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Application to Withdraw CPF on Ground of Leaving Singapore CPF-LM

and West Malaysia Permanently


This form may take you 10 minutes to complete.

IMPORTANT: PLEASE PRINT THIS FORM ON BOTH SIDES OF THE PAPER AND
READ PAGES 3 & 4 BEFORE COMPLETING IT.
It is an offence to make any false statement or to produce any document which is false for any purpose in connection with the Central
Provident Fund Act (Cap. 36). Please sign against any amendment made. Use of correction fluid/tape may render the application void.
PART 1 PARTICULARS OF MEMBER: (as shown on the identity card or passport)

Name: ___________________________________________________________ CPF Account Number:


*S / T
Date of Birth: ___________________ Citizenship: ________________________

Foreign Passport Number: _________________________ Malaysian IC Number (if applicable): _____________________

Email Address: __________________________________ Contact Number: _____________________________________

Overseas Forwarding Address: _________________________________________________________________________


____________________________________________________________________________________________________________

PART 2 PARTICULARS OF PARENT / LEGAL GUARDIAN (IF MEMBER IS BELOW 21 YEARS OLD)

Name: ________________________________________________ Identification / Passport Number: ________________

Relationship to member: *Father / Mother / Legal Guardian Contact Number: ______________________________


PART 3 DECLARATION
1. I declare that *I am / the member is not a citizen of Singapore and that *I am / the member is *about to leave / have
(has) left Singapore and West Malaysia permanently on ___________________ with no intention of returning for further
employment or residence. In accordance with section 15 of the Central Provident Fund (CPF) Act and CPF (Investment
Schemes) Regulations, I hereby apply to withdraw all the monies standing to *my / the members credit in (a) the Central
Provident Fund, (b) *my / the members CPF Investment Account, if any; and (c) all *my / the members investments
under the CPF Investment Scheme Ordinary Account and CPF Investment Scheme Special Account, if any.
2. In accordance with section 27K(5) of the CPF Act, I hereby apply to be excluded from CPF LIFE if I am placed on CPF
LIFE under section 27K(2), such that the CPF LIFE policy would not be issued to me automatically. (Note: If you have a
CPF LIFE policy, you need to apply to terminate your CPF LIFE policy. Please refer to page 4 for more information.)
3. I understand that:
(i) Upon the approval of this application by the CPF Board (the Board)
all the monies in *my / the members CPF Investment Account (if any), and all *my / the members investments
under the CPF Investment Schemes (if any), will be automatically transferred to *me / the member by *my / the
members agent bank and / or product providers; and they will no longer be protected from any claims by *my /
the members creditors and / or the Official Assignee; and
CPF refunds will not be required to be made to my CPF account for CPF monies withdrawn for my existing
property (properties), including the accrued interest when I dispose of them. I will be responsible for informing
HDB and / or my lawyers on the above if I have an ongoing sale transaction.
(ii) The Board may refund any unused MediShield Life premiums to *me / the member (by supplementary payment) at a
later date if the Board is notified by *me / the member or a relevant authority to terminate *my / the members
MediShield Life cover later than this present application.
(iii) If *I am / the member is covered under the Dependants Protection Scheme, *my / the members cover will be
terminated from the day that *I / the member cease(s) to be a Singapore Citizen or Permanent Resident, and any
unused premiums will be refunded to *me / the member.
4. I authorise the Board to obtain verification of information relating to me and to my bank account from the bank, and
the bank to disclose any information whatsoever relating to me and to the account for the purpose of account validation.
My authorisation here shall survive the termination of any of the account with the bank and may be relied on and
enforced as fully and effectively by the bank as if it is addressed to the bank.
* Delete whichever is inapplicable
(04/2016) Page 1 of 4
PART 4 DISCOUNTED SINGTEL SHARES (Please complete this portion if applicable)
I hereby apply for the withdrawal of my discounted Singtel shares. I authorise the CPF Board to transfer all my
discounted Singtel shares to my *individual / joint Central Depository Pte Limited (CDP) Securities Account** as
follows:
1 6 8 1
My joint CDP Securities Account (applicable only if the CDP account indicated above is a joint account) is held with:
_______________________________________________________________________________________________
*Name & NRIC Number (for Singapore Citizen & Permanent Resident) / Name & Passport Number (for foreigner)
I agree to pay the CDP transfer fee of $10.70 (inclusive of 7% GST) to CPF Board by (please tick only one box):
D-PAY at any AXS station; eNETS through the CPF website under E-Services (e-Cashier); or
Cheque number ___________ (Name of Bank __________________) made payable to CPF Board.
I understand that this application is irreversible and that once my discounted Singtel shares are transferred to me,
they will no longer be protected from any claims by my creditors and/or the Official Assignee.
PART 5 BANK DETAILS OF APPLICANT For Banks Certification Only
(i) Bank Account Number : ____________________________________ The Bank hereby certifies that the bank
(Bank account must not be a trust account) account, name and identification / passport
number on this form belong to the applicant.
Name of Bank : ___________________________________________
(ii) To be completed for payment via Telegraphic Transfer only:

