Superannuation Payment Form

Superannuation Payment Form

Purpose: Use this form to provide or amend superannuation fund details and to instruct your employer as to the treatment of employer contributions, salary sacrifice, and additional voluntary payments. Information supplied is used to make payments to the nominated fund and to document employee authorization for payroll processing. All fields are mandatory unless marked optional.

Personal Information

Phone:     Email:

Date of birth:

Position and Employment

Reporting manager:     Employment start date:

Annual salary or base rate: $

Permanent    Fixed term    Casual    Contractor

Superannuation Fund Details

Fund contact phone:     Fund email:

Industry fund    Retail fund    Self-managed super fund (SMSF)    Personal / Other

Contribution Instructions

Employer mandatory contribution (Super Guarantee)    Salary sacrifice    Additional voluntary contributions

Contribution rate (percentage):     Or fixed amount per pay: $

Payment frequency: Weekly Fortnightly Monthly Quarterly

Requested commencement date for contributions:     Requested end date (optional):

Payment Method (if applicable)

BSB:     Account number:     Account name:

Tax Identification

I acknowledge that if I do not provide a tax identification number, the fund or employer may be required to withhold tax from contributions in accordance with applicable law.

Legal Disclosures and Statements

At-Will Employment Statement: Where permitted by law, employment in this organisation is on an at-will basis unless a written contract states otherwise. This form does not constitute a contract of employment. Nothing in this form alters the employment relationship except as expressly stated in a separate written agreement.

Equal Opportunity: The employer maintains a policy of equal employment opportunity. Decisions regarding superannuation arrangements will be administered without unlawful discrimination and consistent with relevant workplace laws and internal policy.

Applicant Certification & Authorization

I certify that the information provided on this form is true and correct to the best of my knowledge. I authorise my employer to make superannuation payments to the fund and account described above, to implement agreed salary sacrifice arrangements and to withhold amounts from my remuneration for that purpose. I authorise the fund or its administrator to provide information necessary to effect contributions.

I authorise my employer to contact prior employers and the nominated fund to verify membership details where reasonably necessary to ensure correct payment of superannuation contributions. I acknowledge that my employer may rely on the details provided and that it is my responsibility to notify payroll in writing of any changes.

Employment History (most recent)

Title:     From:     To:

Title:     From:     To:

Education

Graduation date:

References

Phone:     Email:     Relationship:

Phone:     Email:     Relationship:

Phone:     Email:     Relationship:

Acknowledgement and Consent

By signing below I acknowledge that I have read and understand the information provided. I consent to the release of details contained herein to the nominated fund and to my employer's payroll provider where required to effect contributions. I accept responsibility for ensuring the accuracy of these details and will promptly notify payroll of any changes in writing.

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