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College of Arts, Society & Education
Pay Claim Guide
Instructions
At the end of the professional experience, please complete the Pay Claim Form and Tax File Number Declaration
form.
1. Personal Details
All fields are mandatory. The date of birth (DOB) field is required to correctly identify people with the same name.
2. Claim Details
Enter the Pre-Service Teachers full name, Pre-service Teacher Year Level, Placement Dates
SBTE (School Based Teacher Educator)
Enter the hours of Supervision; note the maximum allowance is five hrs per day.
Site Coordinator
Enter the number of Coordination Days. Then the number of group talks held in hours.
3. Total
Enter a total in each section.
4. Banking Details
All fields are mandatory.
5. Certification
Both SBTE (School Based Teacher Educator) and Site Coordinator/Centre Director to sign.
6. Submit Form
The completed claim form and Tax File Number Declaration Form should be forward to the Professional Experience
Unit, James Cook University via email to eduprofex@jcu.edu.au
Pay Rate
Supervision Payment Rate: $4.21 per hour
Coordination Days Rate: $1.44 per PST per day
Group Talks Payment Rate: $12.28 per hour
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College of Arts, Society and Education
Pay Claim Form
Personal Details
Home Address
Title Phone Number
Claimant’s Surname Email
Claimant’s First Name Name of School
Previous Surname
Date of Birth
Tax File Number Declaration Submitted
Banking Details
Name of Bank BSB
Account Name Account Number
JCU CASE Education USE ONLY
FUNDING ACCOUNT:
2221.11102.0001.7050
Certified by (Signature): Date
HR OFFICE USE ONLY
Personal Record Processed Timesheet Processed: Timesheet Checked: Employee No.: Job No.:
Claim Details
Name of Pre-Service Teacher
Pre-Service
Teacher
Year Level
Placement Dates
SBTE
SITE COORDINATOR
Hours of
Supervision
(Max 5 hrs
per day)
Number of
Coordination
Days
Number
of Group
Talks
(hours)
TOTAL
Certification
SBTE:
I certify that the above details are correct.
Signature Date
Site Coordinator/Centre Director:
I certify that the above details are correct.
Name
Signature
Date
0
0
Please Select
Please Select
Please Select
Please Select
Please Select
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
NAT 3092-09.2017
Instructions and form for taxpayers
Tax file number
declaration
Information you provide in this declaration will allow your payer to
workouthowmuch tax to withhold from payments made to you.
This is not a TFN application form.
To apply for a TFN, goto ato.gov.au/tfn
Terms we use
When we say:
payer, we mean the business or individual
makingpayments under the pay as you go
(PAYG)withholding system
payee, we mean the individual being paid.
Who should complete this form?
You should complete this form before you start to receive
payments from a new payer – for example:
payments for work and services as an employee,
companydirector or office holder
payments under return-to-work schemes, labour hire
arrangements or other specified payments
benefit and compensation payments
superannuation benefits.
You need to provide all information requested on this form.
Providing the wrong information may lead to incorrect
amounts of tax being withheld from payments made toyou.
You don’t need to complete this form if you:
are a beneficiary wanting to provide your tax file number
(TFN) to the trustee of a closely held trust. For more
information, visit ato.gov.au/trustsandtfnwithholding
are receiving superannuation benefits from a super fund
and have been taken to have quoted your TFN to the
trustee of the super fund
want to claim the seniors and pensioners tax offset by
reducing the amount withheld from payments made
to you. You should complete a withholding declaration
form (NAT 3093)
want to claim a zone, overseas forces or invalid and
invalid carer tax offset by reducing the amount withheld
from payments made to you. You should complete a
withholding declaration form (NAT3093).
For more information about your entitlement,
visit ato.gov.au/taxoffsets
Section A: To be completed by
thepayee
Question 1
What is your tax file number (TFN)?
You should give your TFN to your employer only after you start
work for them. Never give your TFN in a job application or over
the internet.
