Tax file number declaration
What is your tax file number (TFN)?
*
For more information, see question 1 on page 2 of the instructions.
Title
*
Mr
Mrs
Miss
Ms
What is your name?
Name
*
First Name
Middle Name
Last Name
What is your home address in Australia
*
Street Address
Street Address Line 2
Suburb/town/locality
State / Province
Postal / Zip Code
If you have changed your name since you last dealt with the ATO, provide your previous family name.
Optional
What is your primary email address?
*
example@example.com
What is your date of birth?
*
-
Day
-
Month
Year
On what basis are you paid? (select only one)
*
Full-Time Employment
Part‑time employment
Labour hire
Superannuation or annuity income stream
Casual Employment
Are you: (select only one)
*
An Australian resident for tax purposes
A foreign resident for tax purposes
A working holiday maker
Do you want to claim the tax-free threshold from this payer?
*
Yes
No (Answer no here if you are a foreign resident or working holiday maker, except if you are a foreign resident in receipt of an Australian Government pension or allowance.)
Do you have a Higher Education Loan Program (HELP), VET Student Loan (VSL), Financial Supplement (FS), Student Start-up Loan (SSL) or Trade Support Loan (TSL) debt?
*
Yes (Your payer will withhold additional amounts to cover any compulsory repayment that may be raised on your notice of assessment.)
No
I declare that the information I have given is true and correct.
*
Date of Signing
*
-
Day
-
Month
Year
Date
Info/Preview PDF
Submit
Should be Empty: