Duties Act 1999

Pensioner Duty Concession Scheme Application Form
for transactions between 1 July 2008 and 31 December 2008

NOTES
•	An application must be received by the ACT Revenue Office by the date the duty must be paid or within 1 year, whichever is earlier.  Duty is payable within 90 days for the grant, transfer or agreement, whichever is earlier or, for an Off the Plan purchase or an Affordable House and Land Package, within 14 days if one of the events happen under s 16A of the Duties Act 1999, otherwise up to 1 year.  Late applications will not be accepted.
•	To help determine if you qualify for a duty concession, provide all details, ATTACH requested documents and tick the appropriate boxes.  Incomplete applications or applications lacking the required supporting information may result in the concession being denied. 	
•	If there are more than two applicants, complete and attach a second application form.
•	Applying for a concession does not stop interest being applied if payment of the required duty is made after the due date. 
 In this form, this symbol means documents should be attached.

Section 1  Applicant Details	
Name of grantee/transferee	Marital Status	Name of domestic partner (if any)	

Nominated Contact - Name	Telephone (daytime)	Postal Address	

                   Postcode:	
	Email Address		
			
Section 2  Eligible Pensioner	
 At the date of the transaction, if the grantees/transferees or their domestic partner/s hold any of the following concession cards, attach a copy:
•	Age pension card; or
•	Department of Veterans’ Affairs gold card held for 1 year prior to the transaction; or  
•	Disability support pension and pensioner is 50 years of age or more – attach proof of age.
	
Section 3  Details of Property Applicant is Purchasing	
Suburb	Section	Block	Unit	Purchase price 	Market value 	
				$	$	
Street Address		

  If the buyer and seller are related parties, attach a qualified valuer’s report to substantiate the current market value of the property	
Is the property vacant land? 	YES 	NO 	
Date of grant/transfer or agreement for transfer (whichever is first)	      /       /       	
What % of the property is being purchased  	                   %	
Are all grantees and transferees together, acquiring both the legal and beneficial interest in the property? 	YES 	NO 	
 Attach original document for stamping 	
Section 4  Details of Property Applicant is Moving From	
Suburb	Section	Block	Unit	Name of owners	Actual or expected date of sale	
						
Street Address		
Section 5  Other Interests in Land	
At the date of the transaction (in section 3), do any grantees/transferees or their domestic partners alone or jointly, hold a legal or equitable interest in land other than the subject property (in section 3) and the property they are moving from (in section 4)?  If YES provide details below.	YES 	NO 	
Suburb	Section	Block	Unit	Name of owner/s	
					
Street Address		
Section 6  Declaration and Undertaking	
I/We declare that: 
•	at least one applicant will reside in the home as their principal place of residence for a continuous period of 6 months and such period is to commence within 1 year of:
-	completion of the eligible transaction for an eligible property; or
-	the date of the Certificate of Occupancy and Use following completion of construction of the residence on the eligible vacant block;
•	all of the information in this application, and in any supporting documentation, is true and correct and that to the best of my/our knowledge, no information relevant to the consideration of my/our application has been omitted.

I/We understand that:
•	in the event that I am/we are granted a concession, the Commissioner for ACT Revenue may issue an amended assessment if it is subsequently determined that I/we did not meet the relevant criteria for the level of concession granted (such as not meeting the residency requirements); 
•	depending on the circumstances, interest and penalties may be applied to any resultant underpayment of duty; and
•	giving false or misleading information is a serious offence	
Signature of all Applicants
NOTE:  All grantees/transferees must sign	Signature:	Date:	
	Full Name:		
	Signature:	Date:	
	Full Name: