $220, calculated as follows:

0.55% x 10 = 5.5%

This is subject to a cap of 2.2%, so:

2.2% x $10,000 = $220

The dollar value of any upfront adviser service fee that is paid will be shown on your CarePlus quote and reduces the amount of your Annuity regular payments. If you have not received a quote, contact your adviser and request one. The amount of any upfront adviser service fee that we pay will also be shown on the Investor Certificate you receive when you buy CarePlus.

If you cancel your Insurance, or your Annuity ceases due to death, we may require that all or part of the upfront adviser service fee be repaid to us (by your financial adviser). This is because the upfront adviser service fee is calculated on the basis that CarePlus is held for a period at least equal to your life expectancy.

Ongoing adviser service fee

You can agree to the payment of an ongoing adviser service fee up to the amount of your Annuity payment and authorise us to pay it on your behalf. If you agree, the ongoing adviser service fee can be deducted from your regular Annuity payments before they are made to you.

For example, if you agree to pay an annual ongoing adviser service fee of $300 (including GST), and you receive after-tax monthly regular payments of $1,000, we will deduct $25 ($300/12 monthly payments). We will pay an adviser service fee of $25 each month and pay you $975. If you agree to pay an annual ongoing adviser service fee of $300, and you receive yearly after-tax payments of $12,000, we will deduct $300. We will pay an adviser service fee of $300 and pay you $11,700.

The ongoing adviser service fee can be cancelled or varied by you at any time by telling your financial adviser and, if you inform us, we will stop paying those fees (see ‘Keeping us informed’ on page 13).

The annual amount of any ongoing adviser service fee that we pay will be shown on the Investor Certificate you receive when you buy CarePlus. We will also confirm the amount paid each year when we send you your annual statement.


Challenger CarePlus

Stamp dutyStamp duty may be payable depending on your State/Territory of residence as summarised in the table below:

State of residence ACT, NSW, NT, QLD, TAS, VIC, WA

SA

Stamp duty payable by you

Nil. Challenger will pay any applicable stamp duty but will not recover it from you.

Stamp duty equal to 1.5%5 of the Insurance premium paid will be deducted from either the sum insured before it is paid to beneficiaries (in the case of death) or from the termination value before it is paid to you (in the case of voluntary termination).

5 The rate of stamp duty relates to life insurance duty and is current as at the date of this PDS. However, stamp duty laws and rates change from time to time. If there is a change to the rate of applicable stamp duty, this will be reflected on your CarePlus quote and deducted accordingly.


Challenger CarePlus

5Starting and managing CarePlusYou can buy CarePlus by talking to your financial adviser. When you buy CarePlus, you will receive Investor Certificates setting out:

• the regular payments Challenger will make to your nominated bank account; and

• the amount of the life insurance cover.

CarePlus will start immediately, and the first Annuity payment will be made at the end of the payment frequency you have chosen. For example, if you choose to be paid monthly, the first payment will be made one month after CarePlus is issued. If you choose to be paid annually, the first payment will be made on the first anniversary of the start of CarePlus.

It is important to keep us informed of any changes.

You cannot transfer your CarePlus or use it as security for borrowing.

Starting your CarePlusCarePlus can only be purchased by an individual who is over 18 and:

• has ACAT approval that specifies them as being eligible to receive Government-subsidised aged care services (including home care); or

• lives in an approved residential aged care facility.

Power of attorneyAn attorney acting under a power of attorney can apply for CarePlus on your behalf, as can a person who has been validly appointed to manage your financial affairs. If someone is acting for you in this capacity, it is important to note that you must provide the following additional documentation with your application:

• a certified copy of the grant of power of attorney or the appointment as financial manager (each page of that document must be certified);

• a reliable sample of the signature of the attorney or financial manager (such as a certified copy of a driver’s licence or passport that includes a recognisable sample of the signature).

For information on who can certify documents, please see the application form.

How to buy CarePlusYou should read this PDS and the Policy Documents before deciding to buy CarePlus. You will also need to get a quote. Contact your financial adviser for an obligation-free quote. The regular payments we offer and insurance premiums are reviewed and updated regularly to reflect market conditions. Your quote will be valid for 14 days from the date on which we provide it. Your quote will show you the Annuity purchase price and Insurance premium payable for the amount you are investing into CarePlus.

Your CarePlus will be issued once we accept your valid application, and the money you used to buy CarePlus clears.

A valid application must include:

1. a completed and signed application form;

2. your quote (if your quote has expired, then your regular payments and insurance premium will be calculated on the day we process your application);

3. the identity verification documents (outlined in the application form); and

4. your CarePlus investment (see ‘Ways to pay’ below).

We are not bound to accept any application for an Annuity or Insurance, and the issue of these products is subject to us accepting your application and receiving full payment of the capital investment amount.

If your valid application and money are received in our Sydney office before 3.00pm Sydney time on a NSW business day (the cut-off time), your application will generally be processed on that day. If your valid application and money are received after the cut-off time, or on a non-business day, your application will generally be processed on the next NSW business day.

Ways to payYou can pay for your CarePlus by providing your capital investment amount by direct debit or by cheque.

Direct debit: You can arrange for the money to be debited from your bank account by completing the direct debit facility section of the application form. All direct debits are subject to the Direct Debit Request Agreement attached to the application form.

Cheque: You can pay by cheque by making the cheque payable to ‘Challenger Life Company Limited <insert the name of the investor>’ and attaching it to the application form.


Challenger CarePlus

Managing your CarePlusInformation you will receive about your CarePlusWhen you buy your CarePlus, you will be sent Investor Certificates which, together with the Policy Documents contained in this PDS, set out the relevant terms and conditions. We will also send you a Centrelink schedule for social security purposes. You should read these documents carefully and contact your financial adviser if you have any questions.

Please keep your Policy Documents and Investor Certificates in a secure place, as they are important documents. A charge may apply if you misplace these documents, as we may advertise for missing policies, and the Life Act allows us to recover some of these expenses from the investor.

Whilst we take all care in producing your Investor Certificates and other investment documentation, we reserve the right to correct the documentation if we make an administrative error.

Each year, you will receive an annual statement with details of your CarePlus, including payments made over the period and other relevant information. We will send you a PAYG payment summary and tax information to assist you in completing your annual tax return.

We may also request evidence to confirm your continued eligibility to receive regular payments from your Annuity.

Making changes to your CarePlusYou can cancel or change an Insurance beneficiary nomination, but you cannot make any other changes to your CarePlus once it has started. You cannot make additional deposits to your CarePlus, but you can buy a new CarePlus on separate terms. You can make changes to the personal information that Challenger holds about you.

Keeping us informedIt is important that we have correct contact details for you so that we can communicate with you and provide you with important information.

You should speak to your financial adviser or call the number listed on the inside back cover to update contact details or to make enquiries.

All other instructions should be made in writing and sent to the address listed on the inside back cover.

When writing to us, please:

• quote your client or policy number;

• state the full name in which your investment is held;

• clearly set out your request;

• provide us with a contact name and daytime telephone number; and

• ensure that the request is signed and dated.

Some changes also require additional supporting documentation (such as a change of name request, where we require a certified copy of the marriage certificate or deed poll). We will only change your nominated bank account if we receive an original, signed and dated, written request.


