CSC
AFSL 238069
RSEL L0001397
ABN 48 882 817 243
1922 Scheme
CSS
RSE R1004649
ABN 19 415 776 361
DFRB Scheme
MilitarySuper
RSE R1000306
ABN 50 925 523 120
DFRDB Scheme
ABN 39 798 362 763
PSS
RSE R1004595
ABN 74 172 177 893
PNG Scheme
PSSap
RSE R1004601
ABN 65 127 917 725
DFSPB
The informaon provided in this form is general advice only and has been prepared without taking account of your personal objecves, nancial situaon or needs. Before acng 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. You should obtain a copy of the
relevant Product Disclosure Statement (PDS) and consider its contents before making any decision regarding your super.
Commonwealth Superannuaon Corporaon (CSC) ABN: 48 882 817 243, AFSL: 238069, RSEL: L0001397
Commonwealth
Superannuaon
Scheme
ABN: 19 415 776 361
RSE: R1004649
Public Sector
Superannuaon
Scheme
ABN: 74 172 177 893
RSE: R1004595
Departmental Report
Employers should complete this form for CSS and PSS members that have
resigned, retired, been made redundant, or had their employment terminated.
EPC20
04/20
FOR
EMPLOYER
USE
A
About the member
Members name
GIVEN NAME(S)
SURNAME
Reference Number (AGS)
Date of birth
D D M M Y Y Y Y
/ /
B
About the employment
Date of exit
D D M M Y Y Y Y
/ /
Has the member
been terminatied or
made redundant?
Yes – If yes, please include a copy of the retirement certificate
No
Final super salary at exit
$
D D M M Y Y Y Y
/ /
Please note: This can be greater than the super salary at the last birthday.
Final 3 birthday salaries
before exit
$
D D M M Y Y Y Y
/ /
$
D D M M Y Y Y Y
/ /
$
D D M M Y Y Y Y
/ /
1 of 2
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
click to sign
signature
click to edit
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