SalaryPackagingPLUS - Application form

The Salvation Army application form

( If employed by NSW Health or Any other employer, please click HERE

General Application

NSW Health

to return to the application forms section to select the appropriate application form. )

Are you an officer with The Salvation Army?

Yes No

Job title

Department/Site

Payroll number

Title

Gender

Preferred name

Date of birth

Email address

Mobile phone number

Secondary email address

Home phone number

Home address

Suburb

Postcode

State

Postal address

Postal Postcode

Postal State

Postal Suburb

Please tick any item below if they apply to you:

Company car

Study and Training
Support Loan
(previously HECS/HELP)

Casual employee

Short term contract

Is your postal address the same as above?

Yes No

Please Note: Casual employees must check with their employer if they are eligible to participate in salary packaging.

If you are on a short term contract SalaryPackagingPLUS can maximise your salary deductions to enable you to package your full benefit within the period of your contract. Just select the option below to maximize your benefit.

Contract end date

Your gross annual salary

Pay frequency

Pay cycle name

^ Only required if your employer has multiple pay cycles

Start Date TSA

Account name

BSB number

Account number

Yes No

Living Expenses	Amount per {{var.application.payFrequency}} cycle*
Salary Packaging Card		{{func.formatNumber(func.calculateSPCard(), "$ 0,0")}}
GST Exclusive Items (Mortgage, rent, credit card, personal loan, school fees, etc)
Additional Expenses
Meal Entertainment Card
Meal Entertainment (Reimbursement)
Total Amount	{{func.formatNumber(func.calculateTotalAmount(), "$ 0,0")}}	{{func.formatNumber(func.calculateSPCard(), "$ 0,0")}}

As an Officer you are eligible to package up to 30% of your fortnightly allowance. The amount will be confirmed with your payroll prior to setting up your deductions.

List of exempt items

You must prove that the payments SalaryPackagingPLUS will make are for legitimate expenses for FBT purposes.

Please attach Documented Evidence of every expense you have selected to salary package.

The total value of evidence you supply should be equal to or more than the amount you wish to salary package annually. If not, you will need to forward evidence as required in order for SalaryPackagingPLUS to continue payments to your account/s. Examples of evidence include:

Mortgage/personal loan: statement showing your minimum repayment
Rent: rental agreement with real estate or landlord
Credit Card: credit card statement showing your repayments
Other: tax invoice/bill with proof of payment

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Maximum {{const.maxFileLimit}} files allowed to upload

Please include your complete NSW Health EML Card Application Form

You must also attach a recent payslip with your application.

As you have selected casual employment, please submit your last 6 payslips so that we can determine your average earnings. Please also complete and return to us the separate casual form , which is available in the forms section on our website.

Select your files

The salary packaging policy set down by your employer offers a number of remuneration options that can be taken as a cash salary and non-cash benefit items. Each staff member is able to select their own salary packaging benefits only from those offered by their employer.

When entering into this agreement, the employee authorises the payroll deductions to enable payment of the salary packaging benefit and administration fee, recognising that the amount of deduction will vary from time to time.

I am eligible to participate in my employer’s salary packaging program.
I have read and agree to the terms and conditions of salary packaging as set by my employer and SalaryPackagingPLUS.
I understand that benefit payments can only be made following deduction from my salary, and that non-payment of salary will result in non-payment of my chosen benefit if there is insufficient balance in my salary packaging account.
Any incorrect information provided to SalaryPackagingPLUS that results in a Fringe Benefits Tax liability will be the responsibility of the employee.
I acknowledge that it is my responsibility to confirm what effect, if any, this salary packaging will have on any government payments I receive or are required to make.
I acknowledge that salary packaging may result in a reportable fringe benefit on my annual payment summary or income statement
I acknowledge the information provided by SalaryPackagingPLUS does not constitute financial or taxation advice
If Meal Entertainment is selected, I confirm that this benefit will only be used for Meal Entertainment expenses as per my employer’s policy.
The information provided in this form is true and correct to the best of my knowledge.
I have read and agree to the Privacy Policy which can be found at https://www.leaseplusgroup.com.au/privacy

I have read, understood and accept all of above

I declare the following:

I am eligible to participate in NSW Health’s salary packaging program
I have read and agree to the terms and conditions of salary packaging as set by NSW Health and SalaryPackagingPLUS
I understand and agree to using the Meal Entertainment Card in accordance with NSW Health policy (when this benefit is selected)
I authorise payroll deductions to enable payment of my chosen salary packaging benefit(s) and administration fee
I understand that benefit payments can only be made following deduction from my salary, and that non-payment of salary will result in non-payment of the benefit if there is insufficient balance in my salary packaging account
I acknowledge that it is my responsibility to confirm what effect, if any, this salary packaging will have on any government payments I receive or are required to make
I acknowledge that salary packaging may result in a reportable fringe benefit on my annual payment summary or income statement
I acknowledge the information provided by SalaryPackagingPLUS does not constitute financial or taxation advice
I acknowledge that any incorrect information provided to SalaryPackagingPLUS that results in a Fringe Benefits Tax liability will be my responsibility
The information provided in this form is true and correct to the best of my knowledge
I have read and agree to the Privacy Policy which can be found at https://www.leaseplusgroup.com.au/privacy

I have read, understood and accept all of above

I declare the following:

I am eligible to participate in The Salvation Army’s salary packaging program
I have read and agree to the terms and conditions of salary packaging as set by The Salvation Army and SalaryPackagingPLUS
I authorise payroll deductions to enable payment of my chosen salary packaging benefit(s) and administration fee
I understand that benefit payments can only be made following deduction from my salary, and that non-payment of salary will result in non-payment of the benefit if there is insufficient balance in my salary packaging account
I acknowledge that it is my responsibility to confirm what effect, if any, this salary packaging will have on any government payments I receive or are required to make
I acknowledge that salary packaging may result in a reportable fringe benefit on my annual payment summary or income statement
I acknowledge the information provided by SalaryPackagingPLUS does not constitute financial or taxation advice
I acknowledge that any incorrect information provided to SalaryPackagingPLUS that results in a Fringe Benefits Tax liability will be my responsibility
The information provided in this form is true and correct to the best of my knowledge
I have read and agree to the Privacy Policy which can be found at https://www.leaseplusgroup.com.au/privacy

I have read, understood and accept all of above

SALARY PACKAGING ONLINE FORM

Apply online application

Salary Packaging Application Form

The Salvation Army application form

Please tick any item below if they apply to you:

Got a question? We have the answer