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Sensitive (when completed)
Complete this statement if the following applies:
n you are an individual or a business
n you have supplied goods or services to another
enterprise(the payer), and
n you are not required to quote an Australia business
number(ABN).
HOW TO COMPLETE THE STATEMENT
n Print clearly in BLOCK LETTERS using a black pen only.
n Use BLOCK LETTERS and print one character in each box.
n Place X in all applicable boxes.
Payers can check ABN records of suppliers by visiting
abr.business.gov.au or phoning 13 72 26 24 hours aday,
7days a week.
NAT 3346-08.2015
Your address
Suburb/town State/territory Postcode
Section A: Supplier details
Your name
Reason/s for not quoting an ABN
Place X in the appropriate box/es.
The supplier is an individual and has given the payer a
written statement to the effect that the supply is either:
made in the course or furtherance of an activity done
asa private recreational pursuit or hobby, or
wholly of a private or domestic nature (from the
supplier’s perspective).
The supplier is an individual aged under 18 years and the
payment does not exceed $350 a week.
The supply that the payment relates to is wholly input taxed.
The payment does not exceed $75, excluding any goods
and services tax (GST).
The whole of the payment is exempt income for
thesupplier.
The supplier is not entitled to an ABN as they are not
carrying on an enterprise in Australia.
The supply is made by an individual or partnership without
areasonable expectation of profit or gain.
The payer is not making the payment in the course of
carrying on an enterprise in Australia.
Statement by a supplier
Penalties apply for deliberately making a false or
misleading statement.
Do not send this statement to us.
Give the completed statement to any payer that you are
supplying goods or services to. The payer must keep this
document with other records relating to the supply for five years.
Section B: Declaration
For information about your privacy, visit our website at ato.gov.au/privacy
Under pay as you go (PAYG) legislation and guidelines administered by us, the named supplier is not quoting an ABN for the current
and future supply of goods or services for the reason or reasons indicated.
Name of supplier (or authorised person)
Signature of supplier (or authorised person)
Day Month Year
Date
Daytime phone number
click to sign
signature
click to edit
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