David Garry & Associates

Firm Name*:
Contact Name*:
Telephone*:
Fax:
Email*:

Street Address
PO Boxes are not acceptable here, only street addresses, and either the street number or lot number must be provided.
Address*:
City*:
State*:
Postcode*:

Delivery Address	As Above
Address*:
City*:
State*:
Postcode*:

Name of Fund*:
State of Fund*:

Note: Stamp Duty may be payable at different rates depending on State/Territory laws.

Do you wish us to attend to the stamping of the fund? Note: Only available in South Australia at this point.

DGA To Attend Stamping	Yes

Note: If the superannuation fund is to have a Corporate Trustee please enter details here. If the individial Members are to be the Trustees please skip this screen

Trustee Name:
ACN:	(if company)

Street Address
PO Boxes are not acceptable here, only street addresses, and either the street number or lot number must be provided.
Street:

City:
State:
Postcode:
Country:	(if not Australia)

If ACN is entered, at least 1 director name must be entered
1st Director:
2nd Director:
Other Directors:

Valid Trustee Structures. To view click here

Surname*:
Given Name(s)*:

Street Address
PO Boxes are not acceptable here, only street addresses, and either the street number or lot number must be provided.
Street 1*:

City*:
State*:
Postcode*:
Country:	(if not Australia)
Date Of Birth:

Sex:	Male Female

	This person must be a member and if there is a trustee company, they must be a director of that company. If the fund has individual trustees then they must be a trustee with another individual.

Surname:
Given Name(s):

Street Address
PO Boxes are not acceptable here, only street addresses, and either the street number or lot number must be provided.
Street 1:

City:
State:
Postcode:
Country:	(if not Australia)
Date Of Birth:

Sex:	Male Female

	Is this person a member: Yes No

	Is this member an employee of another member?
	If so, is that member related to the employer?

Surname:
Given Name(s):

Street Address
PO Boxes are not acceptable here, only street addresses, and either the street number or lot number must be provided.
Street 1:

City:
State:
Postcode:
Country:	(if not Australia)
Date Of Birth:

Sex:	Male Female

	This person must be a member and either an individual trustee or director of trustee company unless the member is a minor.
	Is this member an employee of another member?
	If so, is that member related to the employer?

Surname:
Given Name(s):

Street Address
PO Boxes are not acceptable here, only street addresses, and either the street number or lot number must be provided.
Street 1:

City:
State:
Postcode:
Country:	(if not Australia)
Date Of Birth:

Sex:	Male Female

	This person must be a member and either an individual trustee or director of trustee company unless the member is a minor.
	Is this member an employee of another member?
	If so, is that member related to the employer?

Super Details:
	Must be entered if company name entered
ACN:

Street 1:

Town:	State: Postcode:

To DGA: You are appointed to act as our agent to procure a Trust Deed and ancillary legal documentation from a solicitor, the particulars for such trust deed and legal documents being set out hereinbefore. In consideration for you acting as our agent, payment of solicitors costs, attending to compliation of materials in a register and delivery of same we shall pay you such amounts as agreed.
I Agree (required)	Yes
Payment with the order is required, unless you already have established credit payment facilities with us.

Proposed Method of Payment

Direct Deposit details:

Account Name: David Garry & Associates
Bank: ANZ BankingGroup
BSB: 015-010
Account No: 9002 61003

When making payment by EFT/Direct Deposit please ensure that you include a reference to the chosen Trust Deed name to assist us in correctly identifying and matching the payment.

Name On Card*:
Credit Card Number*:
Credit Card Expiry Date*:

Direct Deposit Comments:

Other form of payment (please specify arrangements):

Prior to submitting the order, you must preview the details entered. When satisfied the details are correct, click on the submit button at the end of the preview and your order will be transmitted. You will receive a copy of the submission to the email address entered. Prior to submission, you may wish to print a copy of the preview.


Preview:

Applicant Details

Direct Deposit details: