Applicant and Employee Form | Austchilli Group Safety

Applicant and Employee Details Form

First Name

Last Name

Preferred Name

Date of Birth

Home Address

Mobile Number

Home Number

Emergency Contact Name

Emergency Contact Phone

Drivers License

Yes

No - Tick here if no licence

Drivers License

Upload File

Vehicle/s registration:

Please name your Employment Agency or Jobactive Provider if applicable (e.g Max, APM, NEATO)

Are you an Australian Citizen?

Yes

Provide a Copy of:

Passport and / or

Birth Certificate and/or

Citizenship certificate.

Upload Passport

Choose File

Upload Birth Certificate

Choose File

Upload Citizenship Certificate

Choose File

Are you a permanent resident?

Yes

Do you have a visa with working rights?

Yes - please provide Austchilli with a VEVO check or Immi Grant Letter Upload Vevo Check

Upload Vevo Check

Name of Award or Agreement that applies:

Pressure Fresh Australia Pty Ltd
(AG2023/1725)

Please confirm at your induction the type of employment you will be engaged as:

Full time

Permanent Part time

Casual/Temp Work

BANK ACCOUNT DETAILS – Ensure details are correct and written clearly

Name of Bank

BSB Number

Account Number

Account Name

Tax File Number & required details

What is your tax file number?

OR I have made a separate application/enquiry to the ATO for a new or existing TFN

OR Claiming exemption because I am under 18 years of age and do not earn enough to pay tax.

OR Claiming exemption because I am in receipt of a pension, benefit, or allowance.

OR I have supplied Tax File Number above.

Are you : (select one only)

An Australian resident for tax purposes.

A foreign resident for tax purposes.

A working holiday maker.

Do you want to claim the tax-free threshold from this payer?

Yes

No - (Answer NO here if you are a foreign resident or working holiday maker, except if you are a foreign resident in receipt of an Australian Government pension or allowance).

Do you have a Higher Education Loan Program (HELP), VET Student Loan (VSL), Financial Supplement (FS), Student Start-up Loan (SSL) or Trade Support Loan (TSL) debt?

Yes - Your payer will withold additional amounts to cover any compulsory repayment that may be raised on your notice of assessment.

Superannuation Choice and required details.

I request that all my future super contributions be paid to:

The fund or retirement savings account I nominate (Complete your nominated fund details below).

The superfund nominated by my employer.

Nominating your APRA fund or RSA :

Fund ABN

Fund Name

Unique superannuation identifier

Your account name

Your member number

DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST

To the best of your knowledge, do you have any volunteer, paid employment or business interests outside of Austchilli which may be potential conflicts of interest during your employment with us?

Yes

DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST - DETAILS

WORKPLACE HEALTH AND SAFETY

Do you have any medical conditions or other factors relating to your health and physical fitness which might impact your ability to fulfil the inherent requirements of the role (as defined within the Position Description).

Yes

Detail of your medical conditions or other factors relating to your health and physical fitness

Are you colour blind?

Yes

Do you have any medical conditions that Austchilli should be aware of that may require medical intervention and / or emergency treatment such as the following: Allergy or Anaphylaxis Hepatitis or other blood disease or other transmissible disease or conditions

Yes

Detail of your medical condition

Are you physically capable of carrying out the following tasks? (tick if YES or add notes if NO)

Checkbox Field

Standing continuously, and / or engaging in repetitive arm movements (such as stacking pallets) for long periods of time (up to a full shift duration with reasonable breaks).

Working consistently in cool temperatures of seven (7) degrees Celsius (in the cold room), and outdoors in regional northern Queensland’s inclement weather year-round.

Safely lifting up to 15-20kgs bins or boxes, repetitive bending and loading of cartons onto pallets or weigh scales.

Any repetitive wrist movement (e.g. scooping fruit from the skin).

Any predisposition to motion sickness (e.g. continually watching moving objects on a conveyor belt).

Permitted to work in Australia under Australian Federal Legislation:

Please provide details below if you CANNOT carry out any of the above:

Disclaimer

Any false, misleading or deceptive information obtained throughout the recruitment and onboarding process may result in an investigation leading to disciplinary action, up to and including termination of employment.

The Privacy Act 1988 sets out requirements for collecting, storing, using and disclosing personal information. Austchilli are committed to upholding the Australian Privacy Principles as contained within this Act. Austchilli collect relevant personal information such as personal and emergency contact details, relevant pre-employment medical information, terms and conditions of your employment, wage or salary details, leave balances, records of work hours, records of engagement, resignation or termination of employment, information about training, performance and conduct, taxation, banking and superannuation, and union, professional or trade membership information. We store this information so we are able to best support our teams and promote a safe working environment. This information will only be used for legitimate purposes such as confirming if employee’s can perform the inherent requirements of the role, identifying reasonable adjustments that could be made to accommodate, and assessing what measures need to be taken to comply with work health and safety obligations. This information may be accessed by the leadership team, HR and Payroll as necessary and appropriate. You can request access to your own personal information by putting a request in writing to HR. You can verify and correct your personal information at any time.

Employee Signature

Date

Current Qualification / Tickets / Licenses

Licenses, certificates or qualifications will be held on file. You must provide a copy or photo evidence of the license/qualification to Austchilli before your start date.

Common licenses to provide are driving license, forklift, chemical spray certifications, etc

Issue Date