BENDZULLA ACTUARIAL PTY LTD
CONSULTING ACTUARIES
GPO BOX 1181, HOBART, TASMANIA 7001. LEVEL 3, 33 SALAMANCA PLACE, HOBART, 7000
TELEPHONE 1800 203 123    FACSIMILE 1800 103 123
ABN 13 009 492 219

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ONLINE REQUEST FOR
POTENTIAL ECONOMIC LOSS CALCULATION

Contact Details

Where would you like the report returned to and who should be contacted if there are any queries:

Contact Name:
Company:
Address:
Post Code:
Phone:
Fax:
Email:
Your Reference:

Personal Details

Name:
Date of Birth:
Sex:
Start Date of Loss:
End Date of Loss (default age 65):
Discount to (default today's date):

Calculation Basis

7% Discount 0% p.a. Inflation
3% p.a. Discount 0% p.a. Inflation
Other - if so please write details below
Discount % p.a.      Inflation % p.a.

Salary Information

Please complete from the start date of loss to the end date of loss with the first and last years showing actual earnings for the part year - not the annual rate of earnings.
This salary information is:
Gross Earnings    Net of Tax and Medicare Earnings
Year Amount Year Amount Year Amount Year Amount
1950/51 1951/52 1952/53 1953/54
1954/55 1955/56 1956/57 1957/58
1958/59 1959/60 1960/61 1961/62
1962/63 1963/64 1964/65 1965/66
1966/67 1967/68 1968/69 1969/70
1970/71 1971/72 1972/73 1973/74
1974/75 1975/76 1976/77 1977/78
1978/79 1979/80 1980/81 1981/82
1982/83 1983/84 1984/85 1985/86
1986/87 1987/88 1988/89 1989/90
1990/91 1991/92 1992/93 1993/94
1994/95 1995/96 1996/97 1997/98
1998/99 1999/00 2000/01 2001/02
2002/03 2003/04 2004/05 2005/06
2006/07 2007/08 2008/09 2009/10
2010/11 2011/12 2012/13 2013/14
2014/15 2015/16 2016/17 2017/18
2018/19 2019/20 2020/21 2021/22
2022/23 2023/24 2024/25 2025/26
2026/27 2027/28 2028/29 2029/30
2030/31 2031/32 2032/33 2033/34
2034/35 2035/36 2036/37 2037/38
2038/39 2039/40 2040/41 2041/42
2042/43 2043/44 2044/45 2045/46
2046/47 2047/48 2048/49 2049/50

Contingencies

Nil i.e. certain payment
With allowance for average mortality
With allowance for average workplace participation

Comments / Special Items

 

Note: You may wish to print this page for your own records before you hit the submit button.

Actuarial Fees

$440.00 (inclusive of GST)
Invoices will be forwarded with report.

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