Show download pdf controls
  • Unclaimed superannuation money statement

    The Unclaimed superannuation money (USM) statement paper form is for super providers with reporting and payment obligations under the Superannuation (Unclaimed Money and Lost Members) Act 1999 (SUMLMA) and for funds reporting New Zealand sourced USM amounts.

    Note: These are the only versions of these forms that will be accepted.

    See also

    Who completes this statement

    Complete this statement if you are a superannuation provider or an authorised super supplier that has reporting and payment obligations under the Superannuation (Unclaimed Money and Lost Members) Act 1999 (SUMLMA) and you have:

    • unclaimed superannuation money (USM)
    • USM that includes a New Zealand-sourced amount. A New Zealand-sourced amount is an amount transferred from a KiwiSaver Scheme under the Trans-Tasman retirement savings portability arrangement.

    Do not use this USM statement if you are lodging for seven or more members - unless you are reporting a New Zealand sourced amount. A USM statement with seven or more members, not including NZ sourced amounts, must be lodged electronically.

    For information about how to report electronically, refer to Unclaimed superannuation money protocol.

    Before you complete this statement

    Before you complete the USM statement, you should refer to:

    • any Section 20C notices you’ve received from us.

    How to complete this statement

    Section A: Supplier details

    Complete this section if you are the supplier of the information and authorised to act on behalf of the super provider – for example, if you are:

    • a tax agent
    • an accountant
    • a super administrator
    • the provider, including        
      • a super fund
      • an approved deposit fund
      • a retirement savings account provider.
       

    If you are the provider and don't have a separate supplier to provide details on your behalf, you must complete section A and B, even if the details are the same.

    Question 1
    Australian business number (ABN)  

    Provide your ABN.

    Question 2
    Organisation name  

    Provide the full name of your organisation.

    Question 3
    Street address  

    Provide your street address, not a post office box.

    Question 4
    Postal address  

    Provide your postal address.

    If this is the same as the street address, write ‘as above’.

    Question 5
    Contact details  

    Provide the name, phone number and email for the nominated supplier contact person who may be contacted on behalf of the provider if we have any questions about the information in this USM statement.

    Question 6
    Your reference  

    Provide a reference that you will find useful in identifying this USM statement if we need to contact you about information supplied in it.

    Section B: Provider details

    Provide details of the provider of the unclaimed superannuation money or former temporary resident accounts.

    Question 7
    Tax file number (TFN)  

    Provide the provider’s TFN.

    Question 8
    ABN  

    Provide the provider’s ABN.

    Question 9
    Name  

    Provide the provider’s current full name.

    Question 10
    Previous 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:

    • MAAS form
    • member exit statement
    • an assessment variation advice
    • a payment variation advice.

    Question 11
    Branch number  

    Provide the branch number if the provider making the report has more than one location.

    Question 12
    Street address  

    Provide the provider’s street address, not a post office box.

    Question 13
    Postal address  

    Provide the provider’s postal address.

    If this is the same as the street address, write ‘as above’.

    Question 14
    Address for service of notices  

    Place an ‘X’ in the applicable box, depending on whether you want notices sent to the provider or supplier.

    If a preference is not indicated, we will send correspondence to the supplier.

    Question 15
    Contact details  

    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.

    Question 16
    Type of superannuation provider  

    Place an ‘X’ in the applicable box. Only one option can be selected.

    Question 17
    Your reference  

    Provide a reference that will help you identify this USM statement if we need to contact you about information supplied in it.

    Section C: Statement details

    Question 18
    Unclaimed money day  

    Provide the unclaimed money day. Report this date as EITHER the 30th of June or the 31st of December of a past reporting period.

    The unclaimed money day is the last day of an unclaimed money period. The schedule statement day is the date the statement is due and payable.

    The unclaimed money days and scheduled statement days are:

    Unclaimed money day

    Scheduled statement day

    30 June

    31 October of the same year

    31 December

    30 April of the following year

    Note: The above scheduled due dates do not apply to trustee voluntary payments (TVPs). However, the existing USM effective dates can be used to report TVP.

