Fillable representative of an incapacitated entity Appointment or cessation (Australian Taxation Office)

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representative of an incapacitated entity Appointment or cessation (Australian Taxation Office)

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Page 1
Sensitive (when completed)
Who should complete this form?
You should complete this form if you are an insolvency
practitioner and you are appointed as a representative
ofanincapacitated entity.
How to lodge the form
Make a copy of your completed form for your own records
before you do one of the following:
Secure messaging in our Business Portal
Send this form as an attachment to a secure message
under the Insolvency subject in the Business Portal.
Fax or mail
Complete and attach the Debt insolvency cover sheet available
on our website at ato.gov.au/insolvencycontact and send
your form by either:
n faxing it to us on 1300 726 594
n mailing it to us at
Australian Taxation Office
PO Box 9003
Penrith NSW 2740
Signing the form
Make sure you have answered all the relevant questions
correctly and read the privacy statement before you sign and
date the form. An incomplete form may delay processing.
NAT 73785‑05.2019
Appointment or cessation of a
representative of an incapacitated entity
Section A: Incapacitated entity details
Name of entity
Tax file number (TFN)
Australian company number (ACN) (if applicable) Australian business number (ABN) (if applicable)
Postal address
Country if other than Australia
Suburb/town Postcode
(Australia only)
State/territory
(Australia only)
Is, or was, the entity the trustee of a trust?
NoUnsure Yes
Day Month Year
Date of birth (if applicable)
Related entity names
What is the ABN of the trust?
For more information, visit
ato.gov.au/insolvencyappointment
See the privacy note in the Declaration
Provide details of related entities that will help us identify the incapacitated entity.
If you have provided the incapacitated entity’s TFN, ACN or ABN, go to the next question.
Page 2
Sensitive (when completed)
Section B: Representative details
Business address
Country if other than Australia
Suburb/town Postcode
(Australia only)
State/territory
(Australia only)
Name of representative’s firm
Phone (area code/number) Facsimile (area code/number)
Email
Family name
First given name Other given names
Title: Mrs Miss Ms Other
Mr
Contact person
Postal address
Country if other than Australia
Suburb/town Postcode
(Australia only)
State/territory
(Australia only)
Representative 1
Family name
First given name Other given names
Title: Mrs Miss Ms Other
Mr
Representative 2
Family name
First given name Other given names
Title: Mrs Miss Ms Other
Mr
Name of appointed representative
Do you want to request direct client access to manage this appointment using our Business Portal?
What is the ABN that your Auskey is registered to?
(Your firm’s ABN)
No Yes
Request for direct access to client details in the Business Portal (voluntary administrators and liquidators only).
Page 3
Sensitive (when completed)
Section C: Appointment or cessation details
Type of administration
Are you a receiver/manager?
Appointment by court order Appointment by instrument Appointment by resolution
Please specifyOther
Method of appointment
This form will be accepted as compliant with the notification requirements under subsections 260‑45(2) (liquidators)
and260‑75(2) (receivers) of Schedule 1 to the TAA 1953.
Sequestration number
Day Month Year
Date appointed
Sequestration year
Go to section DNew appointment
What is the status of your appointment?
Receiver/receiver manager ceased
Administration ceased, liquidator appointed
Administration ceased, Deed of Company Arrangement
entered – you are the deed administrator
Administration ceased, Deed of Company Arrangement
entered – you are not the deed administrator
Administration ceased, company returned to directors
Liquidation finalised
Other
Appointment has ceased Select one of the following:
Provide details below
Other details
Day Month Year
Date representation ceased or changed
Are there any outstanding post insolvency lodgments in this administration? No Yes
If Yes provide details on when these will be completed:
If you are using the form to advise us of the cessation of your representation, you do not need to complete the
remainingquestions. Go to section I – Declaration to sign and submit your form.
This form will be accepted as compliant with the notification requirement for representatives of incapacitated entities when
they cease their appointment under section 58‑30 of the A New Tax System (Goods and Services Tax) Act 1999.
Are you a Deed Administrator?
No
Yes
Full control
Partial controlWhat control do you have?
No
Yes Yes NoIs the entity continuing to trade under
the Deed of Company Arrangement?
Page 4
Sensitive (when completed)
Expectation of dividends
YesNo Unsure
Section F: Dividends
Section D: Tax obligations
Preferred GST reporting method
Cash Accrual
Does the entity have any outstanding superannuation obligations?
Yes
No
Unsure
Do you anticipate having any tax obligations for the following
Yes
No
Unsure
Goods and services tax (GST)
YesNo UnsurePAYG (pay as you go) withholding
YesNo Unsure
Income tax instalments
YesNo UnsureFringe benefits tax (FBT)
YesNo Unsure
Other
In your role as a representative, you must be registered for GST if the incapacitated entity is registered or required to
beregistered. By answering ‘yes’ to GST, you are requesting that we register you for GST in your role as representative
oftheincapacitated entity identified in section A of this form.
BSB code (must be 6 digits)
Account number
Account name
Section E: Your bank account details
(Note – this must not be a practitioner’s trust account). We are unable to refund credits until this information is provided.
For more information, refer to PS LA 2011/22 Refunds of running balance account surpluses and credits – Commissioner’s
discretion to retain amounts.
Section G: GST groups
Is the entity a GST group representative member?
YesNo Unsure
Has the entity entered into an indirect tax sharing agreement?
YesNo Unsure
Is the entity part of a GST group? No Go to next section Yes Unsure
The entity can only continue to be the GST group representative member if all the members of the group have a
representative appointed.
If you want to remove an incapacitated entity from a GST group or make an election as a representative of a GST group
representative member, use the GST group – notification of forming, changing or cancelling (NAT 2952) form.
Page 5
Sensitive (when completed)
Section H: Income tax consolidated groups
Is, or was, the entity the head company of a consolidated group for income tax purposes?
Day Month Year
What was the date of consolidation?
NoUnsure Yes
Is, or was, the entity the provisional head company of a multiple
entry consolidated (MEC) group for income tax purposes?
Day Month Year
What was the date of consolidation?NoUnsure Yes
Is, or was, the entity a member company of a consolidated group for income tax purposes?
NoUnsure Yes
Where the head company of the consolidated group was required to register for
anABN, what is the ABN of the head company of the consolidated group?
Day Month Year
What was the date of entry into the consolidated group?
Has the company exited from the consolidated group?
Day Month Year
What was the date of exit from
theconsolidated group?
NoUnsure Yes
Is there a tax sharing agreement in place?
NoUnsure Yes
Section I: Declaration
Privacy statement
The ATO is authorised by the Taxation Administration Act 1953 to request the provision of tax file numbers (TFNs). We will use
the TFNs to identify you in our records. It is not an offence not to provide the TFNs. However if you do not provide your 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
Signature
Date
Day Month Year
I declare that:
n I am the representative of the incapacitated entity or am authorised by the representative of the
incapacitated entity to complete this form on their behalf
n the information given on this form is true and correct to the best of my knowledge.
Submitting the form by fax or mail
Business Portal users
You must have a valid Auskey to submit this form via secure messaging in the Business Portal.
Your Auskey is your electronic signature. By submitting the completed form via the Business Portal
you declare that the information given on the form is true and correct to the best of your knowledge.
If the entity does not belong to a consolidated group for income tax purposes, go to section I.
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Completed 7 December 2020

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