Challenger CarePlus

6Other information

Social securityCentrelink and Department of Veterans’ Affairs entitlements are determined by two means tests – an assets test and an income test.

CarePlus is assessed as two different products.

CarePlus Annuity

Assets test Income test

The capital investment less 50% of the deduction amount6, calculated every six months in arrears (or 100% of the deduction amount every 12 months in arrears where yearly payments are made).

Regular payments received, less the deduction amount6.

CarePlus Insurance

Assets test Income test

The termination value is the assessable asset value.

As no income is payable, the amount assessed is zero.

The social security treatment of your CarePlus under the assets test and the income test will be outlined in your quote.

If you cancel your Insurance, any amount you receive that is more than the premium you paid for the Insurance will be assessed as income for 12 months.

This is general information only, and we recommend you get advice regarding your individual circumstances. Your local Centrelink or Department of Veterans’ Affairs office can help answer any question you may have. Your financial adviser can also help.

Cooling-off rightsBy law, investors have a cooling-off right. This means you can change your mind about buying the CarePlus products and ask for your capital to be repaid. The cooling-off right must be exercised within 14 days from the earlier of:

• when you receive confirmation your CarePlus has started; or

• the end of the fifth business day after the day you bought your CarePlus.

If you wish to exercise your cooling-off right, we must receive your written instructions within 14 days. You must return your original Policy Documents and Investor Certificates.

Please send the original Policy Documents and Investor Certificates to the address listed on the inside back cover.

If you have any questions about cooling-off rights, please contact your financial adviser. You cannot exercise cooling-off rights after the death of the investor.

Changes to terms and conditionsWe may change the terms and conditions of your Annuity and/or Insurance if changes to tax or other law impact your investment, or if necessary to comply with any law, ruling or determination of any relevant government authority.

We will notify you of any change before, or as soon as practicable after, the change, but no later than 12 months after the change has occurred (or three months if the change is materially adverse).

Incomplete or rejected application formsTo ensure that your application is processed efficiently, it is important that you:

• complete all sections of the application form;

• provide all required identity verification documents outlined in the application form; and

• attach a valid quote to the application form.

We have provided a checklist with the application form to help you meet these requirements.

If your application form is not complete, we may not be able to proceed until the required information is received. In these situations, we may:

• attempt to contact you and/or your financial adviser (if applicable); and/or

• hold your application money in a non-interest bearing account until we receive the required information.

Money may be held for a maximum period of 30 days (in a non-interest bearing account) from the day we receive the funds. After this period, your money will be returned to you via cheque. Your CarePlus will start on the day that all outstanding information is received by us (or the next NSW business day if received after 3.00pm or on a non-business day in NSW), and you will receive the Challenger rates and premiums applicable at that time.

6 The deduction amount applicable to your Annuity will be shown on your quote.


Challenger CarePlus

Customer identification programIn accordance with Anti-Money Laundering and Counter-Terrorism Financing legislation, we need verification of your identity before the CarePlus can start.

If you are investing via a financial adviser, they will be required to get identity verification documents from you prior to lodging your application.

To do this, your financial adviser will need to see original or certified copies of your identity verification documents and take a copy of them. Your financial adviser will then send us copies of your identity verification documents (or if investing via platform, the record of verification documents sighted) together with your application form. If the application form is signed under power of attorney, we will also need a certified copy of the power of attorney and a specimen signature of the attorney.

If you have not provided identity verification documents to a financial adviser, you will be required to provide certified copies of your identity verification documents directly to us.

The application form explains who can certify documents.

We may be required to ask you for additional identity verification documentation and/or information about you or anyone acting on your behalf, either when we are processing your application or at some stage after we issue CarePlus. We may pass any information we collect and hold about you or your CarePlus to the relevant government authority in accordance with Anti-Money Laundering and Counter-Terrorism Financing legislation.

Non-resident account holder reporting requirementsAs a result of an increased international focus on account holder data exchange, a number of countries have legislated that financial institutions (which includes us) identify and report certain information about the financial accounts of investors. The regimes include the United States Foreign Account Tax Compliance Act (FATCA) and the OECD’s Common Reporting Standard (CRS). The United States FATCA regime is already operational, with the CRS due to commence in Australia from 1 July 2017. To comply with our obligations under various reporting legislation, we will provide to the ATO such data as required in respect of your investment with us.

Your duty of disclosureBefore you enter into an insurance contract, you have a duty to tell us anything that you know, or could reasonably be expected to know, may affect our decision to insure you and on what terms. You have this duty until we agree to insure you. You have the same duty before you extend, vary or reinstate the contract.

You do not need to tell us anything that:

• reduces the risk we insure you for; or

• is common knowledge; or

• we know or should know as an insurer; or

• we waive your duty to tell us about.

If you do not tell us somethingIn exercising the following rights, we may consider whether different types of cover can constitute separate contracts of life insurance. If they do, we may apply the following rights separately to each type of cover.

If you do not tell us anything you are required to, and we would not have insured you if you had told us, we may avoid the contract within three years of entering into it.

For CarePlus Insurance, if we choose not to avoid the contract, we may, at any time, reduce the amount you have been insured for. This would be worked out using a formula that takes into account the premium that would have been payable if you had told us everything you should have. We may only exercise this right within three years of entering into the contract.

For CarePlus Annuity, if we choose not to avoid the contract or reduce the amount you have been insured for, we may, at any time, vary the contract in a way that places us in the same position we would have been in if you had told us everything you should have.

If your failure to tell us is fraudulent, we may refuse to pay a claim and treat the contract as if it never existed.


Challenger CarePlus

Privacy and personal informationWe collect and use personal information to:

• process your application;

• provide and administer your CarePlus and send you information;

• improve and personalise our products and services;

• inform you about other products and services that may be useful to you;

• conduct product and market research; and

• comply with our obligations under the law, including in respect of anti-money laundering, financial services and taxation, life insurance and, for an annuity purchased with superannuation money, superannuation laws.

We collect personal information from you and, if relevant, from your financial adviser. We may take steps to verify the information collected. Where you provide us with personal information about someone else (for example, your nominated beneficiaries, power of attorney or other persons connected with your investment, including beneficial owners), you must have their consent to provide their personal information to us, and have shown them this ‘Privacy and personal information’ section of the PDS.

If you choose not to provide some of your personal information to us, the following may apply (depending on the type of information):

• TFN or ABN: We may have to deduct tax at the highest marginal rate (plus applicable Government levies) from regular payments made to you.

• Account details: We may not be able to pay withdrawal proceeds or regular payments to you.

• Incomplete application: We may not be able to process your application.

• Insufficient identity verification documents: We may not be able to process your application or future withdrawal request.

Disclosing your information

We disclose your information to your financial adviser. In addition, we may disclose information we hold about you:

• if you consent to the disclosure;

• if the disclosure is required or authorised by law;

• to organisations acting on our behalf (for example, sending your statements);

• to professional service firms that provide services to us such as legal and audit services, or data or information services;

• to reinsurers;

• to related companies;

• to organisations with which we have an association and of which you are a member (such as National Seniors Australia);

• to electronic identity verification service providers, in order for us to meet our customer due diligence obligations under anti-money laundering laws (which may include information about you or related persons connected with your investment, such as beneficial owners); or

• otherwise in accordance with our privacy policy.

