Suite 2, Level 2 / 22 Albert Road
South MelbourneVictoria 3205
Phone 1300 776 394 / Fax 03 8256 0108
SMSF Establishment
Contact Details:
Advisor Name:
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Advisor Company:
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Postal Address:
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Phone: Email:
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Payment Details:
Enclosed is payment for a SMSF Establishment for $275.00
I would also like to have the Fund registered for an ABN and TFN for an extra $99.00(making the total $374.00)
Direct Deposit* / Cheque*If you would like to pay via Direct Deposit, please forward your order to our office first, and we will email you an invoicewith our bank account details for payment.
FundDetails:
Name of Fund:*
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*Please ensure you do not place ‘The’ at the start of the Fund name.
Registered address of Fund:
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Postal address (if different):
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Address of the meetings of the
Trustees/Members:
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Establishment date: / /
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ABN & TFN Registration Details:
Only completer this section if Super Registry is registering the ABN and TFN for the Fund.
As a new initiative, the ATO is contacting trustees of newly established SMSFs to confirm they understand their duties and obligations as a trustee of the Fund. Please nominate a trustee or director of the Fund that the ATO may contact in this regard:
Trustee / Director Name:
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Contact Number:
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Do you want to add a Tax Agentor Authorised Adviser to the ABN application?YES NO
If yes, please provide the following:
Company Name:
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Contact Person:
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Contact Phone Number:
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Tax Agent Number (if applicable):
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Trustee Declaration
Please read and confirm the following declaration:
I hereby authorise Super Registry to complete and lodge the ABN and TFN application for this Fund on behalf of the trustees, and declare that all information provided in this application form is true and correct.
Member 1 Details:
Title: Name:
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Address:
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Date of Birth: / / Gender: MALE FEMALE
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Tax File Number*: - -
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Is this person an individual Trustee or a Director of the Corporate Trustee?INDIVIDUAL TRUSTEE DIRECTOR
Member 2 Details:
Title: Name:
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Address:
……………………………………………………………………………………………………………………………………………………
Date of Birth: / / Gender: MALE FEMALE
………………………………………
Tax File Number*: - -
………………………………………
Is this person an individual Trustee or a Director of the Corporate Trustee?INDIVIDUAL TRUSTEE DIRECTOR
Member 3 Details:
Title: Name:
………………… …………………………………………………………………………………………………………………………………………
Address:
……………………………………………………………………………………………………………………………………………………
Date of Birth: / / Gender: MALE FEMALE
………………………………………
Tax File Number*: - -
………………………………………
Is this person an individual Trustee or a Director of the Corporate Trustee?INDIVIDUAL TRUSTEE DIRECTOR
Member 4 Details:
Title: Name:
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Address:
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Date of Birth: / / Gender: MALE FEMALE
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Tax File Number*: - -
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Is this person an individual Trustee or a Director of the Corporate Trustee?INDIVIDUAL TRUSTEE DIRECTOR
*providing the Tax file number of the Member is optional
Additional Individual Trustee (for single Member Funds with Individual Trustees):
Title: Name:
………………… …………………………………………………………………………………………………………………………………………
Address:
……………………………………………………………………………………………………………………………………………………
Date of Birth: / / Gender: MALE FEMALE
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Tax File Number*: - -
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Corporate Trustee Details (if applicable):
Company name:
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ACN: - -
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Registered Address:
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Company Chairman:
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Please Fax or Email this completed form to SuperRegistry:
Fax:(03) 8256 0108Email: