IN SERVICE MEMBERS ONLY / FORM 8
Revision 01/2014
Page 1 of 5
Private Bag 50
Bryanston
2021 / 24 Georgian Crescent EastEPPF Office Park
Bryanston East
2021
Please complete and return to your local Human Resources Office, to be placed in your personal record.
SECTION1: PERSONALDETAILS
Surname: / Tax reference number
First names: / Telephone number (H):
Unique number: / Telephone number (W):
Date of birth / Cellphone number:
ID /smart card / passport number:
Email address:
Residential address: / Postal address:
Postal code: / Postal code:
Name and contact details of executor of estate:______
Marital status:
Married / Single / Divorced / Widowed / Multiple spouses / Permanent life partner /live-in partner
EXPLANATORY NOTES
Please note the following IMPORTANT INFORMATION before completing this nomination form:
1.A lump sum benefit is payable by the Eskom Pension and Provident Fund (EPPF) on the death of an in-servicemember. In terms of the Pension Funds Act of 1956, the benefit shall be paid to one or more of the in-service member’s eligible dependants and / or nominated beneficiaries. The Board of Trustees is, in terms of the Pension Funds Act of 1956, tasked with the duty of identifying eligible dependants and making an equitable distribution to such eligible dependants and / or nominees.
2.This nomination is for lump sum death benefits only and does not apply to monthly pensions payable to spouses and / or eligible children in terms of the Rules of the EPPF. / 3.If you wish to furnish the Board of Trustees with any additional information to substantiate your wishes and to assist them in their task, please use Section 4 of this form or attach an additional page, which must be signed and dated.
4.This nomination is made, acknowledging that:
4.1.it is not binding on the EPPF but is a guideline to assist the Board of Trustees in identifying eligible dependants of the deceased in-service member;
4.2.the nomination may be cancelled or changed by the in-service member at any stage by giving proper written notice to the EPPF or by completing a new Beneficiary Nomination Form;
4.3.if any eligible dependant or nominee should predecease the in service member, the estate or the heirs of the deceased dependant or nominee will have no claim to the benefit.
Member’s Unique Number:
/ BENEFICIARY NOMINATION FORM
IN SERVICE MEMBERS ONLY / FORM 8
Revision 01/2014
Page 2 of 5
EXPLANATORY NOTES continued
- The Pension Funds Act of 1956, defines a “Dependant” as:
5.2.a person in respect of whom a member is not legally liable for maintenance, if such person –
(a)was, in the opinion of the Board, upon the death of the member in fact dependent on the member for maintenance;
(b)is the spouse of the member;
(c)is a child of the member, including a posthumous child, an adopted child and a child born out of wedlock;
5.3.a person is in respect of whom the member would have become legally liable for maintenance, had the member not died.
- It is vital that the Board of Trustees be made aware of any person falling into the category of “Dependant”. A lack of full information may cause a considerable delay in paying benefits upon death.While the Pension Funds Act allows the EPPF 12 months in which to finalise payments to eligible dependants, your assistance could enable the EPPF to finalise payment earlier than the 12-months period.
- PleaselistallyourDependants,evenifyou donotwantthemtoreceiveanyofthebenefits payableuponyourdeath-youcanshowthis simplybywriting“Nobenefit”or“Nil%”against aperson’snameinSection2.Itshouldbenoted thatmajorchildren(overtheageof21)are definedasdependantsandshouldthereforebe listed as such.
- Youcanalsonominateoneormorepeoplewho arenot“Dependants”to receivepartorallof thebenefitspayableuponyourdeath.Theseare knownas“Nominees”.Therefore,ifyouwould liketheBoardofTrusteestoconsiderpayingany ofthebenefitstosuchapersonpleaseprovide therequireddetailsinSection3.
- Atrustcanbecreatedtoprovidefortheneeds ofyourdependantsand/ornominees.Ifyoufeelthatthebenefitmustbemanagedandprotected forandonbehalfofabeneficiary,pleaseindicate intheappropriatespacewhetheratrustshould beconsidered.
- If you die leaving no dependants but are survived by your nominee(s) and your estate is insolvent, the EPPF will have to bring your Estate to solvency before making any payment to the nominee(s).
- Ifthereareonlynominee(s), paymentwillonly bemade12monthsafterdateofdeath.
- Death benefit payment is subject to the payment of income tax.
- Shouldyounotunderstandanythingonthisform orrequireadditionalinformation,pleasecontact your local Human Resources Practitioner.
- Pleaseinitialeachpageandanycorrections youmake.Donotusecorrectingfluid(e.g. Tippex).Pleasecompleteinblackink.
Member’s Unique Number:
/ BENEFICIARY NOMINATION FORM
IN SERVICE MEMBERS ONLY / FORM 8
Revision 01/2014
Page 3 of 5
SECTION2 DETAILS OF DEPENDANTS
(For example: spouse, life-partner, children (minor and major), mother, father, niece, nephew, etc.). Refer to Explanatory notes 5-7
PLEASE COMPLETE ALL THE APPLICABLE SECTIONS OF THIS FORM AND ENSURE THAT THE APPORTIONMENTS IN SECTION 2 AND SECTION 3 TOGETHER, REFLECT A FINAL TOTAL OF 100%.
I hereby request that in the event of my death, any lump sum death benefit payable in terms of the Rules of the EPPF be paid as follows: (You may provide any additional information by attaching a separate document if you have more dependants than the space provided below)
Name and Surname / ID/ smart card / passport number or date of birth / Residential address
and
telephone number / Relationship / % of benefit / Place in trust: Yes or No
(Refer to note 9)
Tel.:
Tel.:
Tel.:
Tel.:
Tel.:
Tel.:
Tel.:
Member’s Unique Number:
/ BENEFICIARY NOMINATION FORM
IN SERVICE MEMBERS ONLY / FORM 8
Revision 01/2014
Page 4 of 5
SECTION3 DETAILS OF NON FINANCIAL DEPENDANTS
I would like the following people, who are NOT financially dependent on me, to receive the lump sum death benefit in the following proportions: (Refer to Explanatory note 8)
Name and Surname / ID/ smart card / passport number or date of birth / Residential address
and
telephone number / Relationship / % of benefit / Place in trust: Yes or No
(Refer to note 9)
Tel.:
Tel.:
Tel.:
Tel.:
Tel.:
Tel.:
Tel.:
Final total: Section 2 and 3 should be / 100%
Member’s Unique Number:
/ BENEFICIARY NOMINATION FORM
IN SERVICE MEMBERS ONLY / FORM 8
Revision 01/2014
Page 5 of 5
SECTION4 MOTIVATION / COMMENT
(REFER TO NOTE 3)
I would like to provide the following motivation/comments in support of this Beneficiary Nomination Form: ______
I, (name) ______the undersigned, state that this nomination revokes and replaces all previous nominations made and I recognise that my circumstances and those of the abovementioned beneficiaries may change. I undertake to notify the EPPF when any change should take place regarding my dependants or nominees. This nomination is made in terms of the explanatory notes included on this form.
Signed on this ______day of ______20______
at ______
Member’s signature: / ______
Witness 1signature / ______/ Full names: / ______
Witness 2 signature / ______/ Full names: / ______
THIS FORM IS ONLY VALID IF IN THE POSSESSION OF YOUR HUMAN RESOURCES OFFICE AS AT THE DATE OF DEATH OF THE IN SERVICE MEMBER.
Witnesses may not include any persons, or representatives of any organisation listed on this Nomination Form.
Member’s Unique Number: