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Dealers
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+61
8 9272 7500
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Contact Us
Employee's confidential details
First name
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Last name
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Date of birth
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Address (Street)
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Address (Suburb)
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Address (Postcode)
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Address (State)
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Email
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Phone (Home)
Mobile
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Position
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Bank (Name of bank)
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Bank (Name of account holder)
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Bank (BSB)
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Bank (account number)
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Tax file number
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Superannuation
I would like the G&A Lombardi / RoadWest Transport supperannuation fund - Care auper
I have my own superannuation fund
Nominated superannuation fund
Superannuation contact details
Superannuation (Member number)
Emergency contact 1 (Name)
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Emergency contact 1 (Mobile)
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Emergency contact 2
Emergency contact 2 (Name)
Emergency contact 2 (Mobile)
Emergency contact 3
Emergency contact 3 (Name)
Emergency contact 3 (Mobile)
All provided information is correct
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