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.