Forms and Fact Sheets
Forms and fact sheets
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All schemes formsAgency Direct Debit Request (DDR).pdf
[PDF 350.8 KB]Direct debit is one of many ways you can help your agencies super contribution. If you want to make a contribution through an agency, complete this form.
Authority to release information to a third party
[PDF 343.0 KB]Did you know you're allowed to authorise the release of your super information to a third party? To start this process, complete this form.
This form is for those who wish to nominate your legal personal representative or to confirm or revoke your current nomination to the Triple S, Flexible Rollover or Income Stream schemes.
Consolidate your super
[PDF 179.3 KB]Super SA allows individuals with super contributions in one or more Australian Super Funds to move them all into one place, Complete this form to consolidate your super.
Change to personal details
[PDF 965 KB]Are you looking to change your personal details? You will need this form and proof of your updated details. Complete this form to start your application.
Claim for disablement entitlements
[PDF 781.8 KB]Do you need disability compensation? Complete this form if you are looking to make a claim for disability entitlements with Super SA.
Income Protection review form
[PDF 491.9 KB]Complete this form for review in regards to receiving income protection. You'll be required to provide your member information and a medical report.
Member complaint
[PDF 157.5 KB]We understand that as a member, you may have a complaint regarding your current experience with Super SA. Complete this form to file a complaint to help us improve.
My payment details
[PDF 430.4 KB]This form is to update your bank account details or change your payment or taxation instructions.
Personal health statement
[PDF 1.013 KB]If you have applied to change your cover using the “apply or change my insurance” form, you’ll be required to complete and attach this “personal health statement” to assess your application.
If you've lived with the deceased as a putative spouse, you could be eligible to make a statutory declaration. Complete this form to make a claim.
Putative spouse statutory declaration of independent person (including same sex partner)
[PDF 435.3 KB]When you've previously lived with the deceased as a wife or husband, you could be eligible to make a statutory declaration. To make a claim, complete this form.
Your employer can make super contributions on your behalf through a salary sacrifice as a member of Triple S. Complete this form to make a salary sacrifice.
Statement by referee
[PDF 1.0MB]This form is for referees to confirm the identification and verification of identity for members without standard identity documents.
Statutory Declaration
[PDF 61.8 KB]If you require an early release of your superannuation benefits on severe financial hardship grounds. Make a statutory declaration by filling out this form.
Tax file number notification form
[PDF 345.1 KB]Tax file number notification from. Complete this form to provide your Tax file number to Super SA.
Are you looking to roll your benefit to another Super SA product or Superannuation fund? Complete this form to get started.
Withdraw your super
[PDF 1141 KB]Preparing a withdrawal of your super from Super SA? Complete this form to start your application.
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Triple S formsApplication for payment in relation to a deceased member
[PDF 427.9 KB]This application form allows for a spouse or de facto spouse to receive payment concerning a deceased member. For Triple S members, click through the link to start.
Application for payment of surcharge liability
[PDF 406.5 KB]As a member of Triple S, you can make an application for payment of surcharge liability. To receive payment, click the link to start your application.
Application to split eligible contributions
[PDF 431.4 KB]If you require a split in your superannuation contributions, you can by completing the following form. To make a split eligible contribution, click through the link.
Apply and change spouse death insurance
[PDF 824.9 KB]If you are looking to apply or change your spouse's death insurance level of cover, you'll be required to complete the following application form.
Apply for Death and TPD insurance
[PDF 823.3 KB]This is an application form for Triple S members wishing to apply for Death and Total & Permanent Disability insurance. Click the link to make a claim.
Apply for Income Protection insurance
[PDF 739.7 KB]This is an application to apply for income protection insurance as part of your Triple S membership. Refer to the income protection sheet before applying .
Apply for or change my insurance
[PDF 1.116 KB]If you are looking to apply or change your Death and Total & Permanent Disability and/or Income Protection insurance level of cover, you'll be required to complete the following application form.
Cancel Death and TPD insurance
[PDF 402.5 KB]Are you a Triple S member who needs to cancel their death & total and permanent disability insurance? Click the link to commence your application.
Cancel Income Protection insurance
[PDF 402.5 KB]This application is for Triple S members looking to cancel their income protection insurance. To commence the cancellation process, click through the link.
Cancel spouse death insurance
[PDF 399.7 KB]This application form is to be completed if you wish to cancel your spouse's death insurance cover. To get started, click through to begin your request.
Change Death and TPD insurance
[PDF 830.2 KB]If you require additional units standard or fixed insurance cover or other adjustments. Click the link to start your change of death and TPD insurance form.