    For more information refer Unclaimed superannuation money protocol

    Question 19
    Amount remitted  

    Provide the total value of the cheque, money order or electronic funds transfer.

    You must complete the payment slip provided at the end of the statement if you are paying by cheque or money order.

    Question 20
    Number of members reported  

    Provide the total number of members reported on this USM statement.

    A maximum of six members may be reported using this statement, unless you are reporting a New Zealand sourced amount. If you need to lodge a statement with more than six members, not including NZ sourced amounts, you must lodge electronically.

    Question 21
    Final report  

    Place an ‘X’ in the applicable box to indicate whether this is the final statement to be lodged from this provider.

    If you answer ‘No’, go to section D.

    If you answer ‘Yes’, go to question 24.

    Question 22
    Final report reason  

    Place an ‘X’ in the applicable box to indicate the reason why this is the final statement to be lodged from this provider.

    Section D: Member details

    It is important the information provided is accurate. If multiple members need to be reported for a specific reporting period, you must complete sections D and E for each member using Unclaimed superannuation money statement – additional members (NAT 71864A).

    Question 23
    Member’s TFN  

    Provide the member’s TFN.

    Question 24
    Name  

    Provide the member’s full name.

    Question 25
    Previous name  

    Provide details of the member’s previous name if their name has changed.

    Question 26
    Address  

    Provide the member’s last known residential address.

    Question 27
    Previous address  

    Provide the member’s previous residential address, if available.

    Question 28
    Phone number  

    Provide the member’s last known phone number.

    Question 29
    Sex  

    Place an ‘X’ in the applicable box.

    Question 30
    Date of birth  

    Provide the member’s date of birth.

    If only a year of birth is known (for example, 1976), report the date of birth in the format 00/00/1976.

    Question 31
    Has the date of birth been deemed?  

    Place an ‘X’ in the applicable box.

    Section E: Member account details

    Question 32
    Member status  

    Place an ‘X’ in the applicable box to indicate the current member status.

    Valid values for USM are

    • A – Member reached eligible age
    • N – Non-member spouse
    • D – Deceased

    Valid value for former temporary resident is:

    • R – Report and payment for a former temporary resident – indicates the lodgment and payment is for a former temporary resident identified on s20C notice received by fund.

    Valid values for small and insoluble lost member accounts are:

    • Q – small lost member account – indicates a member account that has been identified as being lost, and the balance of the account is less than $6,000 as at the end of the unclaimed money day.
    • P – insoluble lost member account – indicates a member account that has been identified as being lost, and the provider        
      • has not received an amount in respect of the member within the last 12 months
      • is confident, having regard to the information reasonably available to them, that it will not be possible for them to pay an amount to the member as at the end of the unclaimed money day.
       

    Valid value for inactive low balance accounts is:

    • L – Inactive Low Balance account (ILBA) – indicates a member account that meets the following criteria (subject to limited exception):
      • No amount has been received for the last 16 months.
      • The account balance is less than $6,000.
      • The account is not a defined benefit account.
      • The member has not met a prescribed condition of release.
      • Insurance is not being provided in the account.
      • The fund is not an SMSF or small Australian Prudential Regulation Authority (APRA) fund.
       

    Valid value for trustee voluntary payments is:

    • V – Trustee Voluntary Payment (TVP)
      • Amounts in respect of a member, former member or non-member spouse where the trustee reasonably believes paying the amount to the Commissioner would be in the best interest of the person.
      • The amounts can be identified and reported at any time during the year. The scheduled due dates do not apply to trustee voluntary payments (TVPs). However, the existing USM effective dates can be used to report TVP.
       

    Question 33
    Account details  

    Provide details of the member’s account, including:

    • the super product name and identification number (if available, as this will help in identifying the product within the fund that the member account belongs to)
    • the account number
    • a reference number you may have for the member other than their account number – for example, their employee, payroll, union or Australian Government Service (AGS) number.

