Fillable Salary sacrifice declaration (Australian National University)

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Salary sacrifice declaration (Australian National University)

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Page 1 of 2 WBCSTG08051 1118
St.George Bank – A Division of Westpac Banking Corporation
ABN 33 007 457 141 AFSL and Australian credit licence 233714.
Salary sacrifice declaration
Salary sacrifice is an arrangement between an employee and their employer. The arrangement
allows the employee to reduce their taxable income via a deduction to their gross salary or wage.
Examples of salary sacrifice deductions may include, but are not limited to, employee superannuation contributions
above the Australian Superannuation Guarantee (SG), purchased annual leave, loan repayments, child care payments.
Depending on the circumstance and the information provided by you below, the Bank may consider amounts you salary
sacrifice as available income to service your existing commitments and your new loan repayments.
The below declaration relates to salary sacrifice arrangements currently in place between you and your employer.
Customer full name
Customer signature Date
✗
   /  /
Employer/Company name
Office use only:
Customer number Application number
A. SALARY SACRIFICED AMOUNTS FOR ADDITIONAL SUPERANNUATION CONTRIBUTIONS
Complete the below for a deduction related to additional superannuation contributions.
Each individual deduction must be detailed separately.
Amount sacrificed per pay $
True False Tick ‘True’ or ‘False’ against each of the below questions.
This deduction is not required to repay Self Managed Super Fund borrowings.
This deduction is voluntary, can be cancelled at any time and received as taxable income.
I will cancel this deduction if required to meet my existing commitments and the repayments
for the loan I have requested.
B. SALARY SACRIFICED AMOUNTS FOR PURCHASED LEAVE
Complete the below for a deduction related to purchased leave.
Amount sacrificed per pay $
True False Tick ‘True’ or ‘False’ against each of the below questions.
This deduction is voluntary, can be cancelled at any time and received as taxable income.
I will cancel this deduction if required to meet my existing commitments and the repayments
for the loan I have requested.
Page 2 of 2 WBCSTG08051 1118
C. SALARY SACRIFICE AMOUNTS FOR OTHER PURPOSES
Complete the below for deductions related to items other than additional superannuation contributions and purchased leave.
For example, deductions related to childcare fees or transport expenses.
Each individual deduction must be detailed separately.
Deduction 1
Amount sacrificed per pay $
Description and purpose of
the sacrificed amount
True False Tick ‘True’ or ‘False’ against each of the below questions.
This deduction relates to a repayment or expense declared in my loan application.
This deduction is voluntary, can be cancelled at any time and received as taxable income.
Deduction 2
Amount sacrificed per pay $
Description and purpose of
the sacrificed amount
True False Tick ‘True’ or ‘False’ against each of the below questions.
This deduction relates to a repayment or expense declared in my loan application.
This deduction is voluntary, can be cancelled at any time and received as taxable income.
Deduction 3
Amount sacrificed per pay $
Description and purpose of
the sacrificed amount
True False
Tick ‘True’ or ‘False’ against each of the below questions.
This deduction relates to a repayment or expense declared in my loan application.
This deduction is voluntary, can be cancelled at any time and received as taxable income.
Deduction 4
Amount sacrificed per pay $
Description and purpose of
the sacrificed amount
True False Tick ‘True’ or ‘False’ against each of the below questions.
This deduction relates to a repayment or expense declared in my loan application.
This deduction is voluntary, can be cancelled at any time and received as taxable income.
Deduction 5
Amount sacrificed per pay $
Description and purpose of
the sacrificed amount
True False Tick ‘True’ or ‘False’ against each of the below questions.
This deduction relates to a repayment or expense declared in my loan application.
This deduction is voluntary, can be cancelled at any time and received as taxable income.
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Completed 13 May 2021

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