Change Income Protection insurance level of cover
[PDF 759.1 KB]If you wish to limit or increase the level of income protection insurance cover you receive as part of your Triple S, click the link to start your application.
Change Income Protection insurance waiting period
[PDF 390.8 KB]This application is for Triple S members who wish to change the waiting period of their income protection insurance. Make the change by clicking the link.
Change my regular after-tax contributions
[Digital Form]As a Triple S or Super SA Select member, you can adjust your after-tax contribution rate. If you wish to make the change, click the link to start your application.
Do you require the release of your spouse's entitlements due to permanent disablement? To make a claim, click the link to start your application.
Leave without pay
[Digital Form]If you require to leave without pay as a Triple S member, apply to take an extended period of leave without receiving payment by clicking the link.
Salary sacrifice form
[PDF 144.8 KB]Your employer can make super contributions on your behalf through a salary sacrifice as a member of Triple S. To make a salary sacrifice, click through the link.
Triple S Income Protection claim kit
[PDF 2.4 MB]If you’re needing to make an Income Protection claim, this kit will give you all the information and forms needed to submit a claim.
If you need to make a Total and Permanent Disablement claim, this kit will give you all the information and forms needed to submit a claim.
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Triple S | Police | forms
This application form is for SA Police officers and cadets who wish to change their contribution rate. Complete this form and return it to your employer or HR delegate.
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Triple S | SA Ambulance | formsThis application form is for Triple S SA Ambulance prescribed members who wish to change their contribution rate. Complete this form and return it to your employer or HR delegate.
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Income Stream formsApplication in relation to a deceased investor
[PDF 373.7 KB]This application form is payment in relation to a deceased Income Stream investor. To complete this form, you'll need to provide information to your proof of identity.
Retirement declaration form
[PDF 107.2 KB]Complete this form if you are making a declaration for retirement. This is important for taxation purposes & ensuring your investment is exempt. Click to start.
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Flexible Rollover Product formsApplication for payment in relation to a deceased investor
[PDF 417.7 KB]This application form is payment in relation to a deceased Flexible Rollover Product investor. To complete this form, you'll need to provide information about your proof of identity.
Apply and change Death and TPD and Death only insurance
[PDF 258.6 KB]Apply and change to death & TPD & death insurance as part of the Flexible Rollover Product. Refer to the RFP Insurance Fact Sheet when completing this form.
Apply for or change my insurance
[PDF 1.116 KB]If you are looking to apply or change your Death and Total & Permanent Disability insurance level of cover, you'll be required to complete the following application form.
Cancel Death and TPD or Death only insurance
[PDF 396.1 KB]If you're looking to cancel your death & total & permanent disablement or death only insurance, click through to start your application.
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Super SA Select formsThis application form allows for a spouse or de facto spouse to receive payment relating to a deceased Super SA Select member. To make a claim, click the link to get started.
Super SA Select Binding Death Nomination Form
[PDF 206.0 KB]This form is for those in Super SA Select Scheme who wish to nominate your legal personal representative or to confirm or revoke your current nomination.
If you require an early release of your superannuation due to permanent disablement or terminal illness. Click through to start your application for a release.
Change my regular after-tax contributions
[Digital Form]As a Triple S or Super SA Select member, you can adjust your after-tax contribution rate. If you wish to make the change, click the link to start your application.
Leave without pay form
[PDF 105.0 KB]If you require to leave without pay, submit an application form to take an extended period of leave without receiving payment. Click through to get started.
Pay my Super into Select
[PDF 1,009 KB]This form is for eligible Super SA members to advise Non-SA Government employers that their choice of fund for future superannuation contributions is Super SA Select.
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Super SA Select | SA Ambulance | formsThis application form is for Super SA Select Ambulance prescribed members who wish to change their contribution rate. Complete this form and return it to your employer or HR delegate.
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Lump Sum Scheme formsApplication for payment of surcharge liability
[PDF 391.6 KB]This is an application for payment of surcharge liability under the Lump Sum Scheme. Click through to start your application today.
Lump Sum investment choice
[PDF 155.7 KB]Did you know you can change your investment options in the Lump Sum Scheme? You can change your current balance and/or future contributions by filling out this form.
Application for payment
[PDF 451.3 KB]Ready to make an application for payment under the Lump Sum scheme? Click through to start providing your details and reasons behind making an application.
Application for purchased leave
[PDF 337.3 KB]You can purchase leave by reducing your future superannuation entitlements. To make this happen, click through to complete this application for paid leave form.
Application for transition to retirement
[PDF 411.6 KB]If you have ceased employment with the public sector & want your entitlements released, submit the transitioning to retirement application form. Click through the link to start.