We do not disclose personal information to recipients in foreign jurisdictions.

From time to time, we or our related companies may contact you to tell you about other products and services that might be useful to you, including financial, superannuation, investment, insurance and funds management products and services. Please tell us if you do not want to receive any of this kind of marketing material; see ’Keeping us informed’ on page 13.

Updating, correcting or accessing your information

For how you can correct or update the personal information we hold about you, your power of attorney or nominated beneficiaries, or if you would like to request access to it, see ‘Keeping us informed’ on page 13. If you believe your personal information has been misused and would like to make a complaint, please see the ‘Complaints’ section on the following page for instructions on how to do so. Our privacy policy also contains this information as well as further details about our handling of personal information.

You can obtain a copy of our privacy policy at www.challenger.com.au or by contacting our Investor Services team on 13 35 66.


Challenger CarePlus

Complaints

As part of our commitment to providing quality service to our clients, we endeavour to resolve all complaints quickly and fairly. Our policy is to acknowledge any complaint within five business days of receiving it and investigate, properly consider and decide what action (if any) to take and communicate our decision within 45 days (or 30 days in relation to privacy complaints). If you have a particular complaint regarding your CarePlus, please do not hesitate to contact us by calling our Investor Services team on 13 35 66 or by writing to:

Complaints Resolution OfficerChallenger Life Company LimitedGPO Box 3698Sydney NSW 2001

If you are not satisfied with our response or how the complaint has been handled (of if we have not responded within 45 days or 30 days in relation to privacy complaints), you may contact the following external dispute resolution scheme:

Financial Ombudsman ServiceGPO Box 3Melbourne VIC 3001Tel: 1800 367 287 www.fos.org.au


Challenger CarePlus

This page has been left blank intentionally.

Your policy consists of two parts: this Policy Document and the Investor Certificate you receive when you invest. You should read these documents carefully and keep them in a safe place.

In this Policy Document, references to ‘you’ and ‘your’ are references to the policy owner.

Your policy is a legal contract between you and Challenger Life Company Limited (ABN 44 072 486 938) (Challenger Life) (also referred to as ‘we’, ‘our’, and ‘us’). This Policy Document is deemed to be issued to you only after your valid application form is accepted by Challenger Life and the money used to purchase the policy clears. Whilst we take all care in producing your Investor Certificate and other investment documentation, we reserve the right to correct the documentation if we make an administrative error.

Your policy is administered as part of the Challenger Life Statutory Fund No. 2 and does not share in any surplus generated by the fund.

For the purpose of this Policy Document, the policy owner is the life insured.

1. Commencement dateThe commencement date of your policy will be the date that your application is accepted by Challenger Life. The first regular payment will be made at the end of the payment frequency period you have chosen, calculated from the commencement date.

2. TermThe policy provides regular payments for the duration of your life, no matter how long you live. Regular payments will stop when you die.

3. Regular paymentsThe purchase price you paid purchases the regular payments described in your Investor Certificate. The payments will be made monthly, quarterly, half-yearly or yearly (as chosen at the

start of the policy) for the duration of the life insured’s life. Regular payments will stop when the life insured dies. The payment frequency you have chosen is shown in the Investor Certificate.

The payments will be paid by electronic transfer to your bank, building society or credit union account. Your regular payments are fixed for the duration of the policy. The policy does not have a residual capital value.

4. Withdrawal valueThe policy does not have a withdrawal value.

5. PAYG taxationIf required, Challenger Life deducts pay-as-you-go (PAYG) withholding tax from each regular payment as prescribed by relevant tax legislation.

6. Other government taxes, charges or impostsChallenger Life has the right to recover from you, by deduction from your regular payments, any stamp duty, tax, or other government charges or imposts or a proportionate part thereof that may be imposed in respect of this policy or this class of business.

7. Changes in legislationChallenger Life reserves the right to:

• adjust regular payments and tax instalments as a result of any change in the tax or other relevant legislation;

• vary, without prior notice to the policy owner, any of the terms and conditions of the policy in order to comply with any requirements of, or as a result of, any amendments to any relevant laws or the rulings or determinations of the Commissioner of Taxation, the Australian Prudential Regulation Authority or any other statutory authority which has jurisdiction in respect of this Policy Document as a matter of law.

Policy DocumentCarePlus Annuity



Challenger CarePlus

Challenger Life will advise you of any changes to the conditions relating to your policy as disclosed at the time of its issue in writing either in your annual statement or by other means.

8. NoticesAll notices and statements sent to you will be sent to the last address you give us. Any letter or notice sent to Challenger Life must be left at, or sent by prepaid post to us at the address set out in the current Product Disclosure Statement for the policy. Your Policy Number must be quoted in all correspondence.

9. Continuity CertificateChallenger Life reserves the right to request evidence to satisfy itself of your continued eligibility to receive regular payments. Every six (6) months, we may request that the life insured complete a Continuity Certificate, which must be returned to us within a reasonable period of the request being made (as determined by Challenger Life).

Challenger Life reserves the right to discontinue any regular payments where such evidence is not provided within a reasonable period. We will recover from the recipient any regular payment made by Challenger Life after the date it determines that the regular payments should have ceased.

Challenger Life will also recover payments made (and may do so by adjusting future payments under the policy) in reliance on any incorrect information that is provided to Challenger Life where payments are made in excess of those that would otherwise have been made.

10. Policy cessationUpon your death, the policy ceases. There is no pro rata of regular payments between the last regular payment date and the date of death.

Where regular payments are made after your death outside the terms of this policy, Challenger Life may recover the overpayments from the estate.

11. Lost policyChallenger Life reserves the right to recover the costs of replacing a lost Policy Document and/or Investor Certificate, in the event that the Policy Document and/or Investor Certificate is lost, unless prohibited by law.

12. General informationYour policy cannot be used as security for borrowing. You cannot transfer your policy.

13. Compliance Any legislative provision or regulatory requirement which is either required to be included in this Policy Document, or must be complied with by Challenger Life, in order for the policy to qualify:

• as an annuity for the purposes of any law; or

• for concessional tax treatment in relation to payments by Challenger Life;

is deemed to be included in this Policy Document for so long as such requirement must be complied with.

14. Adviser feesWhere you agree with your financial adviser to the payment of adviser service fees, those fees will be paid by us in accordance with your consent and authorisation as notified to us. We will pay those fees to the Australian Financial Services Licensee responsible for supervising your financial adviser (or your financial adviser directly if they are the Licensee).

15. Communications with usWhere we receive communications in relation to your policy, whether by fax, email or otherwise in writing, or by telephone, we will not be liable to you for any loss you may suffer as a result of a fraudulent communication received by us without your knowledge, unless that loss is a result of our negligence. We will only act on completed communications that we receive. We will not be liable to you for any loss or delay resulting from the non-receipt, or incomplete receipt, of any communication you send us.

Your policy consists of two parts: this Policy Document and the Investor Certificate you receive when you purchase the Insurance. You should read these documents carefully and keep them in a safe place.

In this Policy Document, references to ‘you’ and ‘your’ are references to the policy owner.

Your policy is a legal contract between you and Challenger Life Company Limited (ABN 44 072 486 938) (Challenger Life) (also referred to as ‘we’, ‘our’, and ‘us’). This Policy Document is deemed to be issued to you only after your valid application form is accepted by Challenger Life and the money used to purchase the policy clears. Whilst we take all care in producing your Investor Certificate and other documentation, we reserve the right to correct the documentation if we make an administrative error.

