Section B: Provider details
Provide details of the provider of the unclaimed superannuation money or former temporary resident accounts.
Tax file number (TFN)
Provide the provider’s TFN.
Provide the provider’s ABN.
Provide the provider’s current full name.
Provide the previous full name of the provider.
Only provide this if the name of the provider has changed since their last super lodgment was submitted – for example:
- a member contributions statement
- a member exit statement
- an assessment variation advice
- a payment variation advice.
Provide the branch number if the provider making the report has more than one location.
Provide the provider’s street address, not a post office box.
Provide the provider’s postal address.
If this is the same as the street address, write ‘as above’.
Address for service of notices
Place an ‘X’ in the applicable box, depending on whether you want notices sent to the provider or supplier.
Find Out more
If a preference is not indicated, we will send correspondence to the supplier.
Provide the name, phone number and email for the nominated contact person who may be contacted if we have any questions about the information provided in this USM statement.
Type of superannuation provider
Place an ‘X’ in the applicable box. Only one option can be selected.
Provide a reference that will help you identify this USM statement if we need to contact you about information supplied in it.
Last modified: 21 Oct 2016QC 21679