Change to contribution rate
[PDF 339.4 KB]This application form allows members under the Lump Sum Scheme to adjust their contribution rate per year. Click through to make the change.
Click through to make an election to maintain contributions following a reduction in substantive salary. To start your application, select the link.
Leave without pay
[PDF 726.7 KB]If you need to make an application for leave without pay and a member direct debit request. Click through to start both applications.
This application form is for payment of a preserved Lump Sum entitlement. If you're eligible to make a declaration, click through to start your application.
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SA Ambulance Service Super Scheme forms
This application form is for members in the SA Ambulance Superannuation Service Scheme who wish to change their contribution rate. Complete this form and return it to your employer or HR delegate.
Application for disablement entitlements
[PDF 448.4 KB]This application form is for people requesting disablement entitlements as part of the SA Ambulance Superannuation Service Scheme. Click the link to get started.
Application for non-contributory membership
[PDF 368.0 KB]Click through to submit your application for non-contributory membership as a casual employee as part of the SA Ambulance Service Superannuation Scheme.
Application to establish a spouse account
[PDF 379.9 KB]This application is to establish a spouse account as part of the SA Ambulance Superannuation Service Scheme. Click through to get started.
Claim for disablement entitlements review
[PDF 385.5 KB]To make a claim for your disablement entitlements to be reviewed, complete this form and send it to Super SA. To start your application, click the link.
Nomination of preferred beneficiaries
[PDF 923.4 KB]If you're part of SA Ambulance Service Super Scheme, you can nominate your preferred beneficiaries as a member. Click through the link to start the nomination process.
One off contribution
[PDF 402.1 KB]You can make one-off contributions to your super. If you're over the age of 67 you'll be required to fill out this form. Click through to start your application.
Spouse contribution authority
[PDF 313.5 KB]Assist your spouse to receive a percentage of your superannuation contribution as part of your SA Ambulance Service Scheme membership by completing this form.
If you are wishing to purchase death, total and permanent disablement insurance within the SA Ambulance Superannuation Service Scheme. Click the link to apply.
Application for payment of resignation retirement benefit
[PDF 396.3 KB]This application form is for payment of resignation or retirement benefits under the SA Ambulance Superannuation Service Scheme. Click through to start.
Application to split eligible contributions
[PDF 359.7 KB]Want to split your super contribution with your spouse? Now you can. Click the link to fill out the split eligible contribution application here.
Application for payment in relation to a deceased member
[PDF 415.3 KB]Click through the link to start your application for payment of a deceased member within the SA Ambulance Superannuation Service Scheme.
Apply for or change my insurance
[PDF 1.116 KB]If you are looking to apply or change your Death and Total & Permanent Disability insurance within the SA Ambulance Superannuation Service Scheme you'll be required to complete the following application form.
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Pension Scheme formsApplication for payment
[PDF 1.3 MB]Ready to make an application for payment under the Pension scheme? Click through to start providing your details and reasons behind making an application.
Application for payment of a preserved lump sum entitlement
[PDF 828.0 KB]This application form is for payment of a preserved lump sum pension entitlement. Make a declaration, click through to start your application.
Application for payment of a preserved pension entitlement
[PDF 729.2 KB]This application form is for preserved payment of pension entitlements. If you're eligible to make a declaration, click through to start your application.
Application for purchased leave
[PDF 337.7 KB]Reduce your future superannuation entitlements by purchasing leave. To make this happen, click through to complete this application for paid leave form.
Application for student income
[PDF 398.4 KB]This application will enable students to receive income under a pension. For each child applying, an individual application is required. Click through the link to start.
Application for transition to retirement
[PDF 410.2 KB]Complete this transition to the retirement application form if you're within the six months of moving from employment to retiring. Click through to start.
Change to contribution rate
[PDF 342.4 KB]This application form allows members under the Pension Scheme to make an adjustment to their contribution rate per year. Click through to make the change.
Direct deposit of fortnightly income
[PDF 335.6 KB]Click the link and fill out the Direct deposit of fortnightly income application to be paid into your nominated bank of choice.
You can elect to maintain super contributions following a reduction in substantive salary under the pension scheme. Click through to start your application.
Leave without pay
[PDF 445.8 KB]If you need to make an application for leave without pay under the Pension Scheme. Click through to start completing your application.
Application for payment in relation to a deceased member
[PDF 423.7 KB]This application form is for payment concerning a deceased Pension Scheme member. To make a claim for payment, click through and fill out this application.
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Superannuants formsAre you looking to make an application for spouse/putative spouse and children's entitlements? To get started, click the link to start your claim.
