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  • Section A: Payee details

    Tax file number

    You must show the tax file number (TFN) the payee quoted in this field. For example, show a nine-character TFN as:

    Example of the completed tax file number field with one digit printed in each box.

    To help us process your form, you must substitute the TFN with the numbers listed below where:

    • a new payee has not made a TFN declaration, but 28 days have not passed – use 111 111 111
    • the payee is under 18 years old and earnings do not exceed $350 per week, $700 per fortnight or $1,517 per month – use 333 333 333
    • the payee is an Australian Government pensioner payee – use 444 444 444
    • the payee chose not to quote a TFN and has not claimed an exemption from quoting a TFN or does not fit into any of the above categories – use 000 000 000.


    Separate the surname or family name from the given names and print in the appropriate boxes. For example, show Jane Mary Covers as:

    Example showing 'Covers' in the Surname or family name field and 'Jane Mary' in the Given name(s) field. One letter is printed in each box with a blank box left between words.

    Residential address

    You must show the street number and name, suburb/town/locality, state or territory and postcode separately in the boxes provided. For example, show the address 2 Bell St, Ablem WA 6999 as:

    Example showing '2 Bell Street' in the Residential address field, 'Ablem' in the Suburb/town/locality field, 'WA' in the State/territory field and '6999' in the Postcode field. The numbers and letters are printed in each box with a blank box inbetween to indicate a space.

    Date of birth (if known)

    Provide this information if you have it. Use the format DDMMYYYY, for example:

    Example with Date of birth (if known) question showing '01' in the Day field, '05' in the Month field and '1975' in the Year field.

    Death benefit (Reversionary income stream)

    Is the payee under 60 years old and a death benefits dependant, where the deceased died at 60 years old or over?

    This is used to calculate the payee's defined benefit income cap for payee's receiving capped defined benefit income streams.

    Answer 'Yes' to this question if the payee is receiving a reversionary capped defined benefit income stream and is under 60 years old, and where the deceased died at 60 years or over.

    Answer 'No' to this question where any of these apply:

    • the member is 60 years old or over
    • the member is not in receipt of a reversionary income stream
    • the member is under 60 years old and a death benefits dependent, but the deceased had not yet turned 60.

    Image of Death benefit (Reversionary) income stream question on form.

    Last modified: 07 Apr 2021QC 19550