Unclaimed superannuation money statement

How to complete the Unclaimed superannuation money form (NAT 71864) for super funds.

Last updated 27 June 2022

The Unclaimed superannuation money (USM) statement paper form is for super providers with reporting and payment obligations under the Superannuation (Unclaimed Money and Lost Members) Act 1999 (SUMLMA) and for funds reporting New Zealand sourced USM amounts.

Unclaimed superannuation money (USM) statement (NAT 71864, PDF, 353KB)This link will download a file
Unclaimed superannuation money (USM) statement – additional members (NAT 71864A, PDF, 592KB)This link will download a file

Who completes this statement

Complete this statement if you are a superannuation provider or an authorised super supplier that has reporting and payment obligations under the Superannuation (Unclaimed Money and Lost Members) Act 1999 (SUMLMA) and you have:

unclaimed superannuation money (USM)
USM that includes a New Zealand-sourced amount – a New Zealand-sourced amount is an amount transferred from a KiwiSaver Scheme under the Trans-Tasman retirement savings portability arrangement.

Do not use this USM statement if you are lodging for 7 or more members - unless you are reporting a New Zealand sourced amount. A USM statement with 7 or more members, not including New Zealand sourced amounts, must be lodged electronically.

For information about how to report electronically, refer to Unclaimed superannuation money protocol.

Before you complete this statement

Before you complete the USM statement, you should refer to any Section 20C notices you’ve received from us.

How to complete this statement

Section A: Supplier details

Complete this section if you are the supplier of the information and authorised to act on behalf of the super provider – for example, if you are:

a tax agent
an accountant
a super administrator
the provider, including
- a super fund
- an approved deposit fund
- a retirement savings account provider.

If you are the provider and don't have a separate supplier to provide details on your behalf, you must complete section A and B, even if the details are the same.

Question 1
Australian business number (ABN)

Provide your ABN.

Question 2
Organisation name

Provide the full name of your organisation.

Question 3
Street address

Provide your street address, not a post office box.

Question 4
Postal address

Provide your postal address.

If this is the same as the street address, write ‘as above’.

Question 5
Contact details

Provide the name, phone number and email for the nominated supplier contact person who may be contacted on behalf of the provider if we have any questions about the information in this USM statement.

Question 6
Your reference

Provide a reference that you will find useful in identifying this USM statement if we need to contact you about information supplied in it.

Section B: Provider details

Provide details of the provider of the unclaimed superannuation money or former temporary resident accounts.

Question 7
Tax file number (TFN)

Provide the provider’s TFN.

Question 8
ABN

Provide the provider’s ABN.

Question 9
Name

Provide the provider’s current full name.

Question 10
Previous name

Provide the previous full name of the provider.

Only provide this if the name of the provider has changed since their last super lodgment was submitted – for example:

MAAS form
member exit statement
an assessment variation advice
a payment variation advice.

Question 11
Branch number

Provide the branch number if the provider making the report has more than one location.

Question 12
Street address

Provide the provider’s street address, not a post office box.

Question 13
Postal address

Provide the provider’s postal address.

If this is the same as the street address, write ‘as above’.

Question 14
Address for service of notices

Place an ‘X’ in the applicable box, depending on whether you want notices sent to the provider or supplier.

If a preference is not indicated, we will send correspondence to the supplier.

Question 15
Contact details

Provide the name, phone number and email for the nominated contact person who may be contacted if we have any questions about the information provided in this USM statement.

Question 16
Type of superannuation provider

Place an ‘X’ in the applicable box. Only one option can be selected.

Question 17
Your reference

Provide a reference that will help you identify this USM statement if we need to contact you about information supplied in it.

Section C: Statement details

Question 18
Unclaimed money day

Provide the unclaimed money day. Report this date as EITHER 30 June or 31 December of a past reporting period.

The unclaimed money day is the last day of an unclaimed money period. The schedule statement day is the date the statement is due and payable.

The unclaimed money days and scheduled statement days are:

Unclaimed money day	Scheduled statement day
30 June	31 October of the same year
31 December	30 April of the following year

Note: The above scheduled due dates do not apply to trustee voluntary payments (TVPs). However, the existing USM effective dates can be used to report TVP.

Question 19
Amount remitted

Provide the total value of the cheque, money order or electronic funds transfer.

You must complete the payment slip provided at the end of the statement if you are paying by cheque or money order.

