Suncorp Employee Superannuation Plan Direct Debit Request form

Suncorp Employee Superannuation Plan
Direct Debit Request form (for members)
Suncorp Portfolio Services Limited (Trustee)
ABN 61 063 427 958 AFSL 237905 RSE L0002059
Issued 17 February 2014
Please use this form to set up a regular contribution plan or change your nominated bank account.
Tips to help you complete this form
• Use blue or black pen and CAPITAL letters
• Use a cross ( ) to mark answer boxes
• Complete all sections of the form and sign and date on page 2
Any questions? If you’d like help completing this form, or if you have any questions, just call us on 1800 652 489
1. Personal details
Suncorp Employee
Superannuation Plan
account number
Title Last name
Given name(s) Date of birth
d
Daytime phone number
d / m m / y
y
y
y
Mobile
Email
Providing your tax file number (TFN) is not compulsory. However if you don’t give us your TFN:
• We can’t accept non-concessional contributions (includes personal after tax contributions made and spouse contributions received).
• You may pay additional tax on concessional contributions (includes personal before tax contributions, salary sacrifice, additional employer and
compulsory employer contributions).
TFN
2. Employer details (your employer to complete – if making employer contributions)
Employer number
(if known)
Contact name Company name
Trading name
Daytime phone number
ABN
3. Direct debit options
Please select one of the following options:
Start a new direct debit – continue to section 4
Change existing direct debit – continue to section 4 (if you’re not changing your bank account details, go straight to section 5)
Cancel existing direct debit – continue to section 6
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4. Bank account details
Please debit the following account:
Account name
Name of Australian
financial institution
Branch name or address
Branch BSB
–
Account number
5. Amount to be debited
Deduction frequency
Monthly
Quarterly
Half-yearly
Yearly
Amount and contribution type
Please indicate the type and amount of the contribution per period.
Employee/Personal
contributions
$
Employer contributions
Spouse
contributions
$
Award/SG
$
or
Salary sacrifice
$
Employer additional
$
Total employer
contributions
$
Direct debit date
Your account will be debited on or around the 1st of the month.
Start date
0
1 / m m / y
y
y
y
Contributions will be invested according to your current investment strategy.
6. Direct Debit Request authorisation (bank account holder(s) to complete)
• I/We authorise Suncorp Portfolio Services Limited (User ID 252606), to debit/stop debiting my/our account via the Bulk Electronic Clearing System
in accordance with the instructions detailed in the Schedule below or on the terms set out on the DDR Service Agreement.
• I/We have read and understand the information contained in the DDR Service Agreement.
• I’ll/We’ll notify the Trustee immediately if I’m no longer eligible to contribute.
• This section needs to be signed by different people depending on who is making a direct debit contribution.
Personal contributions – you must sign below
Spouse contributions – contributing spouse must sign below
Employer contributions – your employer must sign below
All bank account signatories must sign below.
Account holder A
Name
Position in company
(employers only)
In the case of a company, two authorised signatories must sign unless a Sole Director and Sole Secretary or Sole Trader
Signature Date d
d / m m / y
y
y
y
y
y
y
Account holder B
Name
Position in company
(employers only)
In the case of a company, two authorised signatories must sign unless a Sole Director and Sole Secretary or Sole Trader
Signature Date d
d / m m / y
Please send the completed form to: Suncorp Employee Superannuation Plan
GPO Box 2585 (IPC: LS004)
Brisbane QLD 4001
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7. Direct Debit Request (DDR) Service Agreement
This DDR Service Agreement forms part of the terms of the Direct Debit
Request (DDR) and should be read in conjunction with this form.
DDR – Suncorp Employee Superannuation Plan
You can arrange to pay your superannuation by DDR.
We’ll process a direct debit to the account nominated on the DDR for
the amount of the superannuation contribution (plus any applicable
Government charges, GST and processing fees) on the date that it’s due.
Changing your DDR Authority
We’ll give you 14 days notice if we change any of the terms of the DDR.
Deferring, stopping or cancelling your DDR
You may defer, alter, stop or cancel your DDR at any time by providing at
least five business days’ notification in writing to any Suncorp Branch
or by mail to:
Non-business days
If your DDR falls due on a weekend or public holiday in Sydney, we’ll
process it on the next business day.
If you’re uncertain of the date your DDR will be processed, you should
contact your financial institution.
Returned or dishonoured DDRs If your DDR is dishonoured or returned unpaid by your financial
institution for any reason, we reserve the right to recover the funds from
you and charge any additional fee that may apply.
Clear funds
You should ensure that you have sufficient clear funds in your account to
enable the DDR to be paid by your financial institution.
Your records
Suncorp Employee Superannuation Plan
GPO Box 2585 (IPC: LS004)
Brisbane QLD 4001
We won’t disclose any details of your DDR to any person or corporation
unless requested to do so by law, or unless the information is required in
relation to a disputed transaction.
Or contact our Customer Service team on 1800 652 489
Your account
Requests to vary the details of the account to be debited must be in
writing and in the terms of the operating authority from the account.
Alternatively, you may stop or cancel your DDR at any time by contacting
the financial institution where your account to be debited is held.
You should be aware that some financial institutions may not allow DDR
to be processed to certain types of accounts.
DDR dispute resolution
If you wish to dispute a DDR transaction, you can contact the financial
institution where your account to be debited is held, or contact us
as follows and we’ll arrange for your disputed transaction to be
investigated and where appropriate, for a correction to be made.
Suncorp Employee Superannuation Plan
GPO Box 2585 (IPC: LS004)
Brisbane QLD 4001
[email protected]
You should check your account details against a recent statement from
your financial institution, or check with your financial institution to ensure
that a DDR can be processed to your account.
If you wish to make enquiries about your DDR
You can contact us by writing to:
Suncorp Employee Superannuation Plan
GPO Box 2585 (IPC: LS004)
Brisbane QLD 4001
[email protected]
Or contact our Customer Service team on 1800 652 489
Or contact our Customer Service team on 1800 652 489
If we’re unable to resolve the dispute to your satisfaction, you should
contact the financial institution where the account to be debited is held
to complete and lodge a DDR Customer Claim Form.
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