Employer sponsored division member details by lindahy

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									              Employer sponsored division member details
                  Please print clearly in black ink.
                  Your employer has chosen First State Super as the superannuation fund to which your superannuation guarantee (SG) contributions will be
                  paid. As a result, a First State Super member account has been automatically opened for you. We now require you to provide the information
                  requested in this form so we have all the information we need to manage your superannuation account.

                  1. Your personal details
              Title (Mr Mrs Ms Miss Dr)                 Male         Female                Birth date        (DD-MM-YYYY)

                                                                                                         -                 -
              Family name


              Given name/s


              Postal address


              Suburb                                                                                                                          State   Postcode


              Daytime contact telephone number                                                                                Mobile number


              Email address




                      I would like to receive newsletters from First State Super at the email address listed above?

                  2. Your employer details
              Name of employer



                  3. Your tax file number
                  Importance of providing your tax file number (TFN)
                  Under the Superannuation Industry (Supervision) Act 1993, your superannuation fund is authorised to collect your TFN, which will only be
                  used for lawful purposes. These purposes may change in the future as a result of legislative change. The trustee of your superannuation
                  fund may disclose your TFN to another superannuation provider when your benefits are being transferred, unless you request the trustee
                  of your superannuation fund in writing that your TFN not be disclosed to any other trustee.
                  It is not an offence not to quote your TFN. However giving your TFN to your superannuation fund will have the following advantages
                  (which may not otherwise apply):
                  ■   your superannuation fund will be able to accept all types of contributions to your account/s;
                  ■   the tax on contributions to your superannuation account/s will not increase;
                  ■   other than the tax that may ordinarily apply, no additional tax will be deducted when you start drawing down your superannuation
                      benefits; and
                  ■   it will make it much easier to trace different superannuation accounts in your name so that you receive all your superannuation benefits
                      when you retire.
                  Otherwise your TFN will be treated confidentially.

              Tax file number




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              FSS 035 05/09 p1
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                 If you need help with this form: Contact Customer Service between
                 8:30 am and 5:30 pm AEST from Monday to Friday on 1300 650 873
              FSS Trustee Corporation ABN 11 118 202 672 AFSL 293340 as the trustee of First State Super Scheme ABN 53 226 460 365                                  Page 1 of 2
  4. What contributions will be made to First State Super?

  Please cross   7 the relevant boxes for the type of contributions you anticipate will be received by First State Super.
  Note: to be eligible to make a non-concessional (personal after-tax) contribution, you must have provided your TFN to the Fund.

        Employer superannuation guarantee (SG) contributions
        Concessional (salary sacrifice) contributions OR non-concessional (after-tax) contributions by payroll deduction – use the form
        FSS 010 Contributions by payroll deduction
        Non-concessional (personal after-tax) contributions – use the form FSS 011 Contributions by cheque OR FSS 021 Contributions by
        electronic funds transfer (EFT)
        Spouse contributions – use the form FSS 011 Contributions by cheque

        Spouse contributions splitting – use the form FSS 038 Application to split superannuation contributions

        Rollover/transfer funds from other complying superannuation funds – use the form FSS 020 Request to transfer benefits to
        First State Super

  Please note that special conditions apply to contributions made from the proceeds of a personal injury payment or a CGT event. For more
  information, please call Customer Service on 1300 650 873.


  5. Member declaration
  I hereby:
  ■   Acknowledge receiving the current First State Super Member Booklet dated 1 May 2009.
  ■   Declare that all information supplied by me in this form is accurate and complete.
  ■   Understand that if I do not choose an investment strategy my superannuation account will automatically be invested according to the
      default investment option chosen by the Trustee, as set out in the Member Booklet.


Signature

                                                                                                   Date

                                                                                                              -             -
  6. Checklist
        I have completed all relevant sections of the Employer sponsored division member details form.

        I have received the current First State Super Member Booklet.

        I wish to nominate beneficiaries and have completed and returned the Nomination of beneficiaries form.

        I wish to elect my own strategy for investment purposes and have completed and enclosed the Choice of investment strategy form.

        I wish to apply for additional insurance cover and have completed and enclosed the Application for insurance form.

        I have signed and dated the Section 5 Member declaration.




       Return the completed form to First State Super PO Box 1229 WOLLONGONG NSW 2500
       If you have any enquiries please call Customer Service on 1300 650 873 between 8:30 am and 5:30 pm
       AEST from Monday to Friday for the cost of a local call (unless calling from a mobile or pay phone).




FSS 035 05/09 p2
                                                                                                                      Clear form            Print




  If you need help with this form: Contact Customer Service between
  8:30 am and 5:30 pm AEST from Monday to Friday on 1300 650 873
                                                                                                                                             Page 2 of 2

								
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