Employment record – Employment Details

Please fill the form if you’ve been working casual, part-time, or full-time but haven’t kept a record of employment details. Now is the time to look after yourselves.

Employers' Legal Name:(Required)

Registered employer's Name

Registered Business Name:

Registered business name of the employer

Employee Name:

First Last

Gender

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mobile/Phone

Date of Birth

Tax File Number

Employee's Bank Details : BSB Number

Please provide BSB

Employee's Bank Details : Account Number

Please provide Account Number

Employment start date:

Employment status:

Ordinary hours of work per week

Agreed/required pay period

Agreed/required pay day

Name of Award or Agreement that applies

Please specified industry award Name i.e. Hospitality or cleaning service award

Superannuation fund name

Superannuation fund Australian Business Number (ABN)

Superannuation fund USI

Superannuation fund employee membership Number

Workers' compensation - Policy Name

Workers' compensation - Policy Number

Next of Kin: Full Name

First Last

Next of kin: Email

Next of Kin: Phone Number

Employee requested termination

Please specified the reason for termination

If the termination of employment was by the employer:

Name of the person who terminated the employee's employment and his/her position in the business.

Notes and Comments:

Authorised Person to handle employee / employment info.(Required)

First Last