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
© Australian Taxation Office for the
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
X
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
Mr
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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