SWIFT Code : ________________(Can be obtained from the bank)


Bank Address: ___________________________________________ ..................................................................
Bank Officers Name, Signature,
___________________________________________ Banks Stamp & Date

SIGNATURE / RIGHT THUMBPRINT OF APPLICANT For Witness Certification Only#


(for applications not completed at CPF Service Centre)
I hereby certify that the applicant had
signed the form in my presence.

...................................................................
______________________________________ _________________ Witness Name, Signature,
Signature / Right Thumbprint Date Official Seal / Stamp & Date
FOR OFFICIAL USE ONLY: RECEIPT OF APPLICATION BY CPF OFFICER
ACKNOWLEDGEMENT OF PAYMENT

Accepted and Checked by: ___________________________________ Payment received by:


Officers Name, Stamp, Signature & Date
___________________________________
A copy of this form and cheque had been forwarded to IVD. Applicants Name, Signature & Date
(Applicable only if there is a request to transfer SDS)

Tax Amount: ______________________________________________ Witnessed by:


Revised Mode of Payment (if any): IBG / TT / CHQ
Refer to WSD78A / dated: _____________________ ___________________________________
Witness Name, Signature & Date

DATE RECEIVED
_____________________ _____________________ ____________
Authorised By Date of Processing Code

Keyed By: _________________ Verified By: __________________


Remarks: _________________________________________________
* Delete whichever is inapplicable
**If you do not have a CDP account, you may sell your discounted Singtel shares through SingPost or your broker. Upon approval of your withdrawal
application, the Board will pay you the sale proceeds that have been credited into your CPF account.
# The witness must be either a Notary Public or an official from the Singapore High Commission / the Embassy of the Republic of Singapore with his
official seal / stamp duly affixed.
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NOTES
CONDITIONS FOR WITHDRAWAL
1) You may apply to withdraw your CPF if you are not a Singapore Citizen / Permanent Resident and are about to leave
or have left Singapore and West Malaysia permanently with no intention of returning to either country for employment or
residence.
Please complete and return this form to CPF Board, Withdrawal Schemes Department, 238B Thomson Road, #08-00
Tower B Novena Square, Singapore 307685 together with copies of the documents stated below.
2) If your application is not completed at CPF Service Centre, your application and all supporting documents must be
witnessed / certified true by either a Notary Public or an official from the Singapore High Commission / the Embassy of
the Republic of Singapore with his official seal / stamp duly affixed. Certifications by a Justice of Peace or Commissioner
for Oaths are not acceptable.
DOCUMENTS FOR WITHDRAWAL
Citizenship Status of Member Documents Required
1. Current valid passport and passports used during your employment /
residence in Singapore.
For a member who has
renounced his Singapore 2. Foreign citizenship certificate (if there is no foreign passport).
A. citizenship to migrate to another 3. Foreign identity card/document showing your personal identification
country (other than West number (if any).
Malaysia).
4. A letter from the Immigration & Checkpoints Authority confirming the
renunciation of your Singapore citizenship.
1. Malaysian identity card that is currently valid.
2. International passport showing the passport number, full personal
For a member who is a particulars, signature and date of the expiry of the passport.
B.
Malaysian 3. Evidence of foreign permanent residency or citizenship.
4. A letter from the Immigration & Checkpoints Authority, confirming the
cancellation of your Singapore Permanent Residency, if applicable.
1. Current valid passport and passports used during your employment /
residence in Singapore.
For a member who is not a 2. Foreign citizenship certificate (if there is no foreign passport).
C. citizen of Singapore or 3. Foreign identity card/document showing your personal identification
Malaysia. number (if any).
4. A letter from the Immigration & Checkpoints Authority, confirming the
cancellation of your Singapore Permanent Residency, if applicable.
We need to authenticate your identity to ensure that you are the rightful
owner of the CPF account before we update your particulars in our records
and process your withdrawal. Hence, please provide the following
documents and information:
1. The names of all the companies in Singapore whom you had worked for
All Members and the years in which you had started and stopped working for each
For verification of CPF account company.
holder^ 2. The full names of your nominee(s) if you had made a CPF nomination or
indicate no CPF nomination made if you had not made a CPF
^You may be required to visit the nomination.
CPF Service Centre personally if
you are unable to provide the 3. Deed poll / change of name certificate / marriage certificate if the name
requested information for in your passport / citizenship certificate / bank account differs from that
verification. in our records. The document must show clearly your original / maiden
name and your new / married name.

