Fillable SEA01.11 01792 Sep19 V1fill Seacare Authority Berths and Levy Returns

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SEA01.11 01792 Sep19 V1fill Seacare Authority Berths and Levy Returns

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1
SEA01.11 September 2019
Seafarers Rehabilitation and Compensation Levy Collection Act 1992
(Levy Collection Act)
Seafarers Rehabilitation and Compensation Levy Collection Regulations 2019
(Levy Collection Regulations)
Section 6 of the Levy Collection Act provides that an employer must provide a Return containing ship berths
information to the person prescribed by the Levy Collection Regulations, within 14 days of the beginning of
each quarter.
The person prescribed by the Regulations is the Seacare Authority.
The Levy Collection Regulations also require that additional information on levy payments be provided with
the Return.
Parts A and B of this form comprise the Return under the Levy Collection Act. Part C is the additional
information required by the Levy Collection Regulations.
All parts of this form should be completed and sent to the Seacare Authority by:
POST - Seacare Authority
GPO Box 9905
CANBERRA ACT 2601
or
FAX - 02 6275 0067
or
EMAIL - seacare@comcare.gov.au
SEACARE AUTHORITY
BERTHS AND LEVY RETURN
2
SEA01.11 September 2019
Return—Part A—Employer Details
Name of employer
Contact person
Phone
Fax
Email
Date of return
/ /
Financial year
Quarter Quarter 1 (Jul-Sept) Quarter 2 (Oct-Dec) Quarter 3 (Jan-Mar) Quarter 4 (Apr-Jun)
Return—Part B—Statement of Ship Berths Details
Please provide a statement of details of the number of seafarer berths on each prescribed ship at the first day of the quarter
and the total number of berths on all ship/s operated by your company.
Ship name Number of berths
TOTAL BERTHS
Please attach berth details for all additional ships. If required attach additional details to this form.
Additional information required—Part C—Levy Payment Details
(a) Total amount of levy paid this quarter: (Total berths
x $50)
$
(b) Method of payment
Direct debit (Payable to: Seacare Authority BSB: 062 987 ACCOUNT: 10003681)
Note: Please include an employer identifier—eg Employer ABN
By cheque (Payable to: Comcare—Seacare )
(c) Date of payment
/ /20
(d) Employer ABN
SEACARE AUTHORITY
BERTHS AND LEVY RETURN
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Completed 3 July 2020

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