Salary Sacrifice Form Template – Australia

The Salary Sacrifice Form Template – Australia is offered in multiple formats including PDF, Word, and Google Docs. Each version is designed to be both editable and printable, ensuring you can customize it to suit your requirements effortlessly.


Sample

Salary Sacrifice Form Template – Australia

Editable | Printable



1. Employee Information


2. Employer Information

3. Purpose of Salary Sacrifice

4. Amount to be Sacrificed

5. Duration of the Salary Sacrifice Agreement

6. Benefits Covered by Salary Sacrifice

7. Employee Acknowledgment

8. Revocation of Salary Sacrifice

9. Tax Implications

10. Signatures and Acceptance




PDF


WORD

Examples


Salary Sacrifice Form Template – Australia (1)
Employee Details:
[Employee’s Name]
[Employee’s ID]
[Employee’s Address]
[Employee’s Phone]
[Employee’s Email]
Employer Details:
[Employer’s Name]
[Employer’s ABN]
[Employer’s Address]
[Employer’s Phone]
[Employer’s Email]
Form Purpose:
This Salary Sacrifice Form allows the employee to request voluntary reductions in their salary in order to receive benefits such as additional superannuation contributions, novated car leasing, or other approved benefits.
Section 1: Employee Declaration
I, [Employee’s Name], hereby request to sacrifice part of my salary as per the details outlined in this form. This arrangement is set to commence on [Start Date] and will continue until further notice or until the maximum contribution limits are reached.
Section 2: Salary Sacrifice Details
Amount to be sacrificed: AUD [Amount] per pay period.
Benefits to be received: [Specify benefits, e.g., additional superannuation, vehicle lease].
Section 3: Impact on Salary
I understand that salary sacrificing may affect my take-home pay and that it is my responsibility to account for any impact on taxes, benefits, or entitlements.
Current Salary: AUD [Current Salary]
Post-sacrifice Salary: AUD [Post-Sacrifice Salary].
Section 4: Acknowledgment
I acknowledge that I have been given the opportunity to seek independent financial advice regarding this salary sacrifice arrangement and its implications.
Section 5: Agreement Conditions
This salary sacrifice arrangement may be reviewed annually, and any changes must be agreed upon by both parties in writing.
This form does not constitute a contractual agreement; the employer reserves the right to amend the terms of the salary sacrifice arrangement based on company policy and legislative requirements.
Signed on [Date]:
Sincerely,
[Employee’s Signature]
[Employee’s Name]
[Employer’s Signature]
[Employer’s Name]
Salary Sacrifice Form Template – Australia (2)
Employee Details:
[Employee’s Name]
[Employee’s ID]
[Employee’s Address]
[Employee’s Phone]
[Employee’s Email]
Employer Details:
[Employer’s Name]
[Employer’s ABN]
[Employer’s Address]
[Employer’s Phone]
[Employer’s Email]
Form Purpose:
This Salary Sacrifice Form enables the employee to arrange to have a portion of their salary redirected towards specific benefits as outlined in this request.
Section 1: Employee Consent
I, [Employee’s Name], consent to the salary sacrifice arrangement detailed in this form, commencing on [Start Date].
Section 2: Salary Sacrifice Arrangement
Amount to be sacrificed: AUD [Amount] per pay period.
Benefits to be obtained: [Detail benefits, e.g., housing expenses, car lease].
Section 3: Implications of Salary Sacrifice
I acknowledge that participating in this salary sacrifice arrangement will affect my taxable income and may influence my eligibility for certain government benefits and entitlements.
Section 4: Review Terms
This salary sacrifice arrangement will be reviewed on an annual basis. Both parties may make amendments to this agreement, which must be documented in writing.
Section 5: Understanding of Risks
I understand the risks involved in salary sacrificing and have had the chance to discuss this with a financial advisor if needed.
Signed on [Date]:
Sincerely,
[Employee’s Signature]
[Employee’s Name]
[Employer’s Signature]
[Employer’s Name]

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Salary Sacrifice Form Template - Australia