Your parent / legal guardian must make the application on your behalf and
provide the following additional documents:
i. Your birth certificate or legal documentation of guardianship (including
For a member below 21 years old
any relevant court order) as proof of relationship between you and your
parent / legal guardian; and
ii. Your parent / legal guardians identification document(s).

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MODE OF PAYMENT

1. Payment will be credited into your bank account as stated in this application via:

(i) Interbank GIRO for a Singapore bank account.

(ii) Telegraphic Transfer for an overseas bank account.

You will need to provide us the SWIFT code and bank address, and ensure that the bank accepts
payment in Singapore dollars. Please note that you will have to bear all bank charges.

Please get your bank to certify your bank account information on Part 5 of the form or mail us your original bank
statement for verification. Online bank statements are not acceptable. Bank certification is not required for a
Singapore POSB (excluding DBS), OCBC or UOB bank account maintained under your Singapore NRIC.

The Board has the discretion to decide whether or not to perform verification of information relating to you and
your account with the bank.

2. If the bank account information is not provided or is incomplete, we will issue a cheque in Singapore Dollars.
(Note: For overseas bank clearance of the cheque, you will need to bear all bank charges.)

3. If you are below 21 years old, payment will be made to your parent / legal guardian. Please indicate your parent /
legal guardians bank details on Part 5 of the form.

4. Upon approval of your application, your CPF savings or part thereof will be forwarded to Inland Revenue
Authority of Singapore (IRAS) to settle your tax liabilities (if any).

CPF LIFE SCHEME

For members who have a CPF LIFE policy:


If your application to withdraw your CPF is approved, you will be given more details to decide whether to:
a) Terminate your annuity policy and receive a refund of the unused annuity premium[1]; or
b) Retain your annuity policy, and receive the annuity monthly payments from your annuity payout start age for as
long as you live.

Termination of your annuity policy is subject to terms and conditions and the Boards approval. There will be no
refund if you are covered under the LIFE Income Plan or if your unused annuity premium is zero.

For members who do not have a CPF LIFE policy:


If your application to withdraw your CPF is approved, you will not need to join CPF LIFE.

IMPORTANT : An incomplete form and / or supporting documents will delay the processing of your
application.

CONTACT DETAILS
Website / Email Call Centre
Website: www.cpf.gov.sg 1800-227-1188 (local)
Email : member@cpf.gov.sg 65-6227-1188 (overseas)

[1] The unused annuity premium is the premium paid for the annuity policy less any monthly annuity payment that has been made.

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