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Payee's Name

(optional):
Has the payee provided a Tax File Number (TFN)? Yes No
If the payee has not provided a TFN, is the payee exempt from needing a TFN? Yes No
Is the payee an Australian Resident? Yes No
Has the payee claimed the Tax Free Threshold? Yes No
Amount the payee claimed for Tax offsets $

Medicare levy variation

Payee claiming exemption or variation from the levy? No Half Full
Payee claiming reduced amount of levy? Yes No
Does the payee have a spouse? Yes No
Combined income less than applicable amount in Ready Reckoner? Yes No
Number of dependent children claimed?

Miscellaneous
Payee entitled to annual leave loading? Yes No
Payee receives payments:
Gross earnings (for the period selected below)? Disregard any cents in the total amount, unless a monthly amount. (Please do not use commas) $
Does the payee have an accumulated Higher Education Loan Programme (HELP) debt? Yes No
Does the payee have an accumulated Financial Supplement debt? Yes No
 
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