Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788
Trustee of
AustralianSuper ABN 65 714 394 898 MySuper authorised 65 714 394 898 85
SECTION A: MEMBER TO COMPLETE
Please complete in pen using CAPITAL letters. Print
7
to mark boxes.
STEP 1. YOUR PERSONAL DETAILS
Last name Mr Ms Mrs Miss Dr
X
X
X
X
X
First name Date of birth
D
D
M
M
Y
Y
Y
Y
Street address
Suburb State Postcode
Tax File Number (TFN)*
Give this form to your employer. Don’t send it to us or the Australian Taxation Oce.
STEP 2. YOUR EMPLOYER DETAILS
Employer name
ABN (if known) Employee number (if applicable)
Street address
Suburb State Postcode
Telephone number Email address
STEP 3. YOUR SUPER ACCOUNT DETAILS
Superannuation Product Identification Number (SPIN)
Fund name OR Unique Superannuation Identifier (USI)
A
U
S
T
R
A
L
I
A
N
S
U
P
E
R
STA0100AU
Fund address Australian Business Number (ABN)
GPO Box 1901, MELBOURNE VIC 3001
65 714 394 898
Fund telephone number (8am to 8pm AEST/AEDT weekdays) Member number (this is listed on your benefit statement)
1300 300 273
STEP 4. SIGN THIS FORM
I request that all my future super contributions be paid to AustralianSuper.
Sign here:
Date
D
D
M
M
2
0
Y
Y
Pay my super into AustralianSuper
Give this completed form to your employer. Don’t send it to us or the Australian Taxation Oce.
Telephone 1300 300 273 Web australiansuper.com
1267.3 06/17 ISS2 page 1 of 2
* You don’t have to quote your TFN but if you don’t provide it, your contributions may be
taxed at a higher rate. Your TFN also helps you keep track of your super and allows you to
make personal contributions to your fund.
Questions?
Telephone 1300 300 273 Web australiansuper.com
INFORMATION FOR THE EMPLOYER
Your employee has chosen to have their super contributions paid into AustralianSuper.
This form is an allowable alternative to an Australian Taxation Oce Standard choice form.
Compliance statement
AustralianSuper is a complying, resident and regulated super fund and can accept all types of super
contributions within the meaning of the Superannuation Industry (Supervision) Act 1993 (SIS Act).
AustralianSuper is a registrable superannuation entity and may be nominated as a default fund, as it meets
the minimum statutory insurance cover requirements. The Trustee of the Fund is AustralianSuper Pty Ltd
ABN 94 006 457 987 AFSL 233788.
How to pay super contributions into AustralianSuper
QuickSuper* is our online payment solution that gives you the choice of making one payment for all your
employees – regardless of the super fund they belong to. It’s suitable for all types of businesses and is free
to use.
You can register for QuickSuper at australiansuper.com/PaySuper
You’ll need to have your company details
and AustralianSuper employer number handy. If you don’t have an AustralianSuper employer number, you
can join us at australiansuper.com/join
* QuickSuper is managed by Westpac and isn’t the responsibility of AustralianSuper. QuickSuper is a registered trademark
and a product owned and operated by Westpac Banking Corporation ABN 33 007 457 141. Westpac’s terms and
conditions applicable to the QuickSuper service are available after your eligibility for the free clearing house service is
assessed by AustralianSuper. A Product Disclosure Statement (PDS) is available from Westpac upon request.
You can choose to submit your contributions using a dierent service, but it needs to meet the Government’s minimum
data standards as legislated in the Stronger Super reforms – australiansuper.com/StrongerSuper
If you don’t meet your
obligations, including
paying your employee
superannuation contribution
to the correct fund, you may
face penalties.
Employers must keep the completed form for their own record for five years. Don’t send it to the Australian Taxation Oce,
the employer’s nominated fund or the employee’s nominated fund.
RECORD OF CHOICE ACCEPTANCE
1267.3 06/17 ISS2 page 2 of 2
SECTION B: EMPLOYER TO COMPLETE
Complete this section when your employee returns the form to you with Section A completed.
In the two months after you receive the form from your employee you can make super
contributions to either the fund you nominated or the fund the employee nominated. After
the two-month period you must make payments to the fund chosen by the employee.
Date employee’s choice is received Date you act on your employee’s choice
D
D
M
M
2
0
Y
Y
D
D
M
M
2
0
Y
Y
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