Superannuation contribution exemption questionnaire Employers are not required to provide superannuation support on behalf of "prescribed employees". As such, the purpose of this questionnaire is to gather the necessary information in order to assess whether an individual qualifies for this exemption. Please complete the questionnaire below and submit it to your local Deloitte contact. Deloitte will then assess the individual employee's facts and circumstances and provide the company with a position paper outlining the applicability of the exemption.

Email address of the Deloitte contact you are dealing with:     Deloitte office: Please select Adelaide Brisbane Darwin Melbourne Perth Sydney   Office location:   Office e-mail address:   Office fax number:     General details Name of employer: Name of employer contact: Phone number of employer contact: Email address of employer contact: Postal address of employer contact: Name of employee: Home country / country of citizenship: Current visa subclass:   456   457   956   957     Other (please specify):   Employment details Current position title: Primary objective of current position: Is this a full time position?   Yes      No Total value of remuneration package:     Less than A$100,000   Between A$100,000 & A$250,000   Between A$250,000 & A$500,000   Over A$500,000 Method of appointment to current position:     Headhunted   Promotion   Secondment / intra-company transfer   Other (please specify):    Is the employee establishing a business activity in Australia on behalf of the employer?       Yes      No Method of sponsorship by the employer for the employee's current visa subclass:     Regional Headquarters Agreement (RHQ)   Labour agreement   Overseas business sponsorship   Standard business sponsorship   Pre-qualified business sponsorship   Not applicable Has the employee been appointed by a company operating in Australia to be a national managing executive, a deputy national managing executive or a state manager?     Yes      No Comments:   Is the employee's current position in the three highest levels of the management structure of the organisation within Australia?     Yes      No Comments:   Is the employee responsible for the strategic policy development affecting a major component of the operation of the business in Australia?     Yes      No Comments:   Please outline the key responsibilities of the employee's current role which are deemed to be essential, material or important to the overall operations of the organisation in Australia:     Does the employee have a direct impact and influence on the following key areas of the overall business in Australia:     Profits?   Yes      No   Production activities?   Yes      No   Significant expenditure?   Yes      No   Major staffing issues?   Yes      No   Human resource strategy?   Yes      No   IT strategy?   Yes      No   Company policy and procedures?   Yes      No Number of employees reporting to the position:     Less than 10   Between 10 and 25   Between 25 and 50   Between 50 and 100   Between 100 and 200   200+ Position (if any) to which the employee reports within the organisation:   Skills and qualification details: Please outline the employee's key qualifications and experience which are relevant to the current position in Australia:     Which professional bodies does the employee belong to:       Security | Legal | Privacy       Grosvenor Place 225 George Street Sydney 2000 NSW   © 2008 Deloitte Touche Tohmatsu. All rights reserved. Deloitte refers to one or more of Deloitte Touche Tohmatsu, a Swiss Verein, and its network of member firms, each of which is a legally separate and independent entity. Please see www.deloitte.com/au/about for a detailed description of the legal structure of Deloitte Touche Tohmatsu and its member firms. Liability limited by a scheme approved under Professional Standards Legislation.