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Email
CSS and PSS: employer.service@admin.csc.gov.au
PSSap: employers@pssap.com.au
Phone
CSS and PSS: 1300 338 240
PSSap: 1300 308 806
Fax
CSS and PSS: (02) 6272 9996
PSSap: 1300 364 144
Web
eac.csc.gov.au
Fax
(02) 6272 9613
Email
employer.service@csc.gov.au
Phone
1300 338 240
Fax
(02) 6275 7010
Post
Employer Service
GPO Box 2252
Canberra ACT 2601
Web
csc.gov.au
Overseas Callers
+61 2 6275 7000
What is the pay day of the final contributions (or other final adjustment)?
D D M M Y Y Y Y
/ /
What is the amount of this contribution (or adjustment)?
$
Please note: You should ensure that you balance the contributions by the last payday immediately before their date of exit.
Personnel checklist
Yes Benefit application form provided to member
Yes Superannuation history print out
Yes N/A Details of any part- time hours worked
Yes N/A Details of any periods of LWOP including maternity/parental LWOP
Yes N/A Retirement certificate attached
Certification by employer
I,
GIVEN NAME(S)
SURNAME
being the officer authorised to sign on behalf of the eligible employer, declare that the above information is true and
correct, and certify that no variations to contributions will be made subsequent to the ceasing entry shown above.
Phone
Email
@
SIGNATURE
Date signed
D D M M Y Y Y Y
/ /
Please email the completed Departmental Report to formsandapplications@csc.gov.au
Where can I get
more information?
EMAIL employer.service@csc.gov.au
PHONE 1300 338 240
FAX 02 6275 7010
MAIL Employer Service
GPO Box 2252
Canberra ACT 2601
WEB csc.gov.au
Please note:
failure to provide the
documents outlined in
this checklist will result
in delays in processing
this application.
Sign
2 of 2
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signature
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