Professional Documents
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Give this form to your employer to ask them to pay your super into your AustralianSuper account.
Complete in pen using CAPITAL letters or type directly into this form and print it out. Use to mark boxes.
V a
First name
K h
Mr
Ms
Mrs
Miss
Dr
Date of birth
D
1
D
4 M
1 M
1 Y
1
Y
9
Y
8
Y
2
Street address
M a
R o
Suburb
State
Postcode
* The law allows super funds to ask for TFNs. You dont have to give your TFN but its a good idea if you do. It helps you keep track of your money,
allows you to pay extra super contributions and makes sure super gets taxed at the special low rate.
STA0100AU
Sign here:
Date
D M M
Compliance statement
AustralianSuper is a complying, resident and regulated super fund
within the meaning of the Superannuation Industry (Supervision)
Act 1993 (SIS Act), AustralianSuper has never received a notice of
non-compliance and is not subject to a direction under section 63
of the SIS Act. This means AustralianSuper can accept all types of
super contributions in accordance with the SIS Act. AustralianSuper
is a registrable superannuation entity and is eligible to be nominated
as a default fund as it meets the minimum statutory insurance
cover requirements for choice of fund. The Trustee of the Fund is
AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788.
Record of choice: Please note when you accept and action this choice of fund.
Date valid choice is accepted
D M M
D M M