Fillable Change of details for individuals (Australian Taxation Office)

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Change of details for individuals (Australian Taxation Office)

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Sensitive (when completed)
NAT 2817-11.2017
Change of details for individuals
You can update your name, address and contact details
online. You can also nominate a representative. You can
login or register for online services from ato.gov.au/online
If you are unable to update your details online then you
maybe able to update your details over the phone.
SeeFind out more below.
Alternatively, you can use this form if you want to:
■ update your name, address and contact details held by the
ATO for taxation purposes
■ nominate another person (your representative) to deal with
uson your behalf and receive information about your
taxationaffairs.
It can take up to 28 days to update your records after we
receive the paper form.
Only you can nominate a representative to deal with uson
your behalf and receive information about your taxation
affairs. If you are not nominating a representative onthis
form, you or a person currently on our records as having
authority to update these details can complete andsign
thisform.
When completing this form
You must complete sections A, C and E and the
questionswhere your details have changed in section B.
Ifyouare nominating a representative you will also need
tocomplete section D.
If you are filling in this form on screen:
■ when completed, print two copies
■ sign and date the declaration
■ mail your completed form to the address shown on page 7
■ keep the second copy for your records.
If you are filling in this form by hand:
■ print clearly in BLOCK LETTERS using a black or dark blue
pen only
■ place X in the applicable boxes
■ do not use correction fluid or covering stickers
■ sign next to any corrections with your full signature
(notinitials)
■ sign and date the declaration at the end of the form
■ make a copy for your records
■ mail your completed form to the address shown on page 7.
Find out more
■ Phone 13 28 61 between 8.00am and 6.00pm,
Monday to Friday.
If you phone, we need to know we are talking to the right
person before we can discuss your tax affairs. We will ask you
for details only you or someone you’ve authorised would
know. An authorised person is someone recorded on our
systems who can act on your behalf.
To help with your enquiry you may also quote your tax
filenumber (TFN). See Quoting TFNs on page 1.
■ Visit ato.gov.au
Section A: Your current details with the ATO
This section is compulsory. You must complete questions 2 to 5.
2 What is your full name?
Provide your name as it was when you last dealt with the ATO.
Family name
First given name Other given names
Title: Mrs Miss Ms Other
Mr
1 Whatisyourtaxlenumber(TFN)?
Quoting TFNs
We are authorised by the Taxation Administration Act 1953 to request tax file numbers (TFNs). We will use your TFN to
identify you in our records. It is not an offence not to provide TFNs. However, if you do not provide your TFN, there may be
a delay in processing this form.
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3 What is your postal address?
Provide your postal address as it was when you last dealt with the ATO – for example, on your last notice of assessment.
Country if other than Australia
Suburb/town/locality
5 Whatisyourdateofbirth?
Day Month Year
State/territory
(Australia only)
Postcode
(Australia only)
4 What is your home address?
Provide your home address as it was when you last dealt with the ATO – for example, on your last notice of assessment.
This must be a street address, for example, 123 Smith St.
This cannot be a post ofce box number, roadside mail bag, roadside delivery or other delivery point address.
Write ‘As above’ if same as postal address at question 3.
Country if other than Australia
Suburb/town/locality State/territory
(Australia only)
Postcode
(Australia only)
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Section B: Do you want to change your name or address details?
Yes Complete this section.
Complete the following questions where your details have changed.
No Go to section C.
6 What is your new full name?
This is the name that appears on all ofcial documents or legal papers.
If you are in business (that is, a sole trader) this information will also be used to update your details
on the Australian Business Register.
Family name
First given name Other given names
Title: Mrs Miss Ms Other
Mr
You must provide one of the following identity documents to support your change of name. It needs to be a certified copy.
Certified copies of documents you mail to us may not be returned to you. We may check the supporting documents you supply
with the agencies that issued them.
Supporting documents
■ Australian full birth certicate (not an extract)
■ Australian change of name certicate
■ Australian marriage certicate.
If you are a foreign resident and cannot provide one of the documents listed above, you can provide a certified copy ofoneof
the following documents:
■ National photo identication card
■ Foreign passport
■ Foreign birth certicate
■ Foreign marriage certicate
■ Foreign government identication
■ Foreign drivers licence.
For more information on certified copies of documents, refer to:
■ Copies of documents – applicants within Australia
■ Copies of documents – applicants outside Australia
7 What is your new postal address? (Your mail will be sent to this address.)
For example, your home address, your post ofce box or your registered tax agent’s postal address.
Yes
No
If you are in business, would you like this address information to be updated on the Australian Business Register?
(This is the address where government departments and agencies will send notices and correspondence.)
Country if other than Australia
