Superannuation Benefits Form

Superannuation Benefits Form

Use this form to nominate your superannuation fund, specify contribution arrangements (including salary sacrifice), make beneficiary nominations, and provide authorisations required by the employer to process superannuation contributions on your behalf. Complete all sections in full and sign the declaration at the end to authorise the instructions.

Personal Information

Date of birth: / /

Position Information

Employment start date:

Employment History (most recent first)

Education

Graduation date:

References

Superannuation Fund Details & Election

I instruct the employer to remit superannuation contributions to:

Contribution Elections

If salary sacrifice selected, enter amount or percentage to be sacrificed from gross pay:

Contribution commencement date:

Beneficiary Nomination

Select nomination type (see declaration for legal effect):

Primary beneficiary 1

Primary beneficiary 2

Tax File Number (TFN) Consent

I consent to the employer providing my Tax File Number (TFN) to the nominated fund for the purpose of processing contributions and complying with tax reporting obligations. I understand that providing my TFN is voluntary but may affect tax treatment of contributions and the ability to accept certain contributions.

Legal Disclosures & Applicant Certification

At-Will Employment: Nothing in this benefits election alters the employment relationship. Employment remains subject to the terms of the employment contract and applicable workplace policies.

Equal Opportunity: The employer is committed to equal opportunity and does not discriminate in the provision of benefits on the basis of protected characteristics.

Declaration and Authorisation: I certify that the information provided on this form is true and complete. I authorise my employer to:

• Remit superannuation contributions to the fund nominated herein in accordance with my election and applicable law;
• Make adjustments to payroll to give effect to salary sacrifice or voluntary contribution elections;
• Provide my TFN and other required details to the nominated fund for the purpose of processing contributions and complying with tax and superannuation law;
• Contact the nominated fund or previous employers to validate membership details or obtain information necessary to transfer or consolidate balances.

Background and Employment Checks: I authorise the employer to contact my previous employers and referees listed on this form for the purposes of verifying employment history. I further authorise reasonable background checks required as a condition of employment, where permitted by law.

Binding Nomination Acknowledgement: If a binding death benefit nomination is selected, I acknowledge that the nomination will only be effective where it complies with the rules of the nominated fund and any statutory requirements; the trustee retains power to accept or reject a nomination where permitted by the fund rules.

Applicant Certification: I certify under penalty of perjury that the information provided on this form is true, accurate and complete. I understand that knowingly providing false information may result in disciplinary action, including termination of employment.

Employer Use Only

Date processed:

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