EMPLOYEE INFORMATION FORM

EMPLOYEE INFORMATION FORM
Employer Name
Personal Information
Name

First NameLast Name
Preferred Name
Email
example@example.com
Previous Name (if you have changed your name since you last dealt with the ATO)

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: 0400000000.
Date Of Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
First Day of Work with this Employer

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Payroll Information

Please complete in full in order to avoid delay in processing your payroll.
Employment Status

Other
Hourly Rate
Average Hours Paid Weekly
Bank Name (CBA / NAB / etc)
Your Bank Account Name
Bank Account Number
BSB
Superannuation Fund Name
If you do not have a super fund and do not sign up for one within 28 days of employment, your employer is required to create one for you with their nominated fund. You can always change and merge funds at a later date. If you do not have a fund, and you wish for your employer to setup a fund for you, enter: Employer
Superannuation Fund ABN or USI
If you aren't sure, try googling your fund name and USI, Or, you can call them. If you do not have a fund, and you wish for your employer to setup a fund for you, enter: Employer
Superannuation Fund Member Number
If you do not have a fund, and you wish for your employer to setup a fund for you, enter: Employer.
Tax Declaration Information

Your employer uses an accounting software that submits your Tax Dec electronically to the ATO. All details herewith must be completed, truthfully and accurately.
Tax File Number
Are you (Select only one)
Do you want to claim the tax-free threshold from this payer? Only claim the tax‑free threshold from one payer at a time, unless your total income from all sources for the financial year will be less than the tax‑free threshold.
Do you have a Higher Education Loan Program (HELP), Student Start-upLoan (SSL) or Trade Support Loan (TSL) debt?
Do you have a Financial Supplement debt?
Emergency Contact Information
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: 0400000000.
Relationship (Spouse, Relative, etc)
Signature
Date Signed

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Should be Empty:

EMPLOYEE INFORMATION FORM

Personal Information

Payroll Information

Tax Declaration Information

Emergency Contact Information