Entity Establishment Form - SMSF

Establishment Form

SMSF
1. Preferred Fund Name*
2. Trustee*
Corporate Trustee Name = Superannuation Fund Name

Example: Smith Group Pty Ltd (As Trustee For) Smith Group Superannuation Fund
3. Number of Members*
Member Details
Member 1
1A. Name*

Mr. / Mrs. / Ms.First NameMiddle NameLast Name
1B. Occupation*
1C. Date of Birth*

DayMonthYear
1D. Country of Birth*
1E. City of Birth*
1F. Address*

Street Address

Street Address Line 2

SuburbState

Post Code
1G. Tax File Number (TFN)*
1H. Email*
1I. Mobile Number*
Format: 0000 000 000.
1J. Upload ID (Driving Licence or Pasport)*

Cancelof
1K. Bank Details*

Account Name

Street Address Line 2

BSBAccount Number

Postal / Zip Code
1L. Director Identification Number (DIN)*
If you do not have a DIN:
- Apply DIN here: https://www.abrs.gov.au/director-identification-number/apply-director-identification-number
- DIN instructions video: https://www.abrs.gov.au/video-how-apply-director-id

Member 2
2A. Name*

Mr. / Mrs. / Ms.First NameMiddle NameLast Name
2B. Occupation*
2C. Date of Birth*

DayMonthYear
2D. Country of Birth*
2E. City of Birth*
YesNo
2F. Address*

Street Address

Street Address Line 2

SuburbState

Post Code
2G. Tax File Number (TFN)*
2H. Email*
2I. Mobile Number*
Format: 0000 000 000.
2J. Upload ID (Driving Licence or Pasport)*

Cancelof
2K. Director Identification Number (DIN)*

Member 3
3A. Name*

Mr. / Mrs. / Ms.First NameMiddle NameLast Name
3B. Occupation*
3C. Date of Birth*

DayMonthYear
3D. Country of Birth*
3E. City of Birth*
YesNo
3F. Address*

Street Address

Street Address Line 2

SuburbState

Post Code
3G. Tax File Number (TFN)*
3H. Email*
3I. Mobile Number*
Format: 0000 000 000.
3J. Upload an ID (Driving Licence or Pasport)*

Cancelof
3K. Director Identification Number (DIN)*

Member 4
4A. Name*

Mr. / Mrs. / Ms.First NameMiddle NameLast Name
4B. Occupation*
4C. Date of Birth*

DayMonthYear
4D. Country of Birth*
4E. City of Birth*
YesNo
4F. Address*

Street Address

Street Address Line 2

SuburbState

Post Code
4G. Tax File Number (TFN)*
4H. Email*
4I. Mobile Number*
Format: 0000 000 000.
4J. Upload an ID (Driving Licence or Pasport)*

Cancelof
4K. Director Identification Number (DIN)*

Member 5
5A. Name*

Mr. / Mrs. / Ms.First NameMiddle NameLast Name
5B. Occupation*
5C. Date of Birth*

DayMonthYear
5D. Country of Birth*
5E. City of Birth*
YesNo
5F. Address*

Street Address

Street Address Line 2

SuburbState

Post Code
5G. Tax File Number (TFN)*
5H. Email*
5I. Mobile Number*
Format: 0000 000 000.
5J. Upload an ID (Driving Licence or Pasport)*

Cancelof
5K. Director Identification Number (DIN)*

Member 6
6A. Name*

Mr. / Mrs. / Ms.First NameMiddle NameLast Name
6B. Occupation*
6C. Date of Birth*

DayMonthYear
6D. Country of Birth*
6E. City of Birth*
YesNo
6F. Address*

Street Address

Street Address Line 2

SuburbState

Post Code
6G. Tax File Number (TFN)*
6H. Email*
6I. Mobile Number*
Format: 0000 000 000.
6J. Upload an ID (Driving Licence or Pasport)*

Cancelof
6K. Director Identification Number (DIN)*

Ackowledgement & Authorisation
I authorise SR Perks to establish the above superannuation structure, debit the bank account for the professional fees, appoint as the Tax Agent, appoint as the ASIC Agent, and establish ESA (Electronic Service Address) account with Wrkr SMSF.

I am unaware, or have no reasonable grounds to suspect, that a person who is, or is acting as, a responsible officer of the trustee is a disqualified person as defined in section 120(1) of the Superannuation Industry (Supervision) Act 1993.
Name*
Signature*

Clear
Date*

DayMonthYear
Should be Empty: