FORM 6

SUPERANNUATION CONTRIBUTION

Employee Name / Employee Number
Employer / ADF ADS Centacare Evangelisation Brisbane  Episcopal & Corporate Office  Parish
Other - please specify:
Department/Service
Centacare Directorate
(if applicable) / Catholic Family & Relationship Services
Corporate Services
 Financial & Accounting Services / Child Care Services
 Pastoral Ministries / Community Services
Superannuation Fund
Membership Number
Pre-tax contributions:
I request that my pre-tax superannuation contributions be fixed at the following percentage or dollar amount of my gross salary (ie the salary calculated in accordance with the rate of pay prescribed by my Award or Enterprise Agreement). I acknowledge that upon receipt of this application, my gross salary will be reduced accordingly by the amount of the contributions made to the fund.
$ / or / % / per fortnight
Post-tax contributions:
I request that my post-tax superannuation contribution be fixed at the dollar amount stated below. I acknowledge that upon receipt of this application, my post-tax salary (net pay) will be reduced accordingly by the amount of the contributions made to the fund.
$
I acknowledge that:
  • I have sought the opinion of a professionally qualified independent financial adviser
  • I am aware the arrangement must be entered into prior to the work being performed ( this means I must give my employer at least 2 weeks notice before commencement of contribution or change)
  • I am aware that I can cease this arrangement and/or alter the contribution at any time
  • I am aware that conditions apply after age 65 years regarding pre-tax and post-tax contributions
  • I am aware that limits apply for both concessional and non-concessional contributions
  • I am aware this will remain in force until such time as pay office receive a change by me in writing

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SIGNATURE: / DATE:

Page 1 of 1Version 1.02May 2011