Fill - Free fillable short version for Withholding declaration (Commonwealth Bank of Australia) PDF form

Instructions and form for taxpayers

NAT 5072-06.2018

Withholding declaration

– short version for

seniors and pensioners

You should complete this declaration if you want to:

 claim your entitlement to the seniors and pensioners

taxoffset (SAPTO)

 claim or stop claiming the tax-free threshold

 advise your payer that you have become (or are no longer)

an Australian resident for tax purposes.

Give the completed form to your payer so your rate of

withholding can be varied. Make sure you have already given

them a Tax file number declaration (NAT 3092).

These instructions are current to 30 June 2019.

You must lodge a new declaration if either:

 you leave your current payer and start to receive

payments from a new payer

 your circumstances change.

If you give the wrong information, insufficient amounts

could be withheld from your payments and this may result

in a significant tax debt at the end of the financial year.

How to complete this form

Section A: Payee’s declaration

Questions 1 and 2

Complete with your personal information.

Question 3

What is your tax file number (TFN)?

We and your payer are authorised by the Taxation

Administration Act 1953 torequest your tax file number (TFN).

Itis 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

 a payment summary issued by your payer.

If you have a tax agent, they may also be able to tell

youyourTFN.

If you still can’t find your TFN you can:

 phone 132861 between 8.00am and 6.00pm,

MondaytoFriday

 visit your nearest shopfront (phone 132861 to make

anappointment)

 complete a Tax file number – application or enquiry for

individuals (NAT1432).

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.

Print X in the appropriate box if you:

 have lodged a Tax file number – application or enquiry for

individuals (NAT1432) or made a phone or counter enquiry

to obtain your TFN

 are claiming an exemption from quoting a TFN. You are

exempt from quoting your TFN if you receive

– certain Centrelink pensions, benefits or allowances or a

service pension from the Department of Veterans’ Affairs.

However you will need to quote your TFN if you receive

Austudy, Newstart, sickness or parenting allowance

– benefits from the Military Rehabilitation and Compensation

Commission.

Question 4

Are you an Australian resident for tax

purposes?

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 do not set up a permanent

home in another country, you may continue to be treated as an

Australian resident for tax purposes.

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.

To check your Australian residency status for tax purposes

or for more information, visit ato.gov.au/residency

Answer no to this question if you are not an Australian resident

for tax purposes, unless you are in receipt of an Australian

government pension or allowance. You must also answer no to

question5.

Question 5

Are you claiming or do you want to claim

thetax-free threshold from this payer?

The tax-free threshold ($18,200 at 1 July 2018) 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

$18,200.

Answer yes if you are a foreign resident in receipt of an

Australian government pension or allowance.

Otherwise answer no.

If you receive any taxable government payments

or allowances such as Newstart, Austudy or Youth

Allowance, you are likely to be already claiming the tax-

free threshold from that payment.

For information about claiming the tax-free threshold, or

which payer you should claim it from or how to vary your

withholding rate, visit ato.gov.au/taxfreethreshold

2 Withholding declaration – short version for seniors and pensioners

Question 6

Do you want to claim the seniors and pensioners

tax offset by reducing the amount withheld from

paymentsmade to you?

Claim the tax offset with only one payer

You are not entitled to claim tax offsets with more than one

payer at the same time.

If your income comes from more than one source, do not

complete this question for any of your payers. Contact us

for more information.

How your income affects the amount of your

taxoffset

You must meet the eligibility conditions to receive SAPTO.

Your rebate income, not your taxable income, determines the

amount of SAPTO, if any, you will receive.

Answer yes if you are eligible and you choose to claim SAPTO

by reducing the amount withheld from payments made to you

during the year.

For more information about eligibility for SAPTO

 visit ato.gov.au/withholdingdecs

 phone us on 13 28 61 between 8.00am and 6.00pm,

Monday to Friday.

Declaration

Make sure that you have signed and dated the declaration.

Give your completed declaration to your payer.

Section B: Payer’s declaration

This section is to be completed by the payer. The following

information will help you comply with your pay as you go (PAYG)

withholding obligations.

Payer obligations

If you withhold amounts from payments, or are likely to withhold

amounts, your payee may give you this form with section A

completed. A Withholding 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 your payee gives you another declaration,

it overrides the previous one.

More information

Useful products

You can get the following forms and publications from

ato.gov.au/onlineordering or by phoning 1300 720 092:

 Tax file number declaration (NAT3092)

 Withholding declaration (NAT3093)

 Tax file number – application or enquiry for individuals

(NAT1432).