Your policy is administered as part of the Challenger Life Statutory Fund No. 2 and does not share in any surplus generated by the fund.

For the purpose of this Policy Document, the policy owner is the life insured.

1. Commencement dateThe commencement date of your policy will be the date that your application is accepted by Challenger Life.

2. TermThe policy provides cover for the duration of your life (unless you choose to cancel the policy), no matter how long you live. Cover ceases when you die.

3. Death benefitUpon your death, we will pay the sum insured as a lump sum to your nominated beneficiaries (if applicable); otherwise, to the legal personal representative of your estate.

4. Sum insuredThe sum insured is shown on your Investor Certificate. The most we will pay under this policy is the sum insured.

5. Policy cancellation (withdrawal)You can cancel the policy at any time. The termination value we pay you is subject to a minimum prescribed under the Life Insurance Act 1995 (Cth) and prudential standards enforced by the Australian Prudential Regulation Authority. We will always provide a termination value equal to the minimum level.

To calculate the termination value, we will work out the discounted value of the sum insured based on the future probabilities of death at the time of calculation. The sum insured is discounted at a rate no more than that prescribed by law, which is currently the yield on a 10-year Commonwealth Government Security, plus 3%.

The termination value calculation may be amended to reflect legislative change.

6. Other government taxes, charges or impostsChallenger Life has the right to recover from you, by deduction from:

• the sum insured before it is payable to your nominated beneficiaries or estate; or

• the termination value before it is paid to you, where you request to cancel the policy;

any stamp duty, tax, or other government charges or imposts or a proportionate part thereof that may be imposed in respect of this policy or this class of business.

7. Recovery of monies owing to ChallengerChallenger Life has the right to recover from you, by deduction from the sum insured before it is payable to your nominated beneficiaries or estate, any monies owing to Challenger Life (owing from this policy or any other policy).

Policy DocumentCarePlus Insurance



8. Changes in legislationChallenger Life reserves the right to:

• adjust the sum insured as a result of any change in the tax or other relevant legislation;

• vary, without prior notice to the policy owner, any of the terms and conditions of the policy in order to comply with any requirements of, or as a result of, any amendments to any relevant laws or the rulings or determinations of the Commissioner of Taxation, the Australian Prudential Regulation Authority or any other statutory authority which has jurisdiction in respect of this Policy Document as a matter of law.

Challenger Life will advise you of any changes to the conditions relating to your policy as disclosed at the time of its issue in writing either in your annual statement or by other means.

9. NoticesAll notices and statements sent to you will be sent to the last address you give us. Any letter or notice sent to Challenger Life must be left at, or sent by prepaid post to us at the address set out in the current Product Disclosure Statement for the policy. Your Policy Number must be quoted in all correspondence.

10. ClaimsChallenger Life requires satisfactory proof of death, and the original Policy Document and Investor Certificate must be delivered to Challenger Life (in accordance with section 9 of this Policy Document), before a claim will be processed.

We must receive notice of any claim for payment as soon as reasonably possible.

11. Nominated beneficiaries You can nominate anyone to be your beneficiary or beneficiaries. Your beneficiary nomination can be changed at any time.

If you nominate a single beneficiary, upon satisfactory proof of your death we will pay that beneficiary a lump sum. If the single beneficiary predeceases you, we will make the lump sum payment to your estate.

If you nominate multiple beneficiaries, upon satisfactory proof of your death we will pay those beneficiaries a lump sum in the proportions you have specified, or otherwise in equal proportions. If a beneficiary predeceases you, their proportion will be distributed pro rata to the remaining beneficiaries. If all beneficiaries predecease you, we will make the lump sum payment to your estate.

Where a beneficiary nomination is made under power of attorney, an attorney nominating themselves must have the specific authority under the power of attorney to give themselves that benefit. The nomination will be assessed at the time of claim and, if the power of attorney did not contain such a power when the nomination was made, the nomination in favour of the attorney will be considered invalid and will automatically be payable to the life insured’s estate.

If you have not made a valid nomination, we will pay the lump sum to your estate.

12. Policy cessationCover ceases upon your death or if you cancel the policy.

13. Lost policyChallenger Life reserves the right to recover the costs of replacing a lost Policy Document and/or Investor Certificate, in the event that the Policy Document and/or Investor Certificate is lost, unless prohibited by law.

14. General informationYour policy cannot be used as security for borrowing. You cannot transfer your policy.

15. ComplianceAny legislative provision or regulatory requirement which is either required to be included in this Policy Document, or must be complied with by Challenger Life, in order for the policy to qualify as life insurance for the purposes of any law is deemed to be included in this Policy Document for so long as such requirement must be complied with.

16. Adviser feesWhere you agree with your financial adviser to the payment of adviser service fees, those fees will be paid by us in accordance with your consent and authorisation as notified to us. We will pay those fees to the Australian Financial Services Licensee responsible for supervising your financial adviser (or your financial adviser directly if they are the Licensee).

17. Communications with usWhere we receive communications in relation to your policy, whether by fax, email or otherwise in writing, or by telephone, we will not be liable to you for any loss you may suffer as a result of a fraudulent communication received by us without your knowledge, unless that loss is a result of our negligence. We will only act on completed communications that we receive. We will not be liable to you for any loss or delay resulting from the non-receipt, or incomplete receipt, of any communication you send us.

Challenger CarePlus

23

Challenger CarePlusApplication Form(Issue date: 19 August 2016)

When you complete the form: • use a black pen • print within the boxes in clear BLOCK LETTERS

1. Investor details

Do you already have an investment with Challenger? Yes No Policy No. (if known)

Surname

Given name(s)

Title (Mr/Mrs/Miss/Ms) Date of birth / / Male Female What other names are you known by? TFN exemption: If you have a TFN exemption, please provide exemption details

Telephone (home) Telephone (work)

Mobile

Email address

Residential care facility address

Street address

Suburb/town State Postcode

Country

Residential address prior to moving into residential care facility

Street address


Country

If your country of residence is not Australia or New Zealand, please ensure that you also complete section 7.

Postal address (this can be primary power of attorney’s address)

C/-

Street address


Country

The Challenger CarePlus PDS dated 19 August 2016 gives information about investing in the CarePlus Annuity (Annuity) and CarePlus Insurance (Insurance) (together referred to as CarePlus). Challenger Life Company Limited (ABN 44 072 486 938) (AFSL 234670) is the Issuer of the Annuity and Insurance. Any person who gives another person access to this application form must also give the person access to the Challenger CarePlus PDS and any supplementary PDS. You should read the PDS before completing this application form.

Challenger Life Company Limited or a financial adviser who has provided an electronic copy of the PDS will send you a paper copy of the PDS and any supplementary document and application form free of charge if you so request.

Office use only

24

2. Investment details

Amount to be invested $ , , . (This amount is the total of the Annuity purchase price and Insurance premium. Minimum investment amount is $10,000.)

Please select your payment method

Direct debit (please complete the direct debit form on page 29)

Cheque (please make cheque payable to ‘Challenger Life Company Limited <insert the name of the investor>’

Please select (4) the origin and source of funds being invested.

