(i) | name of the superannuation fund; | |
(ii) | name and address of the employee; | |
(iii) | the period for which the employee has contributed to the superannuation fund; | |
(iv) | the amount of contribution repaid on account of principal and interest; | |
(v) | the average rate of deduction of tax during the preceding three years; and | |
(vi) | the amount of tax deducted on repayment. |
(2) A verification in the following Form shall be annexed to the statement referred to in sub-rule (1) :
FORM OF VERIFICATION
We/I, the trustee(s) of the above named fund, do declare that what is stated in the above statement is true to the best of our/my information and belief.