SUPERANNUATION CONTRIBUTIONS TAX (ASSESSMENT AND COLLECTION) REGULATIONS 1997 - SCHEDULE 4 Contributed amounts paid/transferred out statement

Commonwealth Consolidated Regulations

Contributed amounts paid/transferred out statement - additional matters

(regulation 3A)

	Member contributions information
101	Information on the matters set out in Schedule 3
	Contributed amounts paid/transferred out information
201	Destination type
202	Name of destination superannuation provider*
203	Destination superannuation provider street address*
204	Destination superannuation provider postal address
205	Destination superannuation provider superfund number (SFN)
206	Destination superannuation provider member account number
207	Destination superannuation provider client identifier
208	Destination superannuation provider Australian Business Number
209	Destination superannuation provider system or product code
210	Unique superannuation provider reference for the contributed amount transferred out
211	Date superannuation provider ceased holding contributions
212	Total contributed amounts transferred*
213	Transferred employer contributed amount (accumulation)*
214	Transferred employer contributed amount (defined benefit)*
215	Transferred post 20 August 1996 component of employer eligible termination payment rolled over on or after 1 July 1997*
216	Transferred allocated surplus amount*
217	Paid/transferred amount and total amounts mentioned in subsection 13 (7) of the Act*