Fillable CSC01 2019 F Change of personal details

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CSC01 2019 F Change of personal details

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Country of origin: AUSTRALIA
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Any nancial product advice provided in this document is general advice only and has been prepared without taking account of your personal objecves, nancial situaon or needs. Before acng
on any such general advice, you should consider the appropriateness of the advice, having regard to your own objecves, nancial situaon and needs. You may wish to consult a licensed nancial
advisor. Before making any decision in relaon to a scheme or nancial product referred to in this document, you should obtain a copy of the Product Disclosure Statement for that scheme or product.
Important information about this form
What this form is for
Use this form to update your personal details and or advise a change to your name.
How to use this form
Please use CAPITAL LETTERS and a black or blue pen.
Mark boxes like this
with a
or
then fill out the next question or section.
CSC01
11/19
Change of personal details
You can also change
your personal details
online at csc.gov.au using
your Access Number.
A
Provide your personal details
AGS or service number
Scheme
CSS
PSS
DFRDB
Military
Super
PSSap
ADF
Super
CSCri
ADF
Cover
Please note: You should select each scheme your details should be updated for.
Your details as they currently appear on your account
Title
Mr Mrs Ms Miss Other
Surname
Given name(s)
Date of birth
D D M M Y Y Y Y
/ /
Postal address
SUBURB STATE POSTCODE
Your privacy is important to us
We’re committed to protecting your privacy. We collect your personal information for the purposes of providing
superannuation services to you, improve our products and to keep you informed. We will only share your personal
information where necessary for providing superannuation services to you. This may include disclosing your personal
information to our scheme administrator, service providers or government or regulatory bodies. Your personal information
may be accessed overseas by our service providers. Please see our privacy policy for full details. Your personal information
will not be otherwise used or disclosed unless required or permitted under law.
A full copy of our privacy policy as well as the privacy complaint process is available at csc.gov.au/Members/Privacy-policy/
CSC01 1 of 3
B
Your new personal details
Postal address
SUBURB STATE POSTCODE
Contact details
MOBILE NUMBER
BUSINESS HOURS
AFTER HOURS
Email
@
Is this email your home or work email address?
Home
Work
How would you like to receive any correspondence from us?
Postal address
Email
Change of name
If you’re still serving or are employed with an eligible employer, please notify Defence/your employer
of your change of name. Please complete this section if you’re:
• not currently serving
• not currently employed by an eligible employer or
• a PSSap choice member.
In order to change your name on our records, we need a certified copy of your:
marriage certificate with your new name,
OR
birth certificate if you have changed back to your maiden name,
OR
change of name certificate if you have changed your name by deed poll.
Your new name
Title
Mr Mrs Ms Miss Other
Surname
Given name(s)
Gender
Male Female Other
Please note:
PSSap, CSCri and ADF
Super members are required
to post their proof of change
of name. Emailed copies of
marriage, birth or change of
name certificates can’t
be accepted.
!
CSC01 2 of 3
C
Declaration
I,
FULL NAME
declare that the information I have provided on this form is complete and correct.
SIGNATURE
Date of declaration
D D M M Y Y Y Y
/ /
D
Submit your form
We can accept your completed form by email* or post. Don’t forget to attach your certified document
if you’re changing your name.
* PSSap, CSCri and ADF Super members must provide their proof of change of name by post. Copies
sent by email can’t be accepted.
Sign
End Form
by post to:
by email to:
CSS, PSS, DFRDB, MilitarySuper and ADF Cover
please email your form to: formsandapplications@csc.gov.au
CSS, PSS, DFRDB, MilitarySuper and ADF Cover
please post your form to: GPO Box 2252, Canberra, ACT 2601
PSSap
please email your form to: formsandapplications@pssap.com.au (excluding change of name)
PSSap
please post your form to: Locked Bag 9300, Wollongong, NSW 2500
ADF Super
please email your form to: formsandapplications@adfsuper.gov.au (excluding change of name)
ADF Super
please post your form to: Locked Bag 9400, Wollongong DC, NSW 2500
CSCri
please email your form to: formsandapplications@cscri.com.au (excluding change of name)
CSCri
please post your form to: Locked Bag 8840, Wollongong, NSW 2500
CSC01 3 of 3
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CSC01 2019 F Change of personal details

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Completed 3 July 2020

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