Income from regular employment (regular and/or bonus) Investment income (e.g. rent, dividends, pension)

Income from operating a business One-off payment (e.g. matured investment, court settlement, redundancy, inheritance)

Sales of assets (e.g. shares, property) Windfall (e.g. gift, lottery winnings) Borrowed funds

Government benefits (e.g. family tax benefit)

3. CarePlus options-please ensure that your quote is attached to the application form

Please set up my CarePlus as per quote ID: - - -

Note: The quote ID can be found at the top of the quotation.

4. Financial institution account details-we will pay your regular Annuity payments to this account

The account must be in the name of the investor (single or joint). Third party payments are not permitted. Cheque payments are not available.

Bank

Branch

Account name

BSB number –

Account number

5. Nominated beneficiary(ies)

You can nominate who will receive any sum insured upon your death.

Important information when a beneficiary nomination is made under power of attorney

An attorney nominating themselves must have the legal authority under the power of attorney to give themselves that benefit. The validity of the nomination under the applicable State or Territory laws will be assessed at the time of claim, and if the nomination is invalid we will pay the benefit (or that part of the benefit which is invalid) to the life insured’s estate (see Estate planning options in the PDS).

Pay my death benefit to my legal personal representative (on behalf of my estate) Percentage of benefit %

and/or

Pay my death benefit to the following individual(s)

Name

Date of birth / /

Percentage of benefit %

Name

Date of birth / /

Percentage of benefit %

Total nominations must equal 100%. If more than two beneficiaries, please photocopy and attach when returning.If the total nomination does not equal 100%, the nomination will be invalid and the sum insured will be payable to your estate.

25

6. Customer identity verification

If you do not have an existing investment with Challenger, you must complete this section. If you are lodging this application through a financial adviser, they are required to provide us with copies of the identity verification documents. If you are not lodging this application through a financial adviser, you are required to provide us with certified copies of the identity verification documents. Please see below for a list of who can certify the documents.

Please provide EITHER A or B (at least one document must show your date of birth)

A. a valid copy of ONE of the following documents:

Australian driver’s licence containing your photograph; or

Passport containing your photograph and signature; or

A card issued under a State or Territory law containing your photograph and proof of age

B. OR if one of the above cannot be provided, please provide information to satisfy group 1 and group 2 requirements below:

Group 1

A copy of one of the following documents:

Birth certificate or Australian birth extract; or

Australian citizenship certificate; or

Pension or Health Care card issued by Centrelink or Department of Veterans’ Affairs

Or

Electronic verification of your details by Challenger, using one of the following sources:

State or Federal electoral roll; or

Medicare records maintained by Federal government

Group 2 (The document must contain your full name and address as shown in section 1 of the application form)

A copy of one of the following documents issued to you:

A notice or bill issued within the preceding three months from a local government body or utilities provider that records the provision of services to you, e.g.:– Council rates notice– Electricity bill– Gas bill– Water rates notice– Telephone bill– Internet services bill

A letter or notice issued within the preceding 12 months from a Commonwealth or State/Territory government department that records the provision of financial benefits to you, e.g.:– Pension Statement– Rent Assistance Statement– Mobility Allowance Statement– Utilities Allowance Statement

A letter or notice issued to you within the preceding 12 months from the ATO that records a debt or refund payable by or to you, e.g.:– Notice of Assessment– Payment reminder

If residing in a care facility, a notice or invoice issued by that facility within the preceding three months that records the provision of care services to you

If you are a non-Australian resident and cannot provide A or B, please provide a valid copy of ONE of the following:

Foreign passport, or similar travel document bearing your signature and photograph; or

National identity card issued by a foreign government that contains your photograph and either your signature or your unique identifier; or

Foreign driver’s licence that contains your photograph.

Please note: • documents are required to be original or certified copies of the original; • documents such as passports, driver’s licences and other cards that have an expiry date must not have expired (however, Australian passports

that have expired within the preceding two years may be accepted); • if any document is in a language other than English, then it must be accompanied by an English translation prepared by an accredited translator; • if any document is in a previous name, then it must be accompanied by evidence of the change of name (e.g. a marriage certi cate).

How to certify documents

A certified copy is a document that has been certified as a true copy of an original document. To certify a document, take the original document and a photocopy to one of the people listed in the categories below and ask them to certify that the photocopy is a true and correct copy of the original document. That person will need to print their name, date and the capacity in which they are signing (e.g. postal agent, Justice of the Peace).

Sample wording

I, [full name], a [category of persons listed below], certify that this [name of document] is a true and correct copy of the original.

[Signature and date]

Documents in a language other than English must be accompanied by an English translation prepared by an accredited translator.

26

6. Customer identity verification (continued)

Who can certify documents?

Financial corporations (bank, building society, credit union)

• Officer with two or more continuous years of service with one or more financial institutions (for the purposes of the Statutory Declaration Regulations 1993 (Cth))

• Finance company officer with two or more continuous years of service with one or more finance companies (for the purposes of the Statutory Declaration Regulations 1993 (Cth))

• Officer with, or authorised representative of, a holder of an Australian financial services licence, having two or more continuous years of service with one or more licensees

Post office • Permanent employee of the Australian Postal Corporation with two or more years of continuous service who is employed in an office supplying postal services to the public

• Agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the public

JP • Justice of the Peace

Legal • Person who is enrolled on the roll of the Supreme Court of a state or territory, or the High Court of Australia, as a legal practitioner (however described)

• Judge of a court• Magistrate• Chief executive officer of a Commonwealth court• Registrar or deputy registrar of a court• Notary public (for the purposes of the Statutory Declaration Regulations 1993 (Cth))• Person authorised as a notary public in a foreign country

Police • Australian Police officer

Diplomatic service • Australian consular officer• Australian diplomatic officer (within the meaning of the Consular Fees Act 1955 (Cth))

Accountant • Member of the Institute of Chartered Accountants in Australia, Certified Practising Accountants (CPA) Australia or the National Institute of Accountants with two or more years of continuous membership

7. Additional information

Only complete this section if:

• your residential address, postal address or tax residency is outside Australia or New Zealand; and/or• you are investing $1 million or more.

What is your country of citizenship? Which option best describes the primary means by which your total wealth is generated?

Income from regular employment – (regular and/or bonus) Investment income (e.g. rent, dividends, pension)

Income from operating a business

One off payment (e.g. matured investment, court settlement, redundancy, inheritance)

Sales of assets (e.g. shares, property) Windfall (e.g. gift, lottery winnings) Borrowed funds

Government benefits (e.g. family tax benefit) What is your occupation? (If retired, please provide prior occupation)

8. Tax residency information

Tax residency rules differ by country. Whether an individual is a tax resident of a particular country is often (but not always) based on the amount of time a person spends in a country, the location of a person’s residence or place of work. For the US, tax residency can be as a result of citizenship or residency.

A Tax Identification Number (TIN) is the number assigned by each country for the purposes of administering tax laws. This is the equivalent of a Tax File Number in Australia or Social Security Number in the US.

Please answer BOTH tax residency questions.

Are you an Australian resident for tax purposes? Yes No

Are you a tax resident of another country? Yes No

If you are a tax resident of a country other than Australia, please provide your TIN or equivalent below. If you are a tax resident of more than one country, please list all relevant countries below.