We and your payer are authorised by the Taxation
Administration Act 1953 to request your TFN. It’s not an
offence not to quote your TFN. However, quoting your
TFN reduces the risk of administrative errors and having
extra tax withheld. Your payer is required to withhold the
top rate of tax from all payments made to you if you do
not provide your TFN or claim an exemption from quoting
your TFN.
How do you find your TFN?
You can find your TFN on any of the following:
your income tax notice of assessment
correspondence we send you
a payment summary your payer issues to you.
If you have a tax agent, they may also be able to tell you.
If you still can’t find your TFN, you can:
phone us on 132861 between 8.00am and 6.00pm,
Monday to Friday.
If you phone or visit us, we need to know we are talking to
the correct person before discussing your tax affairs. We will
ask you for details only you, or your authorised representative,
would know.
You don’t have a TFN
If you don’t have a TFN and want to provide a TFN to your
payer, you will need to apply for one.
For more information about applying for a TFN, visit
ato.gov.au/tfn
You may be able to claim an exemption from quoting
yourTFN.
Print X in the appropriate box if you:
have lodged a TFN application form or made an enquiry to
obtain your TFN. You now have 28days to provide your TFN
to your payer, who must withhold at the standard rate during
this time. After 28days, if you haven’t given your TFN to
your payer, they will withhold the top rate of tax from future
payments
are claiming an exemption from quoting a TFN because you
are under 18 years of age and do not earn enough to pay
tax, or you are an applicant or recipient of certain pensions,
benefits or allowances from the:
Department of Human Services – however, you will need
to quote your TFN if you receive a Newstart, Youth or
sickness allowance, or an Austudy or parenting payment
Department of Veterans’ Affairs – a service pension under
the Veterans’ Entitlement Act 1986
Military Rehabilitation and Compensation Commission.
Providing your TFN to your super fund
Your payer must give your TFN to the super fund they pay your
contributions to. If your super fund doesn’t have your TFN, you
can provide it to them separately. This ensures:
your super fund can accept all types of contributions to your
accounts
additional tax will not be imposed on contributions as a result
of failing to provide your TFN
you can trace different super accounts in your name.
For more information about providing your TFN to your
superfund, visit ato.gov.au/supereligibility
Question 2–5
Complete with your personal information.
Question 6
On what basis are you paid?
Check with your payer if you’re not sure.
Question 7
Are you an Australian resident for tax
purposes or a working holiday maker?
Generally, we consider you to be an Australian resident for tax
purposes if you:
have always lived in Australia or you have come to Australia
and now live here permanently
are an overseas student doing a course that takes more than
six months to complete
migrate to Australia and intend to reside here permanently.
If you go overseas temporarily and don’t set up a permanent
home in another country, you may continue to be treated as an
Australian resident for tax purposes.
If you are in Australia on a working holiday visa (subclass 417)
or a work and holiday visa (subclass 462) you must place an X
in the working holiday maker box. Special rates of tax apply for
working holiday makers.
For more information about working holiday makers, visit
ato.gov.au/whm
If you’re not an Australian resident for tax purposes or a
working holiday maker, place an X in the foreign resident box,
unless you are in receipt of an Australian Government pension
or allowance.
Temporary residence can claim super when leaving Australia,
if all requirements are met. For more information, visit
ato.gov.au/departaustralia
Foreign resident tax rates are different
A higher rate of tax applies to a foreign resident’s taxable
income and foreign residents are not entitled to a tax-free
threshold nor can they claim tax offsets to reduce
withholding, unless you are in receipt of an Australian
Government pension or allowance.
To check your Australian residency status for tax purposes
or for more information, visit ato.gov.au/residency
2 Tax file number declaration
Question 8
Do you want to claim the tax‑free threshold
from this payer?
The tax-free threshold is the amount of income you can earn
each financial year that is not taxed. By claiming the threshold,
you reduce the amount of tax that is withheld from your pay
during the year.
Answer yes
if you want to claim the tax-free threshold, you are
an Australian resident for tax purposes, and one of the following
applies:
you are not currently claiming the tax-free threshold from
another payer
you are currently claiming the tax-free threshold from another
payer and your total income from all sources will be less than
the tax-free threshold.
Answer yes if you are a foreign resident in receipt of an
Australian Government pension or allowance.
