COVID-19/PHASE 2/ROUND 5

EARLY WITHDRAWAL Were you assisted in COVID-19/Phase1

UNEMPLOYMENT/ LWOP Please tick

YES NO

SECTION A: DECLARATION
I understand and agree that:
a) I have read, understood and completed the form and all particulars are true and correct;
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b) herebyI indemnify the FNPF Board from any liability whatsoever, including any loss of that may arise from the
approval of this application;
c) My application is subject to the provisions in the FNPF Act 2011 and all such rules or guidelines that may be imposed from
time to time;

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d) Terminated/permanently laid off /Leave without pay/resigned and still without full time employment since October 2019;
e) Any misuse of funds may result in prosecution and the Fund reserves the right to cease further withdrawals;
f) I understand that I am responsible for the of information received through my preferred communication
medium;
g) I hereby indemnify the Fund from any liability whatsoever, including the loss of privileged information received through the
preferred communication medium.

Signature of Member (As in FNPF Records) Date

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SECTION B - COVID-19 WITHDRAWAL CONSENT
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“I agree to be continually assisted for COVID-19 withdrawal through the fortnightly deduction of $220 from my General
Account until such time the minimum balance is $35. I also agree that, if need be, Government will top up this assistance until
such time it decides otherwise.”

Please tick: Yes No

SECTION C: PARTICULARS OF APPLICANT

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1. Member Number:

3. Full Name (as on Birth

2. TIN:
2
4. Date of Birth: 5. Phone Number:
1
6. E-mail Address:

SECTION D - METHOD OF PAYMENT (Please tick a box)

You can only opt for EFT payment if the following applies:
1. You had applied in Phase 1, 2 Round 4 and the same bank account is valid
2. You did not apply in Phase 1, 2 or 3
If the above does not apply to you then you must opt for M-PAISA.

Direct deposit to my bank account (EFT)

Account Name:

Bank Name: Account No:

Payment via Bill Pay (Post Fiji):

Name:

Phone No:

Head Office Provident Plaza 2 Private Mail Bag, Suva Telephone: (679) 330 7811 Facsimile: (679) 330 7611
Follow us on
Email: information@fnpf.com.fj Website:www.myfnpf.com.fj

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 Payments via M-PAISA Money Transfer:

Name:
Mobile No*: *FNPF will not be responsible for incorrect transfers resulting from any incorrect/invalid bank
account or mobile numbers provided by the member.

EXPLANATORY NOTES:
Who can apply? When will I receive my funds?
Members who have a positive FNPF balance and:
• withdrew in Phase 2 (Round 1,2,3,4) Cycle Application Deadline Payment Date
• are applying for the time & have been Unemployed 1 1 April 2021 6 April 2021
from 1 October 2019 or have just become Unemployed
2 15 April 2021 20 April 2021
or are on Leave without pay.
3 29 April 2021 4 May 2021
What am I entitled to? 4 13 May 2021 18 May 2021
The maximum amount allowed for withdrawal is
5 27 May 2021 1 June 2021
$1,100 per member from their General Account (GA).
Government will top up to the maximum amount for The application must be received and approved before the
members with General Account. application deadline, to receive the installment.

How can I lodge my application? Any missed cycle payments will be paid in the members first
payment.
You must apply on the:
• myFNPF app - no form required How will I receive my funds?
• Employer portal - form required You will receive $220 on a fortnightly basis and will be paid out
The form is also available on our FNPF website. either through:
What documents will I need to submit with this • Direct Transfer to Bank Account
application? • M-PAISA
• Valid bank account details (if applicable) • Post Fiji Bill Pay
• Letter of Unemployment (if applying for the first time
and on the myFNPF app) NOTE: Any Early Withdrawal reduces any future Early Withdrawal Entitlement
and reduces your retirement funds for pension or lump sum upon reaching the
qualifying age of 55 years or upon full withdrawal.

Head Office Lautoka Labasa Sigatoka Branch Nadi Agency Savusavu Agency Ba Agency Valelevu Agency Nausori Branch
Provident Plaza 2 Shop 5, Provident Centre, 6 Rosawa Street Shop 3-4, Hanif Shop 2, Lot 13 Concave Budget Lodge Build- Ganga Singh Street, Ba Shop 3, Rajendra Prasad Lot 1, Main Street,
Private Mail Bag, Suva Naviti Street,Private Mail Bag, Private Mail Bag,Labasa Building, Matamata Subdivision ing Ltd Telephone: (679) Bros Supermarket Com- Nausori Telephone: (679)
Telephone: (679) 330 7811 Lautoka Telephone: (679) Subdivision Namaka Lane, Nadi Main Street, Savusavu 667 0009 plex Valelevu Complex 323 8030, (679) 323 8031
Facsimile: (679) 330 7611 Telephone: (679) 666 1888 881 2111 Phone: (679) 666 1888 Telephone: (679) 323 8018, 323 8006 Telephone: (679) 885 3396 Facsimile: (679) 323 8007 Building

Facsimile: (679) 666 5232 Facsimile: (679) 881 2741 Facsimile: (679) 672 8982 Facsimile: (679) 885 3397 Saqa Place, Valelevu
Telephone: (679) 3343 671
Facsimile: (679) 3343 670
Email: information@fnpf.com.fj Website:www.myfnpf.com.fj

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