How to complete this form

You must:

  • print clearly using a black pen
  • use BLOCK LETTERS and print one character per box.

You do not have to complete every field. For example, where an amount has not been paid or withheld, leave those boxes blank.

Show all amounts in whole dollars - do not show cents. For example, show an amount of $122.76 as $122.

Send the ATO original payment summary to us as part of your PAYG withholding payment summary annual report. We cannot accept photocopies or duplicates.

Avoiding common errors

Do not include salary sacrificed amounts at Gross payments.

Do not report salary-sacrificed amounts anywhere on the payment summary.

Do not include amounts you paid as employment termination payments at Gross payments.

Instead, report employment termination payments on a PAYG payment summary - employment termination payment (NAT 70868).

Do not include cents at Reportable fringe benefit amount.

Do not show cents at any label. Simply drop the cents from any amount before you enter it on the payment summary.

Do not report negative amounts.

To amend a previous year's payment summary, see Amending payment summaries

Do not report amounts containing a decimal point.

Do not report cents at any label. Simply drop the cents from any amount before you enter it on the payment summary.

Do not provide a payment summary containing all zeros.

If you have not paid the payee any withholding payments throughout the year, you do not need to give them a payment summary.

At Payment summary for year ending 30 June, do not show the year as anything but a four digit figure.

Show the year as a four digit figure. For example, show the year ending 30 June 2015 as 2015 and not 15.

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:

An example of a completed label

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

  • a new payee has not made a TFN declaration, but 28 days have not passed – use 111 111 111
  • the payee is under 18 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:

An example of a completed label

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:

An example of a completed label

Date of birth (if known)

Provide this information if you have it.

Use the format DDMMYYYY, for example:

An example of a completed label

Last modified: 10 Aug 2016QC 22557