Answer no if none of the above applies or you are a working
holiday maker.
If you receive any taxable government payments or
allowances, such as Newstart, Youth Allowance or
Austudy payment, you are likely to be already claiming
thetax‑free threshold from that payment.
For more information about the current tax-free threshold,
which payer you should claim it from, or how to vary your
withholding rate, visit ato.gov.au/taxfreethreshold
Question 9
(a) Do you have a Higher Education Loan
Program (HELP), Student Start‑up Loan
(SSL) or Trade Support Loan (TSL) debt?
Answer yes if you have a HELP, SSL or TSL debt.
Answer no if you do not have a HELP, SSL or TSL debt, or you
have repaid your debt in full.
You have a HELP debt if either:
the Australian Government lent you money under
HECS-HELP, FEE-HELP, OS-HELP, VET FEE-HELP or
SA-HELP.
you have a debt from the previous Higher Education
Contribution Scheme (HECS).
You have a SSL debt if you have an ABSTUDY SSL debt.
(b) Do you have a Financial Supplement debt?
Answer yes if you have a Financial Supplement debt.
Answer no if you do not have a Financial Supplement debt, or
you have repaid your debt in full.
For information about repaying your HELP, SSL, TSL or
Financial Supplement debt, visit ato.gov.au/getloaninfo
Have you repaid your HELP, SSL, TSL or Financial
Supplement debt?
When you have repaid your HELP, SSL, TSL or Financial
Supplement debt, you need to complete a Withholding
declaration (NAT 3093) notifying your payer of the change
inyour circumstances.
Sign and date the declaration
Make sure you have answered all the questions in
section A, then sign and date the declaration. Give
your completed declaration to your payer to complete
sectionB.
Section B: To be completed by
thepayer
Important information for payers – see the reverse side of
the form.
Lodge online
Payers can lodge TFN declaration reports online if you
have software that complies with our specifications.
For more information about lodging the TFN declaration
report online, visit ato.gov.au/lodgetfndeclaration
Tax file number declaration 3
© Australian Taxation Office for the
CommonwealthofAustralia, 2017
You are free to copy, adapt, modify, transmit and distribute this material as
youwish (but not in any way that suggests the ATO or the Commonwealth
endorses you or any of your services or products).
Published by
Australian Taxation Office
Canberra
September 2017
JS 39383
Our commitment to you
We are committed to providing you with accurate, consistent and clear
information to help you understand your rights and entitlements and meet
yourobligations.
If you follow our information in this publication and it turns out to be incorrect,
oritis misleading and you make a mistake as aresult, we must still apply the law
correctly. If that means you owe us money, we must ask you to pay it but we will
not charge you a penalty. Also, if you acted reasonably and in good faith we will
not charge you interest.
If you make an honest mistake in trying to follow our information in this publication
and you owe us money as a result, we will not charge you a penalty. However, we
will ask you to pay the money, and we may also charge you interest. If correcting
the mistake means we owe you money, we will pay it to you. We will also pay you
any interest you are entitled to.
If you feel that this publication does not fully cover your circumstances, or you
areunsure how it applies to you, you can seek further assistance from us.
We regularly revise our publications to take account of any changes to the law,
somake sure that you have the latest information. If you are unsure, you can
checkfor more recent information on our website at ato.gov.au or contact us.
This publication was current at September 2017.
More information
Internet
For general information about TFNs, tax and super in
Australia, including how to deal with us online, visit our
website at ato.gov.au
For information about applying for a TFN on the web,
visitour website at ato.gov.au/tfn
For information about your super, visit our website at
ato.gov.au/checkyoursuper
Useful products
In addition to this TFN declaration, you may also need to
complete and give your payer the following forms which you
can download from our website at ato.gov.au:
Medicare levy variation declaration (NAT 0929), if you qualify
for a reduced rate of Medicare levy or are liable for the
Medicare levy surcharge. You can vary the amount your
payer withholds from your payments.
