Payroll deduction form

Use this form to make contributions to your super through your payroll.

Before you start, make sure you have your payroll office's email address or check if your employer is listed under the 'Payroll details' section below, so you can email your completed form to them.

If you have any existing salary sacrifice arrangement with a salary packaging provider you will need to contact them directly to make any changes to your current contributions.

For more information on contributing to your GESB Super or West State Super account, please read the Contributing to your super brochure.

* Required fields

Your details

(7 digits)
You can find your member number on your member statement or other communication you’ve received from us.
(Family name)
Date of birth *
We'll send a copy of your form to this address.
(if known)

Eligibility to contribute

To be able to make contributions, you must meet one of the eligibility criteria under super laws.*

I am under the age of 65
I am age 65 or over but not age 75, and I have worked at least 40 hours in a period of 30 consecutive days in the current financial year

Contribution amount from your pay

Please tick how you would like to contribute (you can select more than one option).*

Please select whether you would like to contribute a set amount or percentage to your account each pay.*

Please enter the amount (in whole dollars) you would like to contribute to your account each pay.*

Please enter the percentage (in whole numbers) of your pay you would like to contribute to your account each pay.*

Check with your employer's payroll office to ensure you are able to select a percentage.

If you salary sacrifice 50% or more of your salary into your super account, you are encouraged to seek financial advice on your salary packaging arrangement.
Please select whether you would like to contribute a set amount or percentage to your account each pay.*

Please enter the amount (in whole dollars) you would like to contribute to your account each pay.*

Please enter the percentage (in whole numbers) of your pay you would like to contribute to your account each pay.*

Check with your employer's payroll office to ensure you are able to select a percentage.

Nominate your account

Select the account where you would like your contribution deposited.*

If you’re a Gold State Super member and do not have an existing West State Super or GESB Super account, please select GESB Super, as a GESB Super account will be opened for you.

If you’re a GESB Super member, there’s a limit on how much you can contribute to your super each year and still be taxed at 15% (the concessional tax rate1). Your concessional contributions cap for the 2019/20 financial year is $25,0002. For more information, please read the Contributing to your super brochure.

Payroll details

Declaration and signature *

  • I understand the conditions that apply to contributions to my super account
  • I am currently employed in the WA public sector
  • I have received financial advice on my proposed salary sacrifice packaging arrangements if I have chosen to salary sacrifice more then 50% of my total employment cost3 to super

You can choose to print or download a copy of your form after clicking 'submit'.




1 If you are a high income earner whose income and relevant concessionally taxed contributions exceed $250,000 then you may be liable for Division 293 tax. For more information see the Tax and super brochure.
2 From 1 July 2017 the general concessional contribution cap is $25,000 and is indexed in line with the Average Weekly Ordinary Time Earnings in increments of $2,500 rounded down.
3 Your total employment cost is made up of your base salary, other cash allowances, non cash benefits, any fringe benefits tax liabilities currently paid by your employer and any variable components. You should talk to your employer if you need to confirm the value of your total employment cost.

Disclaimer: the information contained in this form is of a general nature, and does not constitute legal, taxation or personal financial advice. In providing this information, we have not taken into account your investment objectives, financial situation or needs. We are not licensed to provide financial product advice. Before acting or relying on any of the information in this form, you should read this form in conjunction with the relevant Product Information Booklet and disclosure documents, and consider whether the information is appropriate for you. You may also wish to consult a suitably qualified adviser to assist you.

Page last updated 18 December 2019