Clone of D.DAVIS NEW EMPLOYMENT STARTER FORM

1
SUPERANNUATION & ATO DECLARTIONTo get you set up for payroll, please complete your Tax File Number (TFN) Declaration and Superannuation details through myGov.
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2
FULL NAME
Mr
Mr
Ms
Mrs
Miss
3
DATE OF BIRTH
Date
Month
Day
Year
4
CONTACT NUMBER
5
EMAIL ADDRESS
6
RESIDENTAL ADDRESSProvide your current residential and postal address details.
Street Address
Street Address
City
State
Post Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
7
POSTAL ADDRESS
Street Address
Street Address
City
State
Postal Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
8
ARE YOU AN AUSTRALIAN CITIZEN?
Please Select
Please Select
Yes
No
Working Visa
Sponsored Visa
9
ARE YOU OF ABORIGINAL OR TORRES STRAIT ISLANDER ORIGIN?
Please Select
Please Select
No
Aboriginal
Torres Strait Islander
Both
10
ARE YOU FIT FOR WORK AND ABLE TO PERFORM THE INHERENT REQUIREMENTS OF THE ROLE?
Please Select
Please Select
Yes
No
11
INJURIES OR PHYSICAL LIMITATIONSThis information is important for ensuring you meet site requirements and can work safely.
DO YOU HAVE ANY INJURIES OR PHYSICAL LIMITATIONS THAT MAY AFFECT YOUR WORK?
Please Select
DO YOU HAVE ANY INJURIES OR PHYSICAL LIMITATIONS THAT MAY AFFECT YOUR WORK?
Yes
No
12
MEDICAL CONDITIONSThis information is important for ensuring you meet site requirements and can work safely.
DO YOU HAVE ANY MEDICAL CONDITIONS?
Please Select
DO YOU HAVE ANY MEDICAL CONDITIONS?
Yes
No
DO YOU TAKE PERSCRIBED MEDICATION?
Please Select
DO YOU TAKE PERSCRIBED MEDICATION?
Yes
No
13
EMERGENCY CONTACT FULL NAME
First Name
Middle Name
Last Name
14
CONTACT NUMBER
Please enter a valid phone number.
15
RELATIONSHIP
Please Select
Please Select
Parent
Spouse
Partner
Sibling
Friend
Relative
Guardian
Other
16
RESIDENTIAL ADDRESS
Street Address
Street Address Line 2
City
State
Post Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
17
BANK NAME
18
BSB
19
ACCOUNT NUMBER
20
SHIRT SIZE
Please Select
Please Select
XS
S
M
L
XL
2XL
3XL
4XL
Other
21
PREFERRED SHIRT BRAND
Please Select
Please Select
Hard Yakka Hi-Vis
Bisley Hi-Vis
KingGee Hi-Vis
JB’s Wear Hi-Vis
Syzmik Hi-Vis
22
PANT SIZE
Please Select
Please Select
28
30
32
34
36
38
40
42
44
46
48
50
Other
23
PREFERED PANT STYLE
Please Select
Please Select
Hard Yakka
KingGee
FXD
Bisley
CAT / Anthem
Kmart - slim fit
Other
24
BOOT SIZE
Please Select
Please Select
5
6
7
8
9
9 - 1/2
10
10 - 1/2
11
11 - 1/2
12
13
Other
25
PREFERED BOOT STYLE
Please Select
Please Select
Oliver AT 55 (Lace-Up)
Oliver AT 55 (Zip-Sided)
Steel Blue Southern Cross
Steel Blue Argyle
Steel Blue Parkes
Blundstone (Zip-Sided)
Blundstone (Elastic Sided)
Mongrel (Zip-Sided)
Mongrel (Lace-Up)
Redback (Slip-On)
Mack Boots
Other (please specify)
26
Qantas Frequent Flyer Number
27
Virgin Frequent Flyer Number
28
Driver's Licence Number
29
Driver's Licence Expiry
Date
Month
Day
Year
30
Driver's Licence Class
Please SelectC
C
LR
MR
HR
HC
MC
Suspended
Other
31
State of Issue
Please Select
Please Select
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
32
Do you have any current or pending legal matters that may affect your ability to hold or maintain a valid driver’s licence?
YESNO
33
Do you have any restrictions or bans that may prevent you from accessing mine sites in Western Australia?Please provide details below
34
FMGPlease provide you site email and site number
Please enter your email
35
RIO TINTOPlease provide you site email and site number
Please enter your email
36
BHPPlease provide you site email and site number
Please enter your email
37
ROY HILLPlease provide you site email and site number
Please enter your email
38
Trade Certificate & QualificationsIf applicable, please attach.
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39
VET Training TranscriptIf applicable, please attach.
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40
Current Driver's LicenceThis Document is a requirement, please attached front and back of photos of your current licence
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41
Birth Certificate or PassportIf applicable, please attach.
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42
High Risk Work LicenceIf applicable, please attach.
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43
Working at Heights CertificateIf applicable, please attach.
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44
White CardIf applicable, please attach.
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45
Confined Spaces / First Attack Fire Fighting CertificateIf applicable, please attach.
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46
Passport Style Photo for Site Onboarding
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47
Medical/Fit for Work CertificateNo older than 12 months
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48
Current LAB DASNo older than 3 months
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49
Site Access / Training CopiesIf applicable, please attach.
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50
Additional Certificates (e.g. Police Clearance)If applicable, please attach.
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51
SIGNATURE
52
FULL NAME
First Name
Last Name
53
DATE
Date
Month
Day
Year
Should be Empty: