ATO National Tax Equivalent Regime

ATTACHMENT 3

PAYG INSTALMENT REPORT

National Tax Equivalent Regime
PAYG INSTALMENT REPORT

NTER PAYG instalment for the instalment month/quarter

from _ _ / _ _ /201 _ to _ _ / _ _ /201 _

1. Name of NTER entity
2. Postal address for NTER entity
3. Contact person who completed this form:
4. Contact telephone number:
5. Contact email address:
6. PAYG instalment calculation:
        A. Instalment income: $
        B. Instalment rate given by the NTER Administrator: %
        C. Varied instalment rate*:
*Please attach an explanation of why you have chosen to vary your rate

%
        D. D. PAYG Instalment:
(6A x 6B) or (6A x 6C)
$
7. Credit* from instalment rate variation you wish to claim:
* Please attach calculations of the amount of the credit.
($ )
8. Amount payable to the NTER entity's Treasury or Revenue Office:
(6D - 7)

$

Declaration: I declare that the information given on this form is true and correct, and that I am authorised to make this declaration.

Name: ..............................................
Signature: ........................ Date: ..........................

[History: Attachment 3 amended by April 2014 (Version 9), with effect from the instalment month and instalment quarter starting on 1 January 2014, by inserting reference to instalment month.]

[ History: Attachment 3 amended by February 2012 (Version 8), with effect from 1 February 2012, by replacing the version provided of the approved form of the PAYG instalment report. For the former version of this approved form, see March 2010 (Version 7).]

[Archived: History notes for amendments to the Manual made by Versions 2, 3, 4, 5 & 6 have been archived. For the wording of these history notes, see Version 8 12 February 2012]