Do you want to claim the seniors and pensioners
tax offset by reducing the amount withheld from
paymentsmade 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
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
phone us on 13 28 61 between 8.00am and 6.00pm,
Monday to Friday.
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)
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.
You can get the following forms and publications from
ato.gov.au/onlineordering or by phoning 1300 720 092:
Tax file number declaration (NAT3092)
Withholding declaration (NAT3093)
Tax file number – application or enquiry for individuals
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
For personal tax enquiries, phone us on 132861 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
For PAYG withholding variation enquiries, phone us on
1300360221 between 8.00am and 6.00pm, Monday to
Friday. If you have income from more than one source, you
canalso receive information about claiming the tax offset.
If you do not speak English well and need help from the ATO,
phone the Translating and Interpreting Service on 131450.
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 133677 and ask for the ATO number
Speak and Listen (speech-to-speech relay) users, phone
1300555727 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
1800555660 or email firstname.lastname@example.org
Withholding declaration – short version for seniors and pensioners 3