Joint Authorisation Access

Joint Authorisation Access

strictly private & confidential
Personal Details
Employee Name*

First NameLast Name
Employer*
Email Address*
example@example.com
Payroll Number*
Please complete if you would like to request for an additional person to be authorised to gain access to your Salary Packaging details.
The nominated person will need to advise their full name and your payroll number to gain access to information regarding your Salary Package. Please indicate below type of access allowed.*

Allow access to discuss details onlyAllow access to make amendments on your behalf
Details of Nominated Person
Name*

First NameLast Name
Relationship*
Authorisation Declaration*
Type 'confirm' to authorise
Employee Signature

Clear
Or upload e-signature

Browse Files

Cancelof
I certify that all information provided as part of this application is true and correct to the best of my knowledge.
Should be Empty: