Choice of superannuation fund form

A form for injured workers to nominate a superannuation fund.


What it contains

Fill in this form so your authorised agent can start making superannuation payments into your fund.

You will need to fill in parts 1, 2, 3 and 5, or if nominating a self-managed super fund - parts 1, 2, 4 and 5.

Ensure you sign the consent and declaration. You can digitally sign using an Adobe ID or by inserting a photograph of your signature. Use the 'Fill and sign' function in Adobe Reader to do this.

Return the completed form to your WorkSafe agent.