Version As at 12 September 2017.This Is a Standard Template. Please Do Not Alter the Form

Version as at 12 September 2017.This is a standard template. Please do not alter the form except where inserting details of the request. The template form can be accessed electronically at

REQUEST FOR DISTRIBUTION FROM THE ‘[TRUST NAME]’
Please complete, date and sign the form and return it to

Requesting body to complete

Name, position, telephone number and email address of the person making the request for money/relevant administrative contact person / [Insert]
Date by which the money is sought (or period of time over which the money is required) / [Insert]
Amount sought, and where relevant, frequency of the distributions sought (e.g. monthly, yearly) / [Insert]
Which UCA Funds Management portfolio the money is to be withdrawn from (e.g. Cash Portfolio, Growth Portfolio, Equities Portfolio) / [Insert]
Explanation of the purpose for which the money is sought / [Insert]
Payment method for the money sought (e.g. EFT, cheque) / [Insert payment details, e.g. account name, BSB number, account number, or who the cheque should be made out to]
Signature:
Name and title:
Date: / [Insert]
[Insert]
[Insert] / [Insert]
[Insert]
[Insert]

Synod Trusts Officer (or Synod lawyer) to complete

Will/Trust Deed (‘the trust instrument’) / [Insert]
Date of the trust instrument / [Insert]
Relevant clause/s in the trust instrument / [Insert]
Date and terms of the sanction altering the trust instrument (if any) / [Insert]
Capital at the end of the previous financial year / [Insert]
Accrued income at the end of the previous financial year / [Insert]
Approval of Synod lawyer: / Signature: [Insert]
Name: [Insert]
Date: [Insert]
Approval of Senior Lawyer – Trusts: / Signature: [Insert]
Name: [Insert]
Date: [Insert]
Resolution of The Uniting Church in Australia Property Trust (Victoria): / Resolution number: [Insert]
Date: [Insert]
OR
Resolution of The Uniting Church in Australia Property Trust (Tas.): / Resolution number: [Insert]
Date: [Insert]