Suburb/town/locality State/territory
(Australia only)
Postcode
(Australia only)
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8 What is your new home address?
This must be a street address, for example, 123 Smith St.
This cannot be a post ofce box number, roadside mail bag, roadside delivery or other delivery point address.
Write ‘As above’ if same as postal address at question 7.
Yes
No
If you are in business, would you like this home address information to be updated on
the Australian Business Register as your business address?
Country if other than Australia
Suburb/town/locality State/territory
(Australia only)
Postcode
(Australia only)
Section C: Phone and email contact details
This section is compulsory.
9 Where can we contact you or leave a message if we need more information?
A contact number must be provided.
Daytime phone number
After hours phone number
Mobile phone number
No YesDo you want these details updated on our records?
If you are in business, would you like these contact details
to be updated on the Australian Business Register?
No Yes
Email address
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Section D: Do you want to nominate a representative?
Yes Complete this section.No Go to section E.
Complete this section to nominate a representative (authorised contact) to deal with us on your behalf and receive
informationabout your taxation affairs.
It is important to know that:
■ nominating a representative (authorised contact) does not cancel any previous nomination
■ any nomination will continue indefinitely until you let us know it no longer applies.
Think carefully about the extent of the authority you are giving. We will only discuss your taxation affairs with your
representativeaccording to your statement of authority on this form.
If you are appointing a professional (such as a registered tax or BAS agent, barrister or solicitor) as your representativeyou
cannot use this form. Visit ato.gov.au or phone us for more information.
11 Indicatewhichmattersyounominatetherepresentativetodealwithonyourbehalf.
(Place X in ONE box only.)
To deal with the ATO and receive information concerning all of my taxation affairs.
OR
To deal with the ATO concerning the following specific matter(s):
This nomination will continue indefinitely until you phone and let us know you no longer want your representative to act on
your behalf. See Find out more on page 1.
10 Who is your representative?
Family name
First given name Other given names
Title: Mrs Miss Ms Other
Mr
Daytime phone number
After hours phone number
Mobile phone number
Email address
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Section E: Declaration
This section is compulsory.
If you are nominating a representative (authorised contact) in section D, only you can sign this declaration. If you have not
completed section D, only you or a person currently on our records as having authority to update these details can signthis
declaration. If you would like another person to update your details on your behalf, they must already be listed onour records.
Before you sign this form
Make sure you have answered all the relevant questions correctly and read the privacy statement below before you sign
anddate this page. An incomplete form may delay processing and we may ask you to complete a new form.
Penalties may be imposed for giving false or misleading information.
12 Who is the authorised person signing this declaration? (Complete all of the fields below.)
Full name of signatory
Email address
I declare that the information given on this form is true and correct.
OR
I declare that:
■ this document has been prepared in accordance with information supplied by the individual
■ I have received a declaration from the individual authorising me to complete this form and
statingthattheinformationprovided to me is true and correct.
Signature
You MUST SIGN here
Date
Day Month Year
Privacy
Taxation law authorises the ATO to collect information and todisclose it to other government agencies.
For information about your privacy go to ato.gov.au/privacy
We may check the supporting documents you supply with the agencies that issued them.
Daytime phone number
After hours phone number
Mobile phone number
Sensitive (when completed)
Helpful information (DO NOT SEND THIS PAGE TO THE ATO)
ATOFORMSLODGEDBYYOURREPRESENTATIVE
Your representative can only lodge certain ATO forms on your behalf, such as your income tax return, if you have given them a
declaration for this purpose. If you make a declaration, your representative should hold the original and you should keep a copy.
Below is a sample declaration that you may use.
You do not need to send this page or this declaration to the ATO.
Remember you are still responsible for the accuracy of information you give us, even if someone else, including aregistered
agent, helps you to prepare a tax return or other tax document.
Declaration under Section 388-65 of Schedule 1 to the Taxation Administration Act 1953
I
hereby authorise
to give to the Commissioner of Taxation my
Day Month Year
for the period ended .
I declare that the information I have provided to
for this purpose is true and correct.
Signature
Date
Day Month Year
Lodgingthisform
Keep a copy of this form for your records. Send the form and your supporting documents (if applicable) to us at:
Australian Taxation Office
PO Box 3373
PENRITH NSW 2740
We will aim to process this form within 28 days of receiving all the necessary information. If your form is incomplete, incorrect or
needs checking, it may take longer. Do not lodge another form during this time.
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Change of details for individuals (Australian Taxation Office)

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Completed 13 October 2020

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