Police Union Fees form

WA Police Union Benefit

Step 1 of 5: PERSONAL DETAILS

Title

First name

Last name

Date of birth

Mobile number

Employer

Payroll ID

Step 2 of 5: ADDRESS

Unit Number / Street Name

Suburb

State

Post Code

Step 3 of 5: When would you like to start salary packaging your Union benefit?

Select either one of the options below

From next available pay

This is the next pay date that falls after the Union fee benefit has been set up on your account. Please allow 1-2 pay cycles for this to occur.

Next available pay after a certain date

You can choose for your contributions to start after the date you select from the below. Please allow 1-2 pay cycles for this to occur.

Date

Step 4 of 5: Select level of membership

Select the level of membership you want to salary package

Step 5 of 5: Fee Agreements & Declaration

I agree that my employer my increase my salary packaging deductions if there is an increase in my membership fees.

I authorise my employer to deduct from my gross salary all application fees and charges associated with the salary packaging of my benefits.

Declaration

I am an employee of the WA Police and hold a current membership with the WA Police Union.
I acknowledge that my personal information and details I have provided is true and correct, and will be used and disclosed in accordance with Maxxia’s Privacy Policy (a copy of which can be obtained on www.maxxia.com.au/privacy-policy).
I agree that I will hold the necessary substantiation for this benefit for at least seven (7) years and will provide it to Maxxia, my employer, or the ATO, if required.
I consent to receiving direct marketing materials from Maxxia and may opt out at any stage by contacting Maxxia on 1300 123 123.

In consideration for Maxxia processing this request, by checking this checkbox I warrant that the matters set out in the declaration box above are true and I acknowledge and agree to the condition imposed by Maxxia as set out in that box.

By completing this form, I agree to Maxxia contacting me about its products, services and offerings. Maxxia will handle your information in accordance with its Privacy Policy.