    Question 34
    System code  

    Provide the code for the system or product within your administrative structure that holds the member account.

    This item may be used by those providers maintaining accounts on more than one physical system or offering more than one choice of product to their members to identify the location, system or product where the provider member account is held.

    Question 35
    Provider client identifier  

    Provide the member identifier used to link member accounts within the organisation. For example, a provider client identifier could be a customer number that is used to link different member accounts held by one person.

    If the member’s account number is the unique number you identify them with, you can leave this blank.

    Question 36
    Service period  

    Provide details of the service period, including the:

    • first day of the service period
    • last day of the service period – this will generally be as stated in the scheduled statement day field, unless the fund has identified that an earlier date should apply
    • number of days in the service period – if more than one period is related to the lump sum, the days may not be continuous.

    The first day of the service period is usually:

    • the first day of the first period of employment that the lump sum relates to if the member was employed when some or all of the lump sum accrued
    • the earlier of the following if the member was not employed when some or all of the lump sum accrued        
      • the date when the member joined the fund
      • if the lump sum is attributable to an earlier lump sum previously rolled over, the first day of the service period of the earlier lump sum.
       

    Question 37
    Previous provider name  

    If the member’s account, benefit or interest was transferred from another provider, provide the name of the original provider.

    Question 38
    Agent details  

    Provide contact details of the member’s appointed authorised agent.

    Question 39
    Death benefit  

    Place an ‘X’ in the applicable box to indicate whether the member account is a death benefit. If you answer ‘Yes’, provide the date the member died.

    If only a year of death is known (for example, 2019) complete this in the format 00/00/2019.

    Question 40
    Required payee  

    Place an ‘X’ in the applicable box to indicate whether there are reasons that the trustee would be required to pay the member’s USM to a specific person.

    If you answer ‘No’, go to question 42.

    If you answer ‘Yes’, go to question 41.

    Question 41
    Required payee type  

    Place an ‘X’ in the applicable box to indicate the reason why the trustee would be required to pay the member’s USM to a specific person.

    Valid choices are:

    • BN – binding nomination – indicates that a person has been included in a valid binding nomination.
    • TD – trust deed – indicates that a person has been determined as someone that the trustee would be required to pay in accordance with information contained in a trust deed.
    • OT – other – indicates that other reasons apply as to why the trustee would be required to pay to a specific person.

    You must select the required payee type OT where there is a reversionary beneficiary or a requirement to pay a specific individual under the law.

    Question 42
    Member benefit – taxable component – taxed element  

    Provide the taxable component, which is the total amount of the super benefit less the tax-free component. The taxable component may consist of a taxed element, an untaxed element or both. The taxed element is the amount of the taxable component that has been subject to tax in the fund.

    This value must be more than or equal to zero, and must include cents – for example, $12,345.67.

    Question 43
    Member benefit – taxable component – untaxed element  

    Provide the taxable component, which is the total amount
    of the super benefit less the tax-free component. The taxable component may consist of a taxed element, an untaxed element, or both. The untaxed element is the amount of the taxable component that has not been subject to tax in the fund.
    This amount must be more than or equal to zero, and must include cents.

    Question 44
    Member benefit – tax free component  

    Provide the total value of the following:

    • contributions segment
    • crystallised segment.

    This value must be more than or equal to zero, and must include cents. Amounts must be crystallised before being reported to us.

    Do not include any New Zealand-sourced amount here, include it at question 54.

    Question 45

    New Zealand-sourced amount

    This field is only relevant to super providers who accept KiwiSaver accounts.

    The New Zealand-sourced amount does not include any returning Australian-sourced amount which is generally an amount that was previously received by a participating KiwiSaver scheme from an Australian super provider and was originally accrued in an Australian complying super fund.

    Provide the total value of the New Zealand-sourced amount.

    Question 46
    Total member entitlement  

    Provide the total member entitlement.

    Last modified: 21 Dec 2021QC 21679