Mercer Super

Pay my super into Mercer Super

Use this choice form to tell your employer to pay your super into your Mercer Super account.

 

Personal details

Surname

First name

 
 
 
 
 
 
 
 
 
 

Member number

 
 
/
 
 
/
 
 
 
 

Date of Birth (DD/MM/YYYY)

 
 
 
 
 
 
 
 
 
 
 
 
 
 

Tax file number (TFN) (optional*)

*If you don’t provide your TFN your contributions may be taxed at a higher rate. Your TFN also keeps track of your super and allows you to make personal contributions to Mercer Super.

Your Approval

I authorise my employer to pay all my future super contributions into my Mercer Super account.

 

 

Signature

 
 
/
 
 
/
 
 
 
 

Date (DD/MM/YYYY)

 

Give the completed and signed form to your employer. You don't have to give it to us or the Australian Taxation Office. Your employer must process this form within two months of receiving it. Keep in mind, your employer only has to accept one Superannuation choice form from you every 12 months.

 

Information for the employer

Your employee has chosen to have their super paid into Mercer Super. This form is an allowable alternative to the ATO standard choice form. This means you must process this form within two months of receiving it. Two months after receiving this form, any super contributions for this employee must be paid into their Mercer Super account if:

Your employee is eligible for choice of fund, and
Your employee has not nominated another choice of fund in the past 12 months.

Once you've accepted your employee's choice, record the date of your acceptance on this form and keep it for your records. It does not need to be sent to the ATO or Mercer Super.

Complete this information for your records

 
 
/
 
 
/
 
 
 
 

Date you received this form (DD/MM/YYYY)

 
 
/
 
 
/
 
 
 
 

Date you acted on your employee's choice (DD/MM/YYYY)

 

Mercer Super details

M
E
R
C
E
R
 
S
U
P
E
R
 
 
 
 
 
 
 
 
 
 
 

Fund name

G
P
O
 
B
O
X
 
4
3
0
3
 
 
 
 
 
 
 
 
 
 
 

 

M
E
L
B
O
U
R
N
E
 
V
I
C
 
3
0
0
1
 
 
 
 
 

Address

1
9
 
 
9
0
5
 
 
4
2
2
 
 
9
8
1

ABN

 
 
 
 
 
 
 
 
 
 
 
 
 
 

Unique Superannuation Identifier (USI)