1. Country TIN If no TIN, list reason A, B or C




ReasonResason A – The country of tax residency does not issue TINs to tax residents.Reason B – I have not been issued with a TIN.Reason C – The country of tax residency does not require the TIN to be disclosed.

27

9. Adviser service fees (as per attached quotation)

Upfront adviser service fee* . %

Ongoing adviser service fee (p.a.) $ , .

* The dollar amount of this service fee is shown on the quotation provided to you by your adviser. We will also confirm the amount on your Investor Certificate.

I authorise the payment of the above adviser service fee(s) and acknowledge that the ongoing adviser service fee is an ongoing arrangement that will continue until I direct my financial adviser and inform Challenger otherwise. I understand that fees cannot be refunded by Challenger once paid to my adviser.

Where I have consented to the payment of an adviser service fee(s), I direct Challenger to pay the fee(s) to the Australian Financial Services Licensee responsible for my financial adviser (or my financial adviser directly if they are the Licensee) and I acknowledge that the amount of my regular payments will be less than if I chose not to pay a fee(s).

I understand and agree that the fees are calculated on the total CarePlus investment amount and will be deducted from my regular Annuity payments.

10. Declaration

I declare that:• all details in this application (including all related documents provided) are true and correct and I indemnify Challenger Life Company Limited

(ABN 44 072 486 938) (AFSL 234670) against any liabilities whatsoever arising out of it acting on any incorrect or misleading information provided by me in connection with this application or in the future;

• I have received a copy of the current CarePlus PDS and Policy Documents to which this application applies and have read them. I agree to be bound by the provisions of the policies (including the Policy Documents and Investor Certificates) and this PDS and application. In the event of any inconsistency between the PDS and Policy Documents, I acknowledge that the terms of the Policy Documents prevail;

• I have legal power to invest in accordance with this application and have complied with all applicable laws in making this application;• I have received and accepted this offer in Australia;• the details of my investment can be provided to the dealer group or adviser by the means and in the format that they direct;• I understand that the application form, together with any Challenger quotation, will be relied upon by Challenger Life Company Limited in its decision

to issue an Insurance policy and/or Annuity policy. Where the information on the quotation differs to that on the application form, the policies will be based on the information provided on the application form;

• if this application is signed under a power of attorney, the attorney declares that: • he/she has not received notice of revocation of that power (a certified copy of the power of attorney should be submitted with this application unless

we have already sighted it); and • where the attorney is nominated as a beneficiary and the power of attorney does not give authority to the attorney to give themselves that benefit,

the nomination will be invalid;• I have been assessed by the relevant Aged Care Assessment Team and am eligible to receive Government-subsidised aged care services;• I agree Challenger Life Company Limited has the right to recover from me, by deduction from the sum insured before it is payable to my nominated

beneficiaries or estate, any monies owing to Challenger Life Company Limited (owing from the ‘Insurance policy’ or any other policy);• I agree to provide proof of survival when requested by Challenger Life Company Limited;• I confirm that I am not holding the Annuity or Insurance on behalf of anybody else;• I acknowledge and provide my express consent and authorisation to Challenger to pay the adviser service fees mentioned in section 9 of this

application form to my financial adviser.

In relation to my personal information:• I acknowledge that I have read the pages of the PDS containing the information under the heading ‘Privacy and personal information’. I am aware

that until I inform Challenger Life Company Limited otherwise, I will be taken to have consented to all the uses of my personal information (including marketing) contained under that heading and I have consented to the provision of, and authorised (if applicable) my financial adviser to provide, such personal information to Challenger and its related entities as is required or reasonably deemed necessary by Challenger and its related entities under applicable law. I declare that any third party information in this application has been provided with the third party’s consent and I have shown that third party the pages of the PDS containing the information under the heading ‘Privacy and personal information’;

• I understand that if I fail to provide any information requested in this application form or do not agree to any of the possible uses or disclosures of my information as detailed on the PDS (except in relation to direct marketing material), my application may not be accepted by Challenger Life Company Limited and I agree to release and indemnify Challenger Life Company Limited in respect of any loss or liability arising from its inability to accept an application due to inadequate or incorrect details having been provided.

28

10. Declaration (continued)

Investor 1/Power of Attorney 1

Signature (please sign) Date / /

Print name

Power of Attorney 2


Print name

Power of Attorney 3


Print name

11. Adviser details

By signing this section I declare that:

• The attached documents are true copies of the documents used to satisfy the customer identity verification requirements and I have complied with my obligations under the Anti-Money Laundering and Counter-Terrorism Financing Act 2006.

• I have provided the required additional identity verification information and documents and understand that regular payments and any commutation payments will be withheld until any additional information required is provided. I confirm that the documents contain the full name and address of the investor (new care entrants only).

• The investor has been assessed by the relevant Aged Care Assessment Team and is eligible to receive Government-subsidised aged care services.

• I confirm that the adviser service fees set out in section 9 of this application form have been agreed to by the applicant.

• Where a beneficiary nomination has been made under a power of attorney and the attorney has nominated themselves, I confirm that the power of attorney document gives the attorney specific authority to give themselves that benefit, otherwise the nomination will be invalid (see page 8).

Adviser full name

Adviser group name

Adviser group AFSL No.

Adviser telephone

Signature (please sign)

Date / /

29

11. Adviser details (continued)

Before sending us your application form, please ensure you have provided us with:

your investor details in section 1

your investment details included in section 2 including the investment amount and payment method

a valid quote and the quote ID in section 3. This quote must be attached to this application form

your financial institution account details in section 4

your beneficiary nomination in section 5. If an attorney has nominated themselves as a beneficiary, you need to review the power of attorney document to confirm it authorises the attorney to give themselves that benefit

the required customer identity verification documents and information as outlined in sections 6 and 7

non-resident account holder information (even if you are not a US citizen) in section 8

details of any upfront or ongoing adviser fees in section 9

your adviser declaration in section 11

a TFN declaration. It is not an offence not to quote your TFN, but if you choose not to quote it, tax may need to be deducted at the highest marginal rate (plus applicable Government levies)

and that you have:

read the declaration and signed section 10

Adviser comment/special instructions

Important notesChallenger Life Company Limited may in its absolute discretion refuse any application for a policy. Persons external to the Challenger Group or other entities who market Challenger Group products are not agents of any entity in the Challenger Group but are independent investment advisers. Challenger will not be bound by representations or statements which are not contained in information disseminated by Challenger. Application money paid by cheques from investment advisers will only be accepted if drawn from a trust account maintained in accordance with the Corporations Act. CarePlus Annuity and CarePlus Insurance are offered by Challenger Life Company Limited (ABN 44 072 486 938) (AFSL 234670).

30


31

Challenger Life Company Limited Direct Debit Authority Form

Complete this form if you wish us to debit your account for your investment amount.

Investor 1

Title

Mr Mrs Miss Ms Other

Given name(s)

Surname

Bank account details

Schedule Note: Direct debiting is not available on the full range of accounts. If in doubt, please refer to your financial institution. The bank account to be debited must be held in the name of the investor(s).

Account name which is to be debited

BSB number – Account number

Name of financial institution

Branch where account is held

I/We request Challenger Life Company Limited (ABN 44 072 486 938) (AFSL 234670) (User ID No. 433545) (Challenger), until further written notice is given to Challenger from me/us, to debit my/our account described under Payment method, any amounts which Challenger may direct debit or charge me/us through the Bulk Electronic Clearing System.

