New Employee Form

1. Personal Details:
First Name(s): _________________________ Last Name: __________________________
Date of birth: ___ / ___ / ____ Start Date: ____/____/____
Address: _________________________________________________________________
Suburb: ________ Postcode: _________ State: _________
Email (personal): ___________________________________________________________
Mobile: ___________________________ Home phone: ____________________________
Tax File Number: ___________________

Are you a backpacker for Australian Tax purposes (please circle) Yes No
If you are on a Visa subclass 417 or 462, tick yes

Are you an Australian resident for Tax Purposes (please circle) Yes No

Do you want to claim the tax free threshold from this job (please circle) Yes No
if you have more than one source of income and currently claim the tax free threshold from another employer do not claim it now

Do you want to claim the senior Australians tax offset by reducing the amount withheld from
payments made to you? (please circle) Yes No

Do you want to claim a zone, overseas forces, dependent spouse or special tax offset by reducing
the amount withheld from payments made to you? (please circle) Yes No

Do you have an accumulated Higher Education Loan Programme (Help) debt?

(please circle) Yes No

Do you have an accumulated Financial Supplement debt (please circle) Yes No

What is your employment basis? (please circle) Full time

Part time
Casual

2. Emergency contact: Name _________________________

Relationship to you: ________________ Phone (mobile) ____________________________
Phone (home) _____________________ Phone (work) _____________________________

3.Proof of Eligibility for Work (if applicable)

Passport Origin: ________________________ Number:
Stamp: ________________________________ Valid till: ____________________________
Eligibility type: _____________________________________________________________
Visa Type: ________________________ Number:
(Original sighted and copies taken, sent to head office as well as kept on employee file)
4. Banking Details
(Please double check all the digits and make sure they are easy to read)

Bank: __________________________ Account Name: ___________________________

BSB: Account Number: _________________________

Manager to complete:
Pay rates - Annual: Hourly: Please state exc. super
Full time / Part time / Casual

5. Superannuation Details:
Do you have superannuation account?

- Yes (please provide details below)

- No
Super Fund Name: _________________________________________________________
Membership Number: _________________________________
ABN: ______________________________ SPIN: _________________________________
Bank Details:
Account Name:
Bpay: Biller Code:__________________ Ref Number:___________________
BSB: Account Number: _________________

Cheque: Payable to:_______________________________________________

6. Licences & Classes Currently Held: ________________________________________

Copies Attached Y/N

7. Occupational Health and Safety

Have you had any work related accidents/injuries in the past 3 years? Y/N

If yes, please provide details

Have you had any type of Workers Compensation claims in the past 3 years? Y/N

If yes, please provide details

I hereby confirm that I have read the contract, and understand the rights and responsibilities I
have.

Employee signature: __________________________ Date: _____________________