Confirmation of income entitlements
[PDF 363.9 KB]This application form is to be filled out in regards to the confirmation of your income entitlements. To make the declaration, click the link.
Review of student income
[PDF 440.2 KB]If you have ceased your full-time studies & commenced full-time employment, you'll be required to fill out the review of student income application. Click through the link to get started.
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Employer formsAgency direct debit request (DDR).pdf
[PDF 350.8 KB]Direct debit is one of many ways you can help your agencies super contribution. If you want to make a contribution through an agency, complete this form.
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All schemes fact sheets
- Division 293 Tax [PDF 394.5 KB]
- Early release of superannuation benefits on specified grounds [PDF 215.0 KB]
- Freedom of information (FOI) statement [PDF 357.8 KB]
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Triple S fact sheets
- Beneficiaries and your super entitlement [PDF 559.1 KB]
- Leave without pay [PDF 558.1 KB]
- Superannuation and purchased leave [PDF 553.1 KB]
- Triple S Insurance Restrictions fact sheet [PDF 104.6 KB]
- Triple S Income Protection Insurance fact sheet [PDF 151.6 KB]
- Superannuation and the breakdown of relationships [PDF 578.8 KB]
- Triple S Death and TPD and Death Only Insurance fact sheet [PDF 188.7 KB]
- Insurance and Leaving the Public Sector [PDF 94.4 KB]
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Flexible Rollover Product fact sheets
- Setting up a spouse account [PDF 466.1 KB]
- Beneficiaries and your super entitlement [PDF 440.9 KB]
- Flexible Rollover Product Insurance fact sheet [PDF 168.6 KB]
- Insurance and Leaving the Public Sector [PDF 94.4 KB]
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Super SA Select fact sheets
- Superannuation and purchased leave [PDF 313.2 KB]
- Superannuation and the breakdown of relationships [PDF 326.5 KB]
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Lump Sum Scheme fact sheets
- Preserved Entitlements [PDF 339.5 KB]
- Resignation [PDF 352.1 KB]
- Retirement [PDF 344.1 KB]
- Temporary Disablement entitlement (Income Protection) [PDF 337.7 KB]
- Total and Permanent Disablement [PDF 342.2 KB]
- Government Co-contributions [PDF 349.6 KB]
- Purchased Leave [PDF 340.8 KB]
- Contracts or acting arrangements of 12+ months [PDF 345.8 KB]
- Part-time Employment [PDF 334.5 KB]
- Leave without pay (LWOP) [PDF 342.4 KB]
- Transition to Retirement [PDF 364.6 KB]
- Triple S accounts for Lump Sum Scheme Members [PDF 339.2 KB]
- Entitlements [PDF 410.7 KB]
- Points [PDF 369.3 KB]
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Pension Scheme fact sheets
- Death entitlements [PDF 325.8 KB]
- Fees [PDF 83.4 KB]
- Contracts or acting arrangements of 12+ months [PDF 345.8 KB]
- Income Protection [PDF 337.3 KB]
- Points [PDF 369.3 KB]
- Government Co-contributions [PDF 349.6 KB]
- Leave without pay (LWOP) [PDF 342.4 KB]
- Part-time Employment [PDF 334.5 KB]
- Purchased Leave [PDF 340.8 KB]
- Surcharge [PDF 352.8 KB]
- Total and Permanent Disablement [PDF 342.2 KB]
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All schemes information sheets
- Making a TPD Claim information sheet [PDF 132.1 KB]
- Making an IP Claim information sheet [PDF 121.8 KB]
- Proof of Identity [PDF 113.3 KB]
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Triple S | Police | information sheets
- Guaranteed minimum retirement benefit [PDF 416.3 KB]
- Know your super [PDF 129.3 KB]
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Lump Sum Scheme information sheets
- Pension and lump sum taxes [PDF 114.2 KB]
- Retrenchment [PDF 112.2 KB]
- Salary Sacrifice [PDF 104.4 KB]
- Superannuation and breakdown of relationships [PDF 159.2 KB]
- Targeted Voluntary Separation Package (TVSP) [PDF 125.6 KB]
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Pension Scheme information sheets
- Commutation [PDF 114.7 KB]
- Pension and lump sum taxes [PDF 114.2 KB]
- Preserved entitlements [PDF 110.2 KB]
- Superannuation and breakdown of relationships [PDF 159.2 KB]
- Retirement entitlements [PDF 106.8 KB]
- Retrenchment entitlements [PDF 101.2 KB]
- Salary Sacrifice [PDF 104.4 KB]
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SA Ambulance Service Super Scheme information sheets
- Transfer to Triple S [PDF 137.4 KB]
- Working after age 60 [PDF 134.8 KB]