Question 20
Number of members reported

Provide the total number of members reported on this USM statement.

A maximum of 6 members may be reported using this statement, unless you are reporting a New Zealand sourced amount. If you need to lodge a statement with more than 6 members, not including New Zealand sourced amounts, you must lodge electronically.

Question 21
Final report

Place an ‘X’ in the applicable box to indicate whether this is the final statement to be lodged from this provider.

If you answer ‘No’, go to section D.

If you answer ‘Yes’, go to question 24.

Question 22
Final report reason

Place an ‘X’ in the applicable box to indicate the reason why this is the final statement to be lodged from this provider.

Section D: Member details

It is important the information provided is accurate. If multiple members need to be reported for a specific reporting period, you must complete sections D and E for each member using Unclaimed superannuation money statement – additional members (NAT 71864A).

Question 23
Member’s TFN

Provide the member’s TFN.

Question 24
Name

Provide the member’s full name.

Question 25
Previous name

Provide details of the member’s previous name if their name has changed.

Question 26
Address

Provide the member’s last known residential address.

Question 27
Previous address

Provide the member’s previous residential address, if available.

Question 28
Phone number

Provide the member’s last known phone number.

Question 29
Sex

Place an ‘X’ in the applicable box.

Question 30
Date of birth

Provide the member’s date of birth.

If only a year of birth is known (for example, 1976), report the date of birth in the format 00/00/1976.

Question 31
Has the date of birth been deemed?

Place an ‘X’ in the applicable box.

Section E: Member account details

Question 32
Member status

Place an ‘X’ in the applicable box to indicate the current member status.

Valid values for USM are:

A – Member reached eligible age
N – Non-member spouse
D – Deceased.

Valid value for former temporary resident is:

R – Report and payment for a former temporary resident – indicates the lodgment and payment is for a former temporary resident identified on s20C notice received by fund.

Valid values for small and insoluble lost member accounts are:

Q – small lost member account – indicates a member account that has been identified as being lost, and the balance of the account is less than $6,000 as at the end of the unclaimed money day.
P – insoluble lost member account – indicates a member account that has been identified as being lost, and the provider
- has not received an amount in respect of the member within the last 12 months
- is confident, having regard to the information reasonably available to them, that it will not be possible for them to pay an amount to the member as at the end of the unclaimed money day.

Valid value for inactive low balance accounts is:

L – Inactive Low Balance account (ILBA) – indicates a member account that meets the following criteria (subject to limited exception)
- no amount has been received for the last 16 months
- the account balance is less than $6,000
- the account is not a defined benefit account
- the member has not met a prescribed condition of release
- insurance is not being provided in the account
- the fund is not an SMSF or small Australian Prudential Regulation Authority (APRA) fund.

Valid value for trustee voluntary payments is:

V – Trustee Voluntary Payment (TVP)
- Amounts in respect of a member, former member or non-member spouse where the trustee reasonably believes paying the amount to the Commissioner would be in the best interest of the person.
- The amounts can be identified and reported at any time during the year. The scheduled due dates do not apply to trustee voluntary payments (TVPs). However, the existing USM effective dates can be used to report TVP.

Question 33
Account details

Provide details of the member’s account, including:

the super product name and identification number (if available, as this will help in identifying the product within the fund that the member account belongs to)
the account number
a reference number you may have for the member other than their account number – for example, their employee, payroll, union or Australian Government Service (AGS) number.

Question 34
System code

Provide the code for the system or product within your administrative structure that holds the member account.

This item may be used by those providers maintaining accounts on more than one physical system or offering more than one choice of product to their members to identify the location, system or product where the provider member account is held.

Question 35
Provider client identifier

Provide the member identifier used to link member accounts within the organisation. For example, a provider client identifier could be a customer number that is used to link different member accounts held by one person.

If the member’s account number is the unique number you identify them with, you can leave this blank.

Question 36
Service period

Provide details of the service period, including the:

first day of the service period
last day of the service period – this will generally be as stated in the scheduled statement day field, unless the fund has identified that an earlier date should apply
number of days in the service period – if more than one period is related to the lump sum, the days may not be continuous.

The first day of the service period is usually:

the first day of the first period of employment that the lump sum relates to if the member was employed when some or all of the lump sum accrued
the earlier of the following if the member was not employed when some or all of the lump sum accrued
- the date when the member joined the fund
- if the lump sum is attributable to an earlier lump sum previously rolled over, the first day of the service period of the earlier lump sum.

