I’M WITH MEDIA SUPER

Choice of
super fund
I’M WITH
MEDIA SUPE
R
Standard choice form
VALID
FROM
1 JULY 2014
Please
complete
this form in BLACK PEN and CAPITAL LETTERS.
Your Member No.
Give this form to YOUR EMPLOYER after you complete the following steps.
Do not send this form to the Australian Taxation Office or to your superannuation fund.
This form is to notify your employer of your choice of superannuation fund.
If you need help or assistance with this form, call our Super Helpline on 1800 640 886.
STEP 1 – Complete your personal details
Mr/Mrs/Ms/Miss/Dr
Gender
Date of birth
Male
Female
/
/
Surname
Given names
Residential address (must be advised)
State
Postcode
State
Postcode
Postal address (if different from above)
Daytime telephone
(
Mobile number
)
Email address
STEP 2 – Provide details of your fund of choice
Fund name
M
E
D
I
A
S
U
P
E
R
4
3
0
Fund address
G
P
O
M
E
L
B
O
X
O
U
R
3
State
B
N
E
Fund Australian Business Number (ABN) (if applicable)
4
2
5
7
4
4
2
1
6
5
Fund contact number
1
8
0
0
6
0
Postcode
V
I
C
3
0
0
1
.
A
U
Unique superannuation identifier (USI)
4
2
5
7
4
4
2
1
6
5
0
0
0
1
S
U
P
E
R
.
C
O
M
Fund website address
4
0
8
8
6
M
E
D
I
A
Your account name (if applicable)
STEP 3 – Sign the form
I’m with Media Super. Please pay my Superannuation Guarantee (SG) contributions into my Media Super account.
Applicant’s signature
x
Date
/
/
Issued August 2014 by Media Super Limited ABN 30 059 502 948 AFSL 230254 as Trustee for Media Super ABN 42 574 421 650 USI 42574421650001.
Give this form to your EMPLOYER and keep a copy for your records.
Do not send this form to the Australian Taxation Office or to your superannuation fund.
MSUP 35960
You must keep a copy of this form for your own records for the next five years.
Employer only
IMPORTANT INFORMATION
HOW TO PAY INTO MEDIA SUPER
STATEMENT OF COMPLIANCE
It’s easy to pay contributions into Media Super. We have
two easy-to-use online payment options to choose from:
Employer Online or MercerSpectrum.
The Media Super Trustee’s Complying fund letter is supplied
below.
Don’t forget, the Government’s SuperStream reforms will
soon require all employers to make super contributions
electronically. Sign up for one of our online options now –
you don’t need to wait.
For more information, go to mediasuper.com.au/
employers or call our Super Helpline on 1800 640 886.
FOR YOUR RECORDS
This section must be completed when an employee returns
this form to you after completing Steps 1 to 3.
Date valid choice is accepted
/
/
Date you acted on your employee’s valid choice
/
/
Complying fund letter for employers
To whom it may concern
Media Super is a complying, resident, regulated
superannuation fund under the Superannuation Industry
(Supervision) Act 1993 (SIS Act) and is constituted under
a trust deed dated 28 January 1981, as amended from
time to time. The trustee of Media Super is Media Super
Limited ABN 30 059 502 948 (Trustee).
Media Super meets the minimum insurance standards
required to be considered a default fund under the Choice
of Fund legisation.
In the event that Media Super’s complying status is
revoked, the Trustee would receive notice to that effect
under section 63 of the SIS Act. This would mean Media
Super could not receive any further contributions. The
Trustee confirms that it has not received nor does it
expect to receive any such notice.
Media Super is able to accept contributions from
employers on behalf of their employees. Details of how
you can make contributions to Media Super are avaliable
at mediasuper.com.au/employers.
FUND DETAILS
Fund Name
Media Super
Australian Business Number (ABN)
42 574 421 650
Unique superannuation identifier (USI)
42574421650001
Fund Contact Details
GPO Box 4303 Melbourne VIC 3001
Telephone
1800 640 886
Facsimile
1800 246 707
Website
mediasuper.com.au
Yours faithfully,
Graeme Russell
Chief Executive Officer, Media Super Limited
Give this form to your EMPLOYER and keep a copy for your records.
DO NOT send this form to the Australian Taxation Office or to your superannuation fund.