Superannuation Standard Choice Form

Superannuation

Standard Choice Form
Section A: Employee to complete
1. Your details
Name

First NameMiddle NameLast Name
Employee identification number (if applicable)
Tax File Number (TFN)
2. Choice of superannuation (super) fund
Choice of Superfund - please select
3. Nominating your APRA fund or RSA
You will need current details from your APRA regulated fund or RSA to complete this item.
Fund ABN
Fund Name
Fund Address

Street Address

Street Address Line 2

CityState

Postcode
Fund Phone Number

Area CodePhone Number
Unique superannuation identifier (USI)
Product Name (If applicable)
Your account name
Your member number
4. Nominating your self-managed super fund (SMSF)
You will need current details from your SMSF trustee to complete this item.
Fund Name
Fund Address

Street Address

Street Address Line 2

CityState

Postcode
Fund Phone Number

Area CodePhone Number
Fund Electronic service address (ESA)
Fund Bank Account
BSB code (please include all six numbers)
Fund Bank Account
Account number
If you are not the trustee, or a director of the corporate trustee of the SMSF, then you must attach a letter from the trustee confirming that the fund will accept contributions from your employer.
Attach document

Browse Files

Cancelof
5. Signature and date

If you have nominated your own fund it Item 3 or 4, check that you have attached the required documentation and then place an 'X' in the box below.
Date

DayMonthYear
Date
Signature
Section B: Employer to complete

You must complete this section before giving the form to an employee who is eligible to choose the super fund into which you pay their super contributions.
6. Your details
Business Name

Davies Bakery Pty Ltd

ABN

25 123 302 036
Signature
Date

DayMonthYear
Date
7. Your nominated super fund
If the employee does not choose their own super fund, you are required to pay super contributions on their behalf of the fund that you have nominated below:
Super fund name

ANZ Smart Choice Super

Unique superannuation identifier (USI)

MMF2076AU

Phone (for the product disclosure statement for this fund)

131287

Super fund website address

www.anz.com/smartchoice
PRIVACY STATEMENT

The ATO does not collect this information; we provide this form as a means for employees ot identify and provide necessary information to their employer. An employer is authorised to collect an employee's TFN under the Superannuation Industry (Supervision) Act 1993. It is not an offence for an employee not to quote their TFN. However, quoting a TFN reduces the risk of administrative errors and if the mployee does not quote their TFN their contributions may be taxed at a higher rate. An employee can get more details regarding their privacy rights by contacting their superannuation fund.
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