You should use this form if you would like to enter into an agreement to deduct part of your salary as a superannuation salary sacrifice on top of the standard 10% superannuation guarantee. If you have any questions while completing this form, please do not hesitate to call PayMe Australia on 1800 082 006 to ensure that you complete it correctly.


For example: $400 per week only if 40 hours worked.


I declare that I am responsible for my super salary sacrifice. I understand and acknowledge that:

  1. I am wholly responsible for this superannuation salary sacrifice deduction and to notify PayMe of any changes of the amount being deducted. I am responsible to monitor that I do not go over the threshold of superannuation and do not hold PayMe liable.

  2. I am responsible for obtaining independent financial advice regarding this superannuation salary sacrifice and PayMe accepts no liability should I fail to seek financial advice or for any financial advice I have independently sought.

  3. PayMe accepts no liability should I incur additional income tax or other costs, now or in the future, as a result of this salary sacrifice deduction.

  4. I agree to reimburse PayMe the full cost of any Fringe Benefits Tax liability or penalty incurred as a result of this super salary sacrifice deduction.

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