Confirm your details for ACT Payroll Tax

Please complete this Payroll tax information request form to inform the ACT Revenue Office (ACTRO) of your circumstances.
If further information is required we will contact you. All fields marked ( * ) are mandatory.

Identity







Please enter the reference number as indicated on the payroll tax letter you received from the
ACT Revenue Office *


Please answer the following questions and provide details on your employer status and wage figures for each of the periods listed below.

If you are unsure about your employer status, please visit our website for further information.

1 July 2017 to 30 June 2018

 Is your employer status and wage figures as declared in your annual reconciliation/s and provided
in the email to you correct for 2017-18 financial year (1 July 2017 to 30 June 2018)?*
What was your employer status for this period?*

Independent Employer (non-group member)



Are you claiming the ACT proportion of the threshold?*
Number of days where you paid or were liable to pay taxable or interstate wages: *

Australia wide wages (including ACT): *

Designated Group Employer (DGE) or Joint Return Lodger (JRL)

Have you submitted a DGE/JRL nomination form? If unsure, this form can be located on our website.


Are you the groups DGE and/or JRL (select both if applicable)?*




Are you claiming the ACT proportion of the threshold?*
Number of days where 1 member of the group paid or were liable to pay taxable
or interstate wages:*

Group Australia wide wages (including ACT): *



Ordinary Group Member





1 July 2018 to 30 June 2019

 Is your employer status and wage figures as declared in your annual reconciliation/s and provided
in the email to you correct for 2018-19 financial year (1 July 2018 to 30 June 2019)?*
What was your employer status for this period?*

Independent Employer (non-group member)



Are you claiming the ACT proportion of the threshold?*
Number of days where you paid or were liable to pay taxable or interstate wages: *

Australia wide wages (including ACT): *

Designated Group Employer (DGE) or Joint Return Lodger (JRL)

Have you submitted a DGE/JRL nomination form? If unsure, this form can be located on our website.


Are you the groups DGE and/or JRL (select both if applicable)?*




Are you claiming the ACT proportion of the threshold?*
Number of days where 1 member of the group paid or were liable to pay taxable
or interstate wages:*

Group Australia wide wages (including ACT): *



Ordinary Group Member





1 July 2019 to 30 June 2020

 Is your employer status and wage figures as declared in your annual reconciliation/s and provided
in the email to you correct for 2019-20 financial year (1 July 2019 to 30 June 2020)?*
What was your employer status for this period?*

Designated Group Employer (DGE) or Joint Return Lodger (JRL)

Have you submitted a DGE/JRL nomination form? If unsure, this form can be located on our website.


Are you the groups DGE and/or JRL (select both if applicable)?*
Group number: *


Total ACT taxable wages: *


Are you claiming the ACT proportion of the threshold?*
Number of days where 1 member of the group paid or were liable to pay taxable
or interstate wages:*

Group Australia wide wages
(including ACT): *



Ordinary Group Member

Group number: *

Total ACT Taxable wages: *

Independent Employer (non-group member)



Are you claiming the ACT proportion of the threshold?*
Number of days where you paid or were liable to pay taxable or interstate wages: *

Australia wide wages (including ACT): *

Declaration









Declare that: *

Privacy Statement

Information collected by the ACT Revenue Office (ACTRO) is protected by secrecy provisions contained in Acts administered by the ACTRO, including the Taxation Administration Act 1999, and is used for the purposes of administering those Acts. In addition, personal information provided to the ACTRO is protected by the Information Privacy Act 2014. Information (including personal information) is not disclosed to any third party without the consent of the person involved, unless authorised by law. For example, the ACTRO may disclose tax information in connection with the administration of a tax law, or may be required to disclose information to organisations that have legal authority to require the information in prescribed circumstances, including for law enforcement purposes.

Please read our Privacy Policy which sets out how personal information is collected, used and disclosed by the Commissioner for ACT Revenue and the ACT Revenue Office, how you may access and seek correction of your personal information, and how you may complain about breaches of privacy.