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Page 1
Sensitive (when completed)
NAT 74279-05.2020
Notication of a deceased person
Use this form to officially notify us of a person’s death. If you are the
legal personal representative, for example executor with grant of
probate or court-appointed administrator, you can also use this
form to add your contact details on the deceased person’s record.
Before you complete this form
You can officially notify us of a person’s death and who has
been appointed as the legal personal representative:
■ online – if you are able to attend one of the
participatingAustralia Post retails outlets, go to
ato.gov.au/austpostformdeceased, or
■ phone – if you don’t have the death certificate you
canphone us on 13 28 61 and we may still be able
toadd some information about the person’s death
toourrecords.
See Find out more.
When completing this form
This form can be completed on screen. When complete, print,
sign and date the declaration at the end of the form.
Make sure you provide acceptable supporting documents
(seequestion 9).
Section A: Deceased person’s details
2 What is the full name of the deceased person?
Family name
First given name Other given names
Title: Mrs Miss Ms Other
Mr
1 Do you have the death certicate for the deceased person?
You need to provide the death certificate with this form. It needs to be a certified copy.
See page 2 for more information about supporting documentation requirements.
You cannot use this form. See Find out more above.
Yes
No
Day Month Year
4 What was the deceased person’s date of birth?
Day Month Year
5 What was the deceased person’s date of death?
3 What is the deceased person’s TFN? (See the privacy note in the declaration on page 4.)
If you do not know their TFN, leave this blank.
If completing this form by hand:
■ print clearly in BLOCK LETTERS using a black or dark blue
pen only
■ place X in ALL applicable boxes
■ do not use correction fluid or covering stickers
■ sign next to any corrections with your full signature
(notinitials).
Find out more
For more information on managing the tax affairs of
someone who has died, you can:
■ phone us on 13 28 61 between 8.00am and 6.00pm,
Monday to Friday
■ visit our website at ato.gov.au
If you phone, we need to know we are talking to the right
person before we can discuss the tax affairs of someone
who has died. You will need to provide information about
yourself and the person who has died. If you can, have your
tax file number (TFN) and information about the deceased
person with you (see the privacy note in the declaration on
page 4).
Page 2
Sensitive (when completed)
6 What was the postal address of the deceased person?
Provide the postal address as it was when the person last dealt with the ATO – for example, on their last notice of assessment.
Suburb/town/locality State/territory Postcode
Country if other than Australia
(Australia only)(Australia only)
7 Was the deceased person’s home address different from their postal address?
Provide the home address as it was when the person last dealt with the ATO – for example, on their last notice of assessment.
This needs to 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.
No Provide their home address details below
Yes
Suburb/town/locality State/territory Postcode
Country if other than Australia
(Australia only)(Australia only)
If you are not providing executor or administrator details, go to section C.
Section B: Legal Personal Representative details
We need to ensure you are authorised to act on behalf of the deceased person. If you do not provide all the supporting documents
we ask for, we will not be able to add you as an authorised contact on the deceased person’s record.
8 Are you an executor or administrator?
9 What supporting document will you provide?
You need to provide one of the following current supporting documents in addition to the death certicate, stating you are the
executor or administrator of the deceased estate.
Supporting documents you provide must be certied. Certied copies of documents that you mail to us may not be returned.
We may check the supporting documents you supply with the agencies that issue them.
Go to section C.
Yes
No
Executor – an executor is a person named in a will to carry out the wishes of a person after they die. Generally, the executor
will seek probate of the will. Probate may not be required for low value, less complex estates.
Administrator – an administrator is a person appointed by the court under letters of administration to manage a deceased
estate which has no executor.
For more information on certified copies of documents, refer to:
■ Copies of documents – applicants within Australia
■ Copies of documents – applicants outside Australia
Letters of administration
Grant of probate
The deceased person’s last will and testament
Place X in the applicable box.
If you are an executor and have been granted probate, then a certified copy of the grant of probate must be provided.
Ifyou have decided not to apply for probate or are awaiting court appointment, then a copy of the will must be provided
asevidence of your appointment as executor.
In the absence of probate or letters of administration you cannot be an authorised contact on the deceased person’s
record. Also, we may not be able to release certain information or transfer assets to you.
Page 3
Sensitive (when completed)
10 Do you require a Deceased estate data package?
We can help you to identify the assets and income stream of the deceased by extracting the relevant data from our records
and sending you a Deceased estate data package.
To lawfully access the information of a deceased person you must be the legal personal representative (executor or
administrator) of the deceased estate and have received grant of probate or letters of administration.
Place X in the applicable box.
No Yes
For more information on Deceased estate data packages, refer to:
■ Deceased estate data package
12 What is your full name and contact details?
14 What is your postal address?
Suburb/town/locality State/territory Postcode
Country if other than Australia
(Australia only)(Australia only)
Day Month Year
13 What is your date of birth?
Family name
First given name Other given names
Title: Mrs Miss Ms Other
Mr
Email address (use BLOCK LETTERS)
Business hours phone number Mobile phone number
A contact number must be provided.
Full name
11 What is your TFN? (See the privacy note in the declaration on page 4.)
15 Is your home address different from your postal address?
This needs to 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.
No Provide your home address details below
Yes
Suburb/town/locality State/territory Postcode
Country if other than Australia
(Australia only)(Australia only)
If you need to add additional executors or administrators, provide their details on a separate sheet of paper, including their
fullname and all of the details listed above in Section B.
Page 4
Sensitive (when completed)
16 What postal address do you want on the deceased person’s record for service of notices
and correspondence?
Suburb/town/locality State/territory Postcode
Country if other than Australia
(Australia only)(Australia only)
Section C: Declaration – this section is compulsory
Lodging this form
You can lodge your completed application with current certified supporting documents to us by mailing it to:
Australian Taxation Office
PO Box 3006
PENRITH NSW 2640
I declare that the information given on this form is true and correct.
You MUST SIGN here
Signature
Date
Day Month Year
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.
17 Who is the person signing this declaration?
(Complete all of the elds below)
Mobile phone number
Full name of signatory
Email address (use BLOCK LETTERS)
Business hours phone number
Penalties may be imposed for giving false or misleading information.
Privacy
The ATO is authorised by the Taxation Administration Act 1953 to request tax file numbers (TFNs). We will use the TFN to
identify the deceased person and the executor or administrator in our records. It is not an offence not to provide TFNs.
However, if you do not provide a TFN, there may be a delay in processing this form.
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.
Make a copy of your application for your own records before you lodge it.
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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Completed 25 October 2020

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