Standard choice form (NAT 13080) to choose a super fund
for your employer to pay super contributions to. You can find
information about your current super accounts and transfer
any unnecessary super accounts through myGov after you
have linked to the ATO. Temporary residents should visit
ato.gov.au/departaustralia for more information about super.
Other forms and publications are also available from our website
at ato.gov.au/onlineordering or by phoning 1300 720 092.
Phone
Payee – for more information, phone 13 28 61 between
8.00am and 6.00pm, Monday to Friday. If you want to vary
your rate of withholding, phone 1300 360221 between
8.00am and 6.00pm, Monday to Friday.
Payer – for more information, phone 132866 between
8.00am and 6.00pm, Monday to Friday.
If you phone, we need to know we’re talking to the right person
before we can discuss your tax affairs. We’ll ask for details only
you, or someone you’ve authorised, would know. An authorised
contact is someone you’ve previously told us can act on
yourbehalf.
If you do not speak English well and need help from the ATO,
phone the Translating and Interpreting Service on 131450.
If you are deaf, or have a hearing or speech impairment, phone
the ATO through the National Relay Service (NRS) on the
numbers listed below:
TTY users – phone 133677 and ask for the ATO
number you need (if you are calling from overseas,
phone+61738157799)
Speak and Listen (speech-to-speech relay) users – phone
1300555727 and ask for the ATO number you need (if you
are calling from overseas, phone +61738158000)
Internet relay users – connect to the NRS on
relayservice.gov.au and ask for the ATO number you need.
If you would like further information about the
National Relay Service, phone 1800555660
or email helpdesk@relayservice.com.au
Privacy of information
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
4 Tax file number declaration
5 What is your primary e-mail address?
4 What is your business address?
Suburb/town/locality
State/territory Postcode
There are penalties for deliberately making a false or misleading statement.
Signature of payer
DECLARATION by payer: I declare that the information I have given is true and correct.
Month
Year
Day
Date
2 If you don’t have an ABN or withholding
payer number, have you applied for one?
Yes
No
Section B: To be completed by the PAYER (if you are not lodging online)
Branch number
(if applicable)
1 What is your Australian business number (ABN) or
withholding payer number?
6 Who is your contact person?
Business phone number
7 If you no longer make payments to this payee, print X in this box.
Return the completed original ATO copy to:
Australian Taxation Office
PO Box 9004
PENRITH NSW 2740
IMPORTANT
See next page for:
 payer obligations
 lodging online.
ato.gov.au
This declaration is NOT an application for a tax file number.
 Use a black or blue pen and print clearly in BLOCK LETTERS.
 Print X in the appropriate boxes.
 Read all the instructions including the privacy statement before youcomplete this declaration.
Tax le number declaration
Once section A is completed and signed, give it to your payer to complete sectionB.
NAT 3092-09.2017 [JS 39383]
Section A: To be completed by the PAYEE
6 On what basis are you paid? (select only one)
Full‑time
employment
Part‑time
employment
Casual
employment
Superannuation
or annuity
income stream
Labour
hire
8 Do you want to claim the tax-free threshold from this payer?
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.
No
Yes
Only claim the tax‑free threshold from one payer at a time, unless your
total income from all sources for the financial year will be less than the
tax‑free threshold.
There are penalties for deliberately making a false or misleading statement.
You MUST SIGN here
Signature
Month YearDay
Date
DECLARATION by payee: I declare that the information I have given is true and correct.
9 (a) Do you have a Higher Education Loan Program (HELP), Student Start-up
Loan (SSL) or TradeSupportLoan (TSL) debt?
(b) Do you have a Financial Supplement debt?
Your payer will withhold additional amounts to cover any compulsory
repayment that may be raised on your notice of assessment.
Yes
No
No
Your payer will withhold additional amounts to cover any compulsory
repayment that may be raised on your notice of assessment.
Yes
OR I have made a separate application/enquiry to
the ATO for a new or existing TFN.
For more
information, see
question 1 on page 2
of the instructions.
OR I am claiming an exemption because I am under
18 years of age and do not earn enough to pay tax.
OR I am claiming an exemption because I am in
receipt of a pension, benefit or allowance.
1 What is your tax
le number (TFN)?
