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Employee Number:
Location:
Address
Phone Number: ( )
Mobile number:
Base Salary: $
Superannuation: $
Allowances: $
Bonus/ Commission $
Other Payments: $
If there are other payments please specify the type of payment
Leave balances to be set up: Annual Leave Sick Leave Long Service Leave Other (please specify)
(Please circle)
Additional Comments:
Requestor Name:
Date:
*** NOTE: Please ensure Tax declaration Form and Choice of Fund form is attached along with this completed form ***
*** Any election for salary sacrifice or deposits to additional bank accounts must also be submitted in writing directly form the employee***