Application for endorsement
as a deductible gift recipient
WHEN TO USE THIS APPLICATION
Complete this application if your organisation wants to apply for
endorsement as a deductible gift recipient.
If your organisation is seeking endorsement as a tax
concession charity or income tax exempt fund, complete an
Application for endorsement as a tax concession charity
or income tax exempt fund
(NAT 10651).
COMPLETING YOUR APPLICATION
This application should be completed by a person authorised
by the organisation to act on its behalf.
To complete this application:
n
download a copy of the application to your computer and
check that you can save information in the application
n place X in ALL applicable boxes
n type directly into the form
n
you must answer all questions unless we tell you otherwise.
Before completing this application, read the
Instructions for endorsement as a deductible gift
recipient
(NAT 2949).
Section A: Applicant information
1
What is your organisation’s Australian business number (ABN)?
See instructions
2 What is your organisations legal name and postal address?
See instructions
Legal name
Postal address
Suburb/town State/territory Postcode
Country if other than Australia
3
What are you applying for?
Select one box only
See
instructions
(a)
Endorsement of your organisation as a whole as a deductible gift recipient.
(b)
Endorsement of your organisation as a deductible gift recipient for a fund,
authority or institution your organisation owns or includes.
Legal name of your organisations fund, authority or institution
Provide details below
Address of your organisations fund, authority or institution (if different from your organisations address)
Suburb/town State/territory Postcode
Country if other than Australia
If your organisation is seeking endorsement for more than one fund, authority or institution that it owns or includes, you will
need to lodge a separate endorsement application form for each one.
NAT 2948-01.2015
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(when completed)
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Section B: Endorsement information
4 Which item number applies to your organisation or to your organisations fund, authority or institution?
Provide the item number that best describes your organisation, or your organisations fund, authority or institution.
See instructions
Item number
. .
Only include additional items if they are relevant to your organisation, or your organisations fund, authority or institution.
Item number
. .
Item number
. .
Item number
. .
5 Is your organisation or your organisations fund, authority or institution in Australia?
See instructions
No Your organisation is not entitled to endorsement as a deductible gift recipient.
Yes
6 From what date does your organisation want to be endorsed as a deductible gift recipient?
See instructions
Day Month Year
Section C: Attachments
Have the instructions asked you to complete a schedule?
Refer to the Instructions for endorsement as a deductible gift recipient (NAT 2949) to find out.
No Complete the declaration on the next page.
Yes
Attach the completed schedule to this application and complete the declaration on the next page.
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Section D: Declaration
Before you sign this form, check that the information you have provided is accurate and complete.
Penalties
Penalties may be imposed for giving false or misleading information.
Privacy
Taxation law authorises the ATO to collect information and disclose it to other government agencies. This includes personal
information of the person authorised to sign the declaration. For information about your privacy go to ato.gov.au/privacy
Name of signatory
Position held
Business hours phone number (8.30am to 5.30pm weekdays) Mobile phone number
I am authorised to make this declaration on behalf of the organisation. The information contained within this application is true
and correct.
Signature
Date
Day Month
Year
Time taken to complete this form
Estimate how long (in minutes) it took you to complete this application.
minutes
Lodging your application
n
Print the completed application and attach the schedule (if required)
n Complete and sign the declaration
n Send your completed application to:
Australian Taxation Office
PO Box 3373
PENRITH NSW 2740
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click to sign
signature
click to edit