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Application to nominate a Designated Group Employer or a Joint Return Lodger

Application to nominate a Designated Group Employer or a Joint Return Lodger

An ACT employer which is part of a group may claim the group's entitlement to the ACT proportion of the tax-free threshold, provided it is an approved Designated Group Employer (DGE).

An applicant for DGE status (or an existing DGE) may also apply to become a Joint Return Lodger (JRL) for itself and other ACT group members.

For additional information on employer status and grouping please click here.

Please complete the following questions to nominate a DGE or JRL

All fields marked ( * ) are mandatory.

Contact details

Payroll tax client reference number (CRN) *

Contact name *

Contact email address *

Contact Telephone Number

Position in company *

ACT Group Number (if known)

Nomination of a DGE

Name the company nominated as the DGE: *

ABN: *

ACN:

Trading name or trust name: *

ACT business address: *

Postal address: *

This nomination will take effect from: Day Month Year

Nomination of a JRL

Do you nominate the DGE in section 2 to be the JRL for all the ACT group members listed in section 4? *

ACT group members

List all ACT Group Members paying wages in the ACT, please include client id (if known), company legal name,
ABN and date of joining group.

Company 1:

Company 2:

Company 3:

Company 4:

Company 5:

Company 6:

Company 7:

Company 8:

Company 9:

Company 10:

If you require additional space attach a list of all ACT Group Members paying wages in the ACT here:

Group members outside of ACT

List all Group Members outside of the ACT and include company legal name, ABN and the state of registration.
Overseas members please provide company legal name, registration number and country of registration.

Company 1:

Company 2:

Company 3:

Company 4:

Company 5:

Company 6:

Company 7:

Company 8:

Company 9:

Company 10:

If you require additional space attach a list of all other Group Members outside of ACT here:

Declaration

I, *

Declare that by submitting this form, I declare that the information provided in this application to nominate a DGE and a JRL for ACT payroll tax purposes to be true and correct.

I acknowledge that under section 338 of the Criminal Code 2002, giving false or misleading information is a serious offence.

I will notify the ACT Revenue Office in writing and provide full details if there is a change in my circumstances during the financial year. This includes change of contact or address details, cessation of trading in the ACT of change in group structure.

Privacy Statement

All information collected by the ACT Revenue Office is protected by secrecy provisions in Acts administered by the Office and only used for the purposes of those Acts. In addition, personal information provided to the ACT Revenue Office is protected by the Information Privacy Act 2014. Information (including personal information) is not disclosed to any third party unless authorised by law or with the consent of the person involved.

Contact us

If you require further information on payroll tax and group structures, please contact the ACT Revenue Office by clicking here or call us on (02) 6207 0028.