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  • Contributions for personal injury forms

    These forms and instructions are for superannuation fund members who have received an eligible personal injury payment (structured settlement) and want to contribute:

    • all or part of the amount to super without it counting towards their non-concessional contributions cap
    • total superannuation balance
    • transfer balance cap.

    The form that you use will depend upon the year the contribution was made.

    If you made a personal injury contribution:

    • on or after 1 July 2007, the contribution would be reported to us by your super provider if you have completed Contributions for personal injury election form NAT 71162.
    • before 1 July 2007, use the Transfer balance event notification form NAT 74919 to notify us of any personal injury contribution that has been received.

    See also:

    How to get the forms

    You can download the forms in Portable Document Format (PDF)

    Who should complete the forms

    You, or your legal personal representative, should complete one of these forms if you:

    • have received a structured settlement
    • want to contribute all or part of that payment to super without it counting towards your non-concessional contributions cap, total super balance and transfer balance cap.

    Structured settlements are either of the following:

    • a payment made under a written settlement agreement regarding a claim for damages for personal injury or a court order for such a claim
    • a workers compensation payment taken as a lump sum.

    When to complete these forms

    For structured settlements made on or after 1 July 2007 you must:

    • send Contributions for personal injury election form NAT 71162 to your super provider before or when you make the contribution. You do not need to send us a copy as your super provider will report the contribution
    • make your contribution within 90 days or such period as the Commissioner allows from whichever of the following events occurs last
      • the day you received the personal injury payment
      • the day an agreement for settlement of a personal injury payment was entered into
      • the day on which a court order for the personal injury payment was made.
       

    A notification is not valid if you provide it after the contribution it refers to has been made. If you do not provide a valid notification:

    • your contribution will not be excluded from the non-concessional contributions cap, total super balance or transfer balance cap
    • your super provider will not be able to report to us that a valid notification was made
    • your super provider will report the entire contribution as a personal contribution for the year.

    You may have to pay extra tax on personal super contributions which are not covered by this notification.

    See also:

    If you have any concerns, contact your super provider to ensure that your contribution has been reported to us correctly.

    You do not need to notify the ATO your super provider will report the contribution to us.

    For structured settlements made before 1 July 2007 you must:

    • complete a Transfer balance event notification form NAT 74919 and lodge this form with us as soon as practicable to ensure that our information is updated to reflect your situation correctly.

    If you do not complete this form and return it to us:

    • your contribution will not be excluded from the non-concessional contributions cap, total super balance or transfer balance cap
    • your super provider will report the entire contribution as a personal contribution for the year.

    You may have to pay extra tax on personal super contributions which are not covered by this notification.

    See also:

    How to complete Contributions for personal injury election form NAT 71162?

    Section A: Your fund’s details

    Complete all the details of the super fund you are paying your contributions to.

    Section B: Your details

    Provide your personal details to your super fund.

    We do not collect the personal details you provide on this form. This form is to assist you in providing details to your super fund. Your super fund is authorised to request your personal details, including your TFN, under the Superannuation Industry (Supervision) Act 1993.

    It is not an offence if you do not provide your TFN. However, if you do not provide your TFN and your super fund does not already hold your TFN, they cannot accept the contribution covered by this form. For more information about your privacy please contact the super fund you are providing this form to.

    Section C: Legal representative’s details

    If your legal representative completes this form on your behalf, they must provide their details.

    Your super fund may need your authorisation to deal with your legal personal representative.

    Section D: Amount

    Provide the amount from your personal injury payment that you wish to exclude from your non-concessional contributions cap.

    Section E: Declaration

    Read the declaration thoroughly. If it is correct, print your full name, sign and date the declaration. The date is important and must be the actual date you sign the form. If you make a false declaration, you may be penalised. If the form is completed by your legal representative, they will need to sign the declaration on your behalf.

    Give your signed and dated form to your super fund before or when you make the contribution. If you lodge it late – after making your contribution – it won’t be valid and your super fund will have to reject it.

    Do not send this form to us. It’s only valid if you give it to your super fund. Your super fund will report to us that you have notified them of your structured settlement when it reports all your contributions for the year.

    Last modified: 20 Jul 2018QC 19583