2 What is your name?
Title: Mr Mrs Miss Ms
Surname or family name
First given name
Other given names
4 If you have changed your name since you last dealt with the ATO,
provideyour previous family name.
5 What is your date of birth?
Month YearDay
3 What is your home address in Australia?
Suburb/town/locality
State/territory Postcode
Sensitive (when completed)
30920917
3 What is your legal name or registered business name
(or your individual name if not in business)?
An Australian resident
for tax purposes
A foreign resident
for tax purposes
A working
holiday maker
7 Are you: (select only one)
OR
Print form
Save form
Reset form
Payer information
The following information will help you comply with your pay as
yougo (PAYG) withholding obligations.
Is your employee entitled to work in Australia?
It is a criminal offence to knowingly or recklessly allow
someone to work, or to refer someone for work, where
that person is from overseas andis either in Australia
illegally or is working in breach of their visa conditions.
People or companies convicted of these offences may
face fines and/or imprisonment. To avoid penalties, ensure
your prospective employee has a valid visa to work in
Australia before you employ them. For more information
and to check a visa holder’s status online, visit the
Department of Immigration and Border Protection website
at border.gov.au
Is your payee working under a working holiday
visa (subclass 417) or a work and holiday visa
(subclass 462)?
Employers of workers under these two types of visa need
to register with the ATO, see ato.gov.au/whmreg
For the tax table “working holiday maker” visit our website
at ato.gov.au/taxtables
Payer obligations
If you withhold amounts from payments, or are likely to withhold
amounts, the payee may give you this form with section A
completed. A TFN declaration applies to payments made after the
declaration is provided to you. The information provided on this form
is used to determine the amount of tax to be withheld from payments
based on the PAYG withholding tax tables we publish. If the payee
gives you another declaration, itoverrides any previous declarations.
Has your payee advised you that they have applied
for a TFN, or enquired about their existing TFN?
Where the payee indicates at question 1 on this form that they have
applied for an individual TFN, or enquired about their existing TFN,
theyhave 28 days to give you their TFN. You must withhold tax for
28 days at the standard rate according to the PAYG withholding
tax tables. After 28days, if the payee has not given you their TFN,
you must then withhold the top rate of tax from future payments,
unlesswe tell you not to.
If your payee has not given you a completed form
you must:
notify us within 14 days of the start of the withholding obligation by
completing as much of the payee section of the form as you can.
Print‘PAYER’ in the payee declaration and lodge the form – see
‘Lodging the form’.
withhold the top rate of tax from any payment to that payee.
For a full list of tax tables, visit our website at
ato.gov.au/taxtables
Lodging the form
You need to lodge TFN declarations with us within 14 days after
the form is either signed by the payee or completed by you (if not
provided by thepayee). You need to retain a copy of the form
for your records. For information about storage and disposal,
seebelow.
You may lodge the information:
online – lodge your TFN declaration reports using software that
complies with our specifications. There is no need to complete
sectionB of eachform as the payer information is supplied by
your software.
by paper – complete section B and send the original to us
within14 days.
For more information about lodging your
TFNdeclaration report online, visit our website
at ato.gov.au/lodgetfndeclaration
Provision of payee’s TFN to the payee’s super fund
If you make a super contribution for your payee, you need to give
your payee’s TFN to their super fund on the day of contribution, or if
the payee has not yet quoted their TFN, within 14 days of receiving
this form from your payee.
Storing and disposing of TFN declarations
The TFN Rule issued under the Privacy Act 1988 requires a TFN
recipient to usesecure methods when storing and disposing of
TFN information. You maystore a paper copy of the signed form or
electronic files of scanned forms. Scanned forms must be clear and
not altered inanyway.
If a payee:
submits a new TFN declaration (NAT 3092), you must retain a
copy of the earlier form for the current and following financial year.
has not received payments from you for 12 months, you must
retain a copy of the last completed form for the current and
following financial year.
Penalties
You may incur a penalty if you do not:
lodge TFN declarations with us
keep a copy of completed TFN declarations for your
records
provide the payee’s TFN to their super fund where the
payee quoted their TFN to you.
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