Superannuation Fund Choice Form SU01a This document is a form. To move between data fields press the TAB key. Use the Spacebar to check/uncheck a check box. Employee Name: Staff Number: E-mail Address: Telephone: Extension: Home: Important Information – Complete EITHER Part A OR Part B You do not have to make a choice; contributions made on your behalf will be paid into the fund that ICL Pty Ltd has chosen (see Part A of this form). This may not be the same as your current fund. Choice of Fund will be actioned in the first pay period of the month following receipt of the request. PART A – Employee to complete if selecting the default fund I request that all future superannuation contributions be made to my employer’s fund Employer Name: ICL Pty Ltd Fund Name: Unisuper Signature (Employee): Date: ____________ Return this form to the Office of Human Resources. Do NOT send this form to the ATO or your Superannuation Fund. PART B – Employee to complete ONLY if making a choice I request that all future superannuation contributions be made to my choice of fund 1. Your chosen fund details: Please note: Form will be returned to you if incomplete. Superannuation contributions will be made to the default fund until the form is correctly completed and returned to the Office of Human Resources. Fund Name: Membership Number: Account Name: Fund Australian Business Number (ABN) if applicable: Superannuation Product Identification Number (SPIN)*: * SPIN is mandatory and must be in the format “XXX9999XX” i.e. 3 letters followed by 4 digits followed by 2 letters. 2. I have attached the following supporting documentation (all of which is mandatory): a letter from the trustee stating that this is a complying fund and (for a self-managed superannuation fund ) a copy of documentation from the Australian Taxation Office confirming that this fund is regulated, written evidence from this fund that they will accept contributions from my employer, and details about how my employer can make contributions to this fund. Signature (Employee): Date: ____________ Return this form to the Office of Human Resources. Do NOT send this form to the ATO or your Superannuation Fund.
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