I/We understand and acknowledge that:

1. The bank/financial institution may, in its absolute discretion, determine the order of priority of payment by it of any monies pursuant to this request or any authority or mandate, and at any time by notice in writing to me/us, terminate this request as to future debits.

2. The bank/financial institution will provide to me/us upon request general descriptive information of the kind referred to in sections 13.1 and 13.2 of the Code of Banking Practice, concerning the operation of accounts, banking facilities and cheques.

3. The information which I/we have provided on this form is accurate and not misleading and I am/we are aware that Challenger is relying on it.

4. This direct debit arrangement is governed by the terms of the Bulk Electronic Clearing System Procedures and the Direct Debit Request Service Agreement received from Challenger which I have read and agreed to.

5. Should the bank/financial institution charge any fees/charges related to this direct debit request (including a withdrawal or dishonour fee), I/we will be responsible for such fees/charges.

Bank account signatory 1 Signature (please sign) Date / /

Surname

Given name(s)

Capacity (if relevant) Sole Director Director Secretary (company investments only)

Bank account signatory 2 Signature (please sign) Date / /

Surname

Given name(s)

Capacity (if relevant) Sole Director Director Secretary (company investments only)

32

Direct Debit Request Service Agreement

This is your Direct Debit Request Service Agreement with Challenger Life Company Limited (ABN 44 072 486 938) (AFSL 234670) (Challenger) (User ID No. 433545). It explains what your obligations are when undertaking a Direct Debit arrangement with us. It also details what our obligations are to you as your Direct Debit provider.Please keep this agreement for future reference. It forms part of the terms and conditions of your Direct Debit Request and should be read in conjunction with your Direct Debit Request authorisation.

Definitions and interpretationaccount means the account held at your financial institution from which we are authorised to arrange for funds to be debited.agreement means this Direct Debit Request Service Agreement between you and us.banking day means a day other than a Saturday or a Sunday or a public holiday listed throughout Australia.debit day means the day that payment by you to us is due.debit payment means a particular transaction where a debit is made.direct debit request means the Direct Debit Request between us and you.us or we means Challenger, (the Debit User) you have authorised by requesting a Direct Debit Request.you means the customer who has signed or authorised by other means the Direct Debit Request.your financial institution means the financial institution nominated by you on the Direct Debit Request at which the account is maintained.

A reference to:• this agreement, the BECS regulations and procedures or another instrument includes any variation or replacement of any of them;• person includes a firm, body corporate, an unincorporated association or an authority and their executors, administrators, successors, substitutes

(including, without limitation, persons taking by novation) and assigns; and• anything includes the whole and each part of it and a reference to a group of persons includes all of them collectively, any two or more of them

collectively and each of them individually.

Headings are inserted for convenience and do not affect the interpretation of this agreement.

1. Debiting your account 1.1 By signing a Direct Debit Request or by providing us with a valid instruction, you have authorised us to arrange for funds to be debited from

your account. You should refer to the Direct Debit Request and this agreement for the terms of the arrangement between us and you. 1.2 We will only arrange for funds to be debited from your account as authorised in the Direct Debit Request in consideration for providing

interests in the Fund to you. The Direct Debit Request details the terms of your debit arrangements including, among other things, the amount, the frequency, the expiry (if any) and the recipient of the funds. You should carefully read the Direct Debit Request to familiarise yourself with the details of your debit arrangements.

1.3 If the debit day falls on a day that is not a banking day, we may direct your financial institution to debit your account on the following banking day. If you are unsure about which day your account has or will be debited you should ask your financial institution.

2. Amendments by us 2.1 We may vary any details of this agreement or a Direct Debit Request at any time by giving you at least fourteen (14) days written notice.

3. Amendments by you 3.1 You may change*, stop or defer a debit payment, or terminate this agreement by providing us with at least five (5) days notification by

writing to: Challenger Life Company Limited GPO Box 3695 SYDNEY NSW 2001 or by telephoning us on 13 35 66 during business hours; or arranging it through your own financial institution, which is required to act promptly on your instructions. * Note: in relation to the above reference to ‘change’, your financial institution may ‘change’ your debit payment only to the extent of

advising us (Challenger) of your new account details.

4. Your obligations 4.1 It is your responsibility to ensure that there are sufficient clear funds available in your account to allow a debit payment to be made in

accordance with the Direct Debit Request. 4.2 If there are insufficient clear funds in your account to meet a debit payment: (a) you may be charged a fee and/or interest by your financial institution; (b) you may also incur fees or charges imposed or incurred by us; (c) we are authorised to direct debit an amount up to the available balance in the nominated bank account at that time. However, we are

under no obligation to effect a reduced direct debit; and (d) you must arrange for the debit payment to be made by another method or arrange for sufficient clear funds to be in your account by

an agreed time so that we can process the debit payment. 4.3 You should check your account statement to verify that the amounts debited from your account are correct. 4.4 You are responsible for: (a) ensuring that the authorisation on the Direct Debit Request is identical to the account signing instruction held by the financial institution

of the nominated account; (b) telling us if you close or change the account you nominated; and (c) arranging a suitable alternate payment method if the direct debit arrangements are stopped, either by you or your financial institution.

5. Dispute 5.1 If you believe that there has been an error in debiting your account, you should notify Colonial First State on 1800 805 605 and confirm that

notice in writing with us as soon as possible so that we can resolve your query more quickly. Alternatively you can take it up directly with your financial institution.

5.2 If we conclude as a result of our investigations that your account has been incorrectly debited we will respond to your query by arranging for your financial institution to adjust your account (including interest and charges) accordingly. We will also notify you in writing of the amount by which your account has been adjusted.

5.3 If we conclude as a result of our investigations that your account has not been incorrectly debited we will respond to your query by providing you with reasons and any evidence for this finding in writing. We will respond to you within seven days.

3333

Direct Debit Request Service Agreement (continued)

6. Accounts 6.1 You should check: (a) with your financial institution whether direct debiting is available from your account as direct debiting is not available on all accounts

offered by financial institutions; (b) your account details which you have provided to us are correct by checking them against a recent account statement; and (c) with your financial institution before completing the Direct Debit Request if you have any queries about how to complete the Direct

Debit Request. 6.2 Your financial institution may, in its absolute discretion, determine the order of priority of payment by it of any monies pursuant to this

request or any authority or mandate, and at any time by notice in writing to me/us, terminate this request as to future debits.

7. Confidentiality 7.1 We will keep any information (including your account details) in your Direct Debit Request confidential. We will make reasonable efforts to

keep any such information that we have about you secure and to ensure that any of our employees or agents who have access to information about you do not make any unauthorised use, modification, reproduction or disclosure of that information.

7.2 We will only disclose information that we have about you: (a) to the extent specifically required by law; or (b) for the purposes of this agreement (including disclosing information in connection with any query or claim).

8. Notice 8.1 If you wish to notify us in writing about anything relating to this agreement, you should speak to your financial adviser 8.2 We will notify you by sending a notice which will be available in your Document library. 8.3 Any notice will be deemed to have been received on the third banking day after uploading.

