Fillable Superannuation fund nomination (Australian National University)

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Superannuation fund nomination (Australian National University)

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Page 1
Sensitive (when completed)
NAT 8676-02.2014
Superannuation fund nomination
WHEN TO USE THIS FORM
You complete this form to nominate a superannuation fund or
retirement savings account (RSA) to receive the superannuation
entitlements we hold for you, including unclaimed superannuation.
Making an electronic nomination
For fast service, you can make your nomination online at
ato.gov.au/superseeker
This service provides you with details of all your accounts held
by superannuation funds, including the account number and
fund contact details, as well as any accounts we hold on your
behalf. You can also consolidate your superannuation accounts.
MORE INFORMATION
If you need help with completing this form, phone us on
131020 between 8.00am and 6.00pm, Monday to Friday.
If you do not speak English well and need help from the ATO,
phone the Translating and Interpreting Service on 13 14 50.
If you are deaf, or have a hearing or speech impairment,
phonethe ATO through the National Relay Service (NRS)
onthenumbers listed below:
n TTY users, phone 13 36 77 and ask for the ATO number
youneed
n Speak and Listen (speech-to-speech relay) users, phone
1300 555 727 and ask for the ATO number you need
n internet relay users, connect to the NRS on
relayservice.com.au and ask for the ATO number youneed.
COMPLETING THIS FORM
n You must answer all questions.
n Place
X
in all applicable boxes.
Completing section A: your details
Complete your details.
Completing section B: fund details
Before providing the details of the superannuation fund or
RSAyou want to nominate, check that both the following
applyto the fund/RSA:
n it is a complying superannuation fund
n it will accept superannuation payments from the ATO.
To check the complying status of your fund/RSA, use
the Super Fund Lookup service at abn.business.gov.au
Contact your fund/RSA to obtain:
n their Australian business number (ABN)
n the unique superannuation identifier (USI) – to ensure
paymentis made to the correct superannuation product
n the member account number the superannuation payments
should be allocated to.
We recommend you ensure your fund/RSA has the same name
and contact details for you as we have. Any discrepancies in
these details could result in delays in processing your
superannuation payments.
6 Email address
5 Current residential address
Suburb/town PostcodeState/territory
Section A: Your details
2 Full name
Family name
First given name Other given names
Title: Mrs Miss Ms Other
Mr
We are authorised by the Taxation Administration Act 1953 to request your tax file number (TFN). It is not
anoffencenottoquote your TFN but not providing it may lead to delays in processing your nomination.
1 Taxlenumber(TFN)
Day Month Year
3 Dateofbirth
4 Daytimephonenumber
Page 2
Sensitive (when completed)
Lodging your nomination form
Mail it to:
Australian Taxation Office
PO Box 3578
ALBURY NSW 2640
11 Memberaccountname
8 Full name of superannuation fund/RSA
Section B: Fund details
Read the instructions at the start of this form to help you complete this section.
This nomination form will continue to apply until either:
n you nominate a new complying superannuation fund or RSA
n the fund or RSA you have nominated advises us that they will no longer accept payments.
7 Thefund’s/RSA’sABN
10 Memberaccountnumber
Section C: Signature
Penalties
The tax law imposes heavy penalties for giving false or misleading information.
Privacy
The ATO is a government agency bound by the Privacy Act 1988 in terms of collection and handling of personal information
and tax file numbers (TFNs). For further information about privacy law notices please go to ato.gov.au/privacy
Signature
Date
Day Month Year
9 Uniquesuperannuationidentier
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Superannuation fund nomination (Australian National University)

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Completed 20 January 2021

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