Section D: Declaration

There are two declarations. Complete the declaration that applies to you. Print your full name, then sign and date the declaration.

Your two choices are:

• Intent to claim a tax deduction – complete this declaration if this is an original notice, or an additional notice to increase the amount you intend to deduct
• Variation of previous valid notice of intent – complete this declaration if you have already lodged a valid notice with your fund for these contributions and you wish to reduce the amount stated in that notice.