Employer details
Contact details
Facility type
Debit bank account – for contribution payments

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Employer details
Registered company name*
ABN or WPN*
Postal address*
Suburb*
State*
Postcode*
Business address (if different from above)
Suburb
State
Postcode
Email address*
Phone number
Mobile number
Total number of employees
Contact details
First name*
Surname*
Position/Title
Email address*
Phone number
Mobile number
Facility type – Please select one
Debit bank account – for contribution payments
BSB*
Account number*
Account name*
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