IndemnityYou indemnify us against all losses, costs, damages and due liability (‘loss’) that we suffer as a result of you breaching this agreement or you providing us with an invalid, ineffective or non-binding Direct Debit Request addressed to us or if for any other reason the instructions contained in a Direct Debit Request provided by you are not or cannot be performed. This indemnity includes, without limitation, legal costs and expenses on a full indemnity basis. This indemnity is a continuing obligation, separate and independent from your other obligations and survives termination of this agreement. It is not necessary for us to incur expense or make payment before enforcing a right of indemnity conferred by this agreement. This indemnity does not apply to loss as a result of our (or any of our delegates’ or agents’) fraud, negligence or breach of trust. You will pay us any sum due under this clause fully without deduction or set-off (and irrespective of any counterclaim) whatsoever.

Governing lawThis agreement and the transactions contemplated by this agreement are governed by the law in force in New South Wales. Each party irrevocably and unconditionally submits to the non-exclusive jurisdiction of the courts of New South Wales for determining any dispute concerning this agreement or the transactions contemplated by this agreement.

34


35

4343

3 What is your legal name or registered business name (or your individual name if not in business)?

5 Who is your contact person?

Business phone number

4 What is your business address?

Suburb/town/locality

State/territory Postcode

There are penalties for deliberately making a false or misleading statement.

Signature of payerDECLARATION by payer: I declare that the information I have given is true and correct.

Month YearDayDate

6 If you no longer make payments to this payee, print X in this box.

Yes No

2 If you don’t have an ABN or withholding payer number, have you applied for one?

Section B: To be completed by the PAYER (if you are not lodging online)Branch number (if applicable)

1 What is your Australian business number (ABN) or withholding payer number?

Return the completed original ATO copy to: Australian Taxation Office PO Box 9004 PENRITH NSW 2740

IMPORTANT

See next page for:payer obligationslodging online.

This declaration is NOT an application for a tax file number.

Print X in the appropriate boxes.

NAT 3092-07.2016 [JS 35902]

Section A: To be completed by the PAYEE 6 On what basis are you paid? (Select only one.)Full-time

employmentPart-time

employmentCasual

employmentSuperannuation

or annuity income stream

Labour hire

(Visit ato.gov.au/residency to check)Yes No

9 Do you want to claim the seniors and pensioners tax offset by reducing the amount withheld from payments made to you?

NoYesComplete a Withholding declaration (NAT 3093), but only if you are claiming the tax-free threshold from this payer. If you have more than one payer, see page 3 of the instructions.

8 Do you want to claim the tax-free threshold from this payer?

Answer no here and at question 10 if you are a foreign resident, except if you are a foreign resident in receipt of an Australian Government pension or allowance.

NoYes

Only claim the tax-free threshold from one payer at a time, unless your total income from all sources for the financial year will be less than the tax-free threshold.

There are penalties for deliberately making a false or misleading statement.

You MUST SIGN here

Signature

Month YearDayDate

DECLARATION by payee: I declare that the information I have given is true and correct.

10 Do you want to claim a zone, overseas forces or invalid and invalid carer

NoComplete a Withholding declaration (NAT 3093).Yes

11 (a) Do you have a Higher Education Loan Program (HELP), Student Start-up

(b) Do you have a Financial Supplement debt?

Your payer will withhold additional amounts to cover any compulsory repayment that may be raised on your notice of assessment.Yes No

NoYour payer will withhold additional amounts to cover any compulsory repayment that may be raised on your notice of assessment.Yes

OR I have made a separate application/enquiry to the ATO for a new or existing TFN. For more

information, see question 1 on page 2 of the instructions.

OR I am claiming an exemption because I am under 18 years of age and do not earn enough to pay tax.

OR I am claiming an exemption because I am in receipt of a pension, benefit or allowance.

1 What is your tax

2 What is your name? Title: Mr Mrs Miss Ms

Surname or family name

First given name

Other given names

3 If you have changed your name since you last dealt with the ATO,

4 What is your date of birth?

Month YearDay

5 What is your home address in Australia?

Suburb/town/locality

State/territory Postcode

30920716Sensitive (when completed)

X

L E V E L 2

5 M A R T I N P L A C E

S Y D N E Y

N S W 2 0 0 0

4 4 0 7 2 4 8 6 9 3 8

C H A L L E N G E R L I F E

C O M P A N Y L I M I T E D0 2 9 9 9 4 7 0 0 0

Please refer to the ato.gov.au for instructions on how to complete this form.

Use a black or blue pen and print clearly in BLOCK LETTERS.Print X in the appropriate boxes.Do not use correction fluid or covering stickers.

36


37

Withholding declaration form – short version for seniors and pensioners

Complete this declaration to authorise your payer to adjust

You must provide, or have previously provided, your payer with a completed Tax file number declaration

before you can make a Withholding declaration.

Read the Instructions before completing this declaration.

X in the appropriate boxes.

PAYER’S COPY

Sensitive NAT 5072-06.2017

4 Are you an Australian resident for tax purposes? Yes NoYou must answer no

Payee’s declaration To be completed by payee.

1 What is your name?

Given names

Title: Mrs Miss MsMr

2 What is your date of birth? Day Month Year

5 Are you claiming or do you want to claim Yes No

6 Do you want to claim the seniors and pensioners

Are you:A member of an illness-separated couple

A member of a couple

Yes No

The tax laws impose heavy penalties for giving false or misleading statements.

I declare that the information I have given on this form is true and correct.

Date

Day Month Year

Privacy ato.gov.au/privacy

38

2 What is your registered business name or trading name

The tax laws impose heavy penalties for giving false or misleading statements.

I declare that the information I have given on this form is true and correct.

Date

Day Month Year

This declaration will constitute written notice under section 15-15 of schedule 1 to Taxation Administration Act 1953

the payee has given a completed Tax file number declaration to the payer, or

the payee has notified the payer of the varied rate of withholding in writing on

The information in the completed Withholding declaration form must be treated as

Do not send it to us.

Privacy Act 1988, you must use secure methods

new Withholding declaration or leaves your employment, you must still keep this declaration for the current and next financial year.

Do not send this declaration form to us.

Sensitive

Payer’s declaration To be completed by payer.

4 4 0 7 2 4 8 6 9 3 8

CHALLENGER L IFE COMPANY LIMITED

39


40


Contact details

By phone Investor Services team 13 35 66 (during Sydney business hours)

By email [email protected]

By fax 02 9994 7777

By mail Challenger Life Company Limited Reply Paid 3698 Sydney NSW 2001

Website www.challenger.com.au

New South WalesLevel 25 Martin PlaceSydney NSW 2000Telephone 02 9994 7000Facsimile 02 9994 7777

VictoriaLevel 1931 Queen StreetMelbourne VIC 3000Telephone 02 9994 7000Facsimile 02 9994 7777

QueenslandLevel 6215 Adelaide StreetBrisbane QLD 4000Telephone 07 3136 5400Facsimile 07 3136 5407

Western AustraliaLevel 26140 St Georges TerracePerth WA 6000Telephone 08 6466 9613Facsimile 08 9321 5277

South AustraliaLevel 7, Suite 714147 Pirie StreetAdelaide SA 5000Telephone 08 8427 9511Facsimile 08 8227 0395

Investor Services13 35 66

Adviser Services1800 621 009

32509/CG1024/0618

www.challenger.com.au