For more information about income tests for a number of tax

offsets and government benefits, refer to Income tests on our

website at ato.gov.au

Phone

For personal tax enquiries, phone us on 132861 between

8.00am and 6.00pm, Monday to Friday. You can:

 get help to complete this form

 receive information about 

– claiming the tax-free threshold

– Australian residency

– SAPTO.

For PAYG withholding variation enquiries, phone us on

1300360221 between 8.00am and 6.00pm, Monday to

Friday. If you have income from more than one source, you

canalso receive information about claiming the tax offset.

Other services

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

 Speak and Listen (speech-to-speech relay) users, phone

1300555727 and ask for the ATO number you need

 internet relay users, connect to the NRS on relayservice.

com.au and ask for the ATO number you need.

If you would like further information about the NRS, phone

1800555660 or email helpdesk@relayservice.com.au

Withholding declaration – short version for seniors and pensioners 3

CommonwealthofAustralia, 2018

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

June 2018

C122-0002

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 June 2018.

Other agencies

Department of Human Services

For help working out your eligibility for a social security

orCentrelink pension:

 visit humanservices.gov.au

 phone 132300 between 8.30am and 5.00pm,

MondaytoFriday.

Department of Veterans’ Affairs

If you are a veteran and not sure whether you are

eligibleforapayment:

 visit dva.gov.au

 phone 133254 between 8.30am and 5.00pm,

MondaytoFriday.

4 Withholding declaration – short version for seniors and pensioners

Withholding declaration form

– short version for seniors and pensioners

Complete this declaration to authorise your payer to adjust

theamount of tax withheld from payments made to you.

You must provide, or have previously provided, your payer with

a completed Tax file number declaration (NAT 3092), quoting

your tax file number or claiming an exemption from quoting it,

before you can make a Withholding declaration.

 Read the Instructions before completing this declaration.

 Print neatly in BLOCK LETTERS.

 Print

in the appropriate boxes.

PAYER’S COPY

Sensitive (when completed)

NAT 5072-06.2018

4 Are you an Australian resident for tax purposes?

Yes No

You must answer no

at questions 5.

Section A: Payee’s declaration

To be completed by payee.

1 What is your name?

Family name

Given names

OtherTitle: Mrs Miss Ms

2 What is your date of birth?

Day Month Year

5 Are you claiming or do you want to claim

thetax‑free threshold from this payer?

Yes No

6 Do you want to claim the seniors and pensioners

taxoffset by reducing the amount withheld

frompayments made to you?

Are you:

Single

A member of an

illness-separated couple

A member

of a couple

Yes No

I am claiming an exemption becauseI am a pensioner.I have lodged a TFN application.

If you have not provided your TFN, indicate if any of the following reasons apply:

3 What is your tax le number (TFN)?

For information about tax file numbers, see instructions.

DECLARATION BY PAYEE

The tax laws impose heavy penalties for giving false or misleading statements.

I declare that the information I have given on this form is true and correct.

Signature of payee

Date

Day Month Year

Privacy

For information about your privacy, visit our website at ato.gov.au/privacy

HOW MUCH SHOULD YOU WITHHOLD?

The payee’s answers at questions 4 and 5 will indicate which

of the weekly, fortnightly or monthly tax tables you should use

as the base rate of withholding.

A yes answer at question 6 will generally require a variation

of the rate of withholding specified in the tax tables.

YOUR DETAILS

1 What is your Australian business number (ABN)

(or your withholding payer number if you are not in business)?

2 What is your registered business name or trading name

(or your individual name if you are not a business)?

DECLARATION BY PAYER

The tax laws impose heavy penalties for giving false or misleading statements.

I declare that the information I have given on this form is true and correct.

Signature of payer

Date

Day Month Year

Privacy

For information about your privacy, visit our website at ato.gov.au/privacy

WRITTEN NOTICE

This declaration will constitute written notice under section 15-15 of schedule 1 to

theTaxation Administration Act 1953 (TAA 1953) of the Commissioner’s approval

tovary the amount required to be withheld where:

 the payee has given a completed Tax file number declaration to the payer, or

theyhave entered into a voluntary agreement with the payer

 the payee has notified the payer of the varied rate of withholding in writing on

thisapproved form at section A.

STORING AND DISPOSING OF WITHHOLDING DECLARATIONS

The information in the completed Withholding declaration form must be treated as

sensitive. Once you have completed, signed and dated the declaration, you should

fileit. Do not send it to us.

Under the TFN guidelines in the Privacy Act 1988, you must use secure methods

when storing and disposing of TFN information. Under tax laws, if a payee submits a

new Withholding declaration or leaves your employment, you must still keep this

declaration for the current and next financial year.

Do not send this declaration form to us.

Sensitive (when completed)

Section B: Payer’s declaration

To be completed by payer.

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