EMPLOYEE INFORMATION FORM
Employer Name
*
Personal Information
Name
*
First Name
Last Name
Preferred Name
Email
*
example@example.com
Previous Name (if you have changed your name since you last dealt with the ATO)
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Date Of Birth
*
/
Day
/
Month
Year
Date
First Day of Work with this Employer
*
/
Day
/
Month
Year
Date
Payroll Information
Please complete in full in order to avoid delay in processing your payroll.
Employment Status
*
Full Time
Part Time
Casual
Temp/Contract
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)
*
Australian Resident for Tax Purposes
A Foriegn Resident for Tax Purposes
A Working Holiday Maker
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.
*
Yes
No - Answer no here if you have an additional job you already are claiming the tax-free threshold or if are a foreign resident or working holidaymaker, except if you are a foreign resident in receipt of anAustralian Government pension or allowance.
Do you have a Higher Education Loan Program (HELP), Student Start-upLoan (SSL) or Trade Support Loan (TSL) debt?
*
Yes - Your Employer will withhold additional amounts to cover any compulsoryrepayment that may be raised on your notice of assessment.
No
Do you have a Financial Supplement debt?
*
Yes - Your Employer will withhold additional amounts to cover any compulsoryrepayment that may be raised on your notice of assessment.
No
Emergency Contact Information
Name
*
First Name
Last Name
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Relationship (Spouse, Relative, etc)
Signature
*
Date Signed
*
/
Day
/
Month
Year
Date
Submit
Should be Empty: