Form 007 – Employee Profile

Personal Details

Title

Mr
Mrs
Miss

First Name*

Middle Name

Last Name*

Date of Birth*

Tax File Number

You will need to complete a Tax File Number Declaration Form. Please see Rachel or Andrea for a copy.

Have you changed your name since you last dealt with the ATO, provide your previous family name.

On what basis are you paid? (select only one)*

Full-time employment
Part-time employment
Labour Hire
Superannuation or annuity income stream
Casual employment

Are You: (select only one)*

An Australian Resident for Tax Purposes
A Foreign Resident for Tax Purposes
A Working Holiday Maker

Do you Wish to Claim the Tax Free Threshold?*

YES
NO (Answer No here if you are a foreign resident or working holiday maker, except if you are a foreign resident in receipt of an Australian Govt pension or allowance)
UNSURE

Only claim the tax-free threshold from one payer at a time, unless your total income from all sources for the financial year will be less than the tax-free threshold.

Do you have a Higher Education Loan Program (HELP), Vet Student Loan (VSL), Financial Supplement (FS), Student Start-Up Loan (SSL) or Trade Support Loan (TSL) debt?

YES
NO

Your payer will withhold additional amounts to cover any compulsory repayment that may be raised on your notice of assessment

Declaration by Payee:*

I declare that the information I have given is true and correct.

Date

Superannuation Fund Details*

I have my own Super fund I would like future contributions paid into
I would like to use the Super Fund nominated by BG Brisbane
Unsure

You will need to see Rachel or Andrea for a Superannuation Standard Choice Form.

Super Fund ABN

Super Fund Name

Super Fund USI

Superannuation Member Number

Contact Details

Address*

Street Address Address Line 2 Suburb State Postcode Country

Mobile

Email

Right To Work - Are you an Australian Citizen ?*

Yes (Copy of one (1) of the following documents is required Birth Certificate, Passport, Citizen Certificate)
No ( Copy of Valid Visa Must Be Provided)

Would you Like your payslips emailed to this address ?

Yes
No

Medical History

The information provided on this form is being obtained for the purpose of ascertaining relevant medical information, and other health care related needs in the event of a medical emergency. This information will be treated confidentially by BG Brisbane and will be stored securely and will only be used in the event of a medical emergency.

Do you suffer from any of the following medical conditions?

Asthma

Yes
No

Diabetes

Yes
No

Epilepsy

Yes
No

Heart Condition

Yes
No

Other Medical Condition

Yes
No

Do you suffer from any of the following allergies?

Food

Yes
No

Medication

Yes
No

Other Allergy

Yes
No

Other relevant Medical information

Year of last Tetanus Booster

Private Health Insurance

Yes
No

COVID Vaccination

Yes
No

Have you had at least 1 dose of an approved Covid Vaccination?

Medicare Number

Any other relevant medical history / information?

Emergency Contact Details

Name

Relationship

Address*

Street Address Address Line 2 Suburb State Postcode Country

Home Phone

Work Phone

Mobile

Name

This field is for validation purposes and should be left unchanged.