Question 37
Previous provider name

If the member’s account, benefit or interest was transferred from another provider, provide the name of the original provider.

Question 38
Agent details

Provide contact details of the member’s appointed authorised agent.

Question 39
Death benefit

Place an ‘X’ in the applicable box to indicate if the member account is a death benefit. If you answer ‘Yes’, provide the date the member died.

If only a year of death is known (for example, 2019) complete this in the format 00/00/2019.

Question 40
Required payee

Place an ‘X’ in the applicable box to indicate whether there are reasons that the trustee would be required to pay the member’s USM to a specific person.

If you answer ‘No’, go to question 42.

If you answer ‘Yes’, go to question 41.

Question 41
Required payee type

Place an ‘X’ in the applicable box to indicate the reason why the trustee would be required to pay the member’s USM to a specific person.

Valid choices are:

BN – binding nomination – indicates that a person has been included in a valid binding nomination.
TD – trust deed – indicates that a person has been determined as someone that the trustee would be required to pay in accordance with information contained in a trust deed.
OT – other – indicates that other reasons apply as to why the trustee would be required to pay to a specific person.

You must select the required payee type OT where there is a reversionary beneficiary or a requirement to pay a specific individual under the law.

Question 42
Member benefit: taxable component – taxed element

Provide the taxable component, which is the total amount of the super benefit less the tax-free component. The taxable component may consist of a taxed element, an untaxed element or both. The taxed element is the amount of the taxable component that has been subject to tax in the fund.

This value must be more than or equal to zero, and must include cents – for example, $12,345.67.

Question 43
Member benefit: taxable component – untaxed element

Provide the taxable component, which is the total amount of the super benefit less the tax-free component. The taxable component may consist of a taxed element, an untaxed element, or both. The untaxed element is the amount of the taxable component that has not been subject to tax in the fund. This amount must be more than or equal to zero, and must include cents.

Question 44
Member benefit – tax free component

Provide the total value of the following:

contributions segment
crystallised segment.

This value must be more than or equal to zero and must include cents. Amounts must be crystallised before being reported to us.

Do not include any New Zealand-sourced amount here, include it at question 54.

Question 45

New Zealand-sourced amount

This field is only relevant to super providers who accept KiwiSaver accounts.

The New Zealand-sourced amount does not include any returning Australian-sourced amount which is generally an amount that was previously received by a participating KiwiSaver scheme from an Australian super provider and was originally accrued in an Australian complying super fund.

Provide the total value of the New Zealand-sourced amount.

Question 46
Total member entitlement

Provide the total member entitlement.

Section F: Declaration

Read the declaration. If it is correct, print your full name and position, then sign and date the declaration.

Both declarations must be completed if you are a supplier of USM information, lodging the USM statement on behalf of the provider.

If you are the provider lodging the USM statement, only complete the provider declaration.

Before you sign the USM statement, check you have provided complete and accurate information. This statement will be returned to you if it is not signed.

Lodging your USM statement

USM payments can be made by cheque, money order or electronic funds transfer.

If you are paying the USM payment with a cheque or money order, make sure you attach it with the payment slip.

Cheques must be for amounts in Australian dollars and payable to the 'Deputy Commissioner of Taxation'. Cheques should be crossed 'Not negotiable' and must not be postdated.

EFT payments can be made using the BPAY^® or direct credit payment methods. For more information about how to make payment using EFT, refer to Unclaimed superannuation money – for superannuation providers.

Next Step

Send your completed USM statement (with attached USM payment and payment slip, if you are paying with a cheque or money order) to:

Australian Taxation Office
Locked Bag 1936
ALBURY NSW 1936

Deferral to lodge or pay

To request a deferral of time to lodge a USM statement, lodge a non-lodgment advice or make a payment:

lodge a request using the Super Enquiry Service.

phone us on 13 10 20
write to us at

Australian Taxation Office
PO Box 3578
ALBURY NSW 2640

In your request you should include the:

super provider's name
super provider's Australian business number (ABN)
reason the deferral is required
date to which the deferral is required
number of members that will be impacted
sections of the Superannuation (Unclaimed Money and Lost Members) Act 1999 that relate to the deferral being requested.

More information

For more information about the USM statement:

phone us on 13 10 20 between 8.00am and 6.00pm, Monday to Friday
write to us at