Employment record – Employment Details Employers' Legal Name:(Required) Registered employer’s NameEmployee Name:(Required) Prefix Dr.MissMr.Mrs.Ms.Prof.Rev. First Name Surname GenderMaleFemaleOthersAddress Residential Address Email(Required) Mobile/Phone(Required) Date of Birth(Required) Account Holder Name BSB Number Account Number Bank Name Employment start date:(Required) Employment status:Full TimePart TimeCasualOngoingTemperaryOtherTax Form Declaration(Required)Employee Tax File Number Australian Resident for Tax Purpose(Required) Yes No Claim the tax-free threshold(Required) Yes No Higher Education Loan Debt (HELP) Yes No Financial Supplement Debt Yes No Name of Fund(Required) Fund ABN(Required) Superannuation fund USI Employee – Fund member number(Required) Next to Kin: Full Name Next to Kin : Contact Number Notes and Comments:Signature(Required)Date DD slash MM slash YYYY
