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Unregistered Payroll Tax
Employers Questionnaire Note:
This form constitutes an approved return for payroll tax under section 34 of the Taxation Administration Act 1996.
If you need more room, complete your answers on a separate Word or Excel document. Upload the completed form, including copies of your financial statements, FBT returns, and
all other relevant documents via ‘Upload Information’ on http://www.osr.nsw.gov.au/info/online/payroll/questionnaire
Do not copy or use this form for other client questionnaires. If you are not currently registered for payroll tax and consider you may be entitled to an
exemption, you must still complete this questionnaire and an Application for Exemption which is available at www.osr.nsw.gov.au
Company details
1. Name of the legal entity conducting this business 2. Trading name 3. Principal place of business
State Postcode
4. Postal address State Postcode
5. Address of inspection of records State Postcode
6. ABN ACN
Registration
7. Was this business already registered for payroll tax before we sent you this questionnaire? Yes Go to Question 8 No Go to Question 9
8. What is your payroll tax Client ID?
Contact details
9. Contact name Mobile 10. Daytime phone ( ) Fax ( ) 11. Email Web address 12. External accountant/Professional adviser 13. Daytime phone ( ) Fax ( ) 14. Email
Unregistered Payroll Tax | Employers Questionnaire | 2013
Business details
15. What is the nature of the business? 16. When did the business first employ staff in NSW? 17. Does the business employ staff in other states?
Yes Go to Question 18 No Go to Question 2018. In which states and territories do you employ?
VIC QLD ACT SA WA NT TAS19. For each state in which you employ, provide the date(s) on which the employment first
commenced. Also, if your entity is registered in that state, please provide your payroll tax registration number(s).
Grouping
20. Is this business carried on by a trust? Yes Provide the details in the table below No Go to Question 21
Name of trust(Including name of trustee)
Type of trust(Discretionary or Unit)
Names of beneficiariesValue of interest(If a Unit Trust, the number of units held)
21. List all the shareholders, partners or proprietors of this entity during the period 1 July 2009 to current date:
If a corporation(including trustee company),names of shareholders
If a partnership,names of partners
Value of interest(Percentage of shareholding or interest in a partnership)
Acquisition date(dd/mm/20yy)
Disposaldate(dd/mm/20yy)
22. If this entity is a corporation, list all the directors during the period 1 July 2009 to the current date. If not Go to Question 23
Name of director(s) Appointment date(dd/mm/20yy)
Resignation date(dd/mm/20yy)
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23. Did this entity hold an interest in any other entity during the period 1 July 2009 to current date? Note: An interest includes shareholdings in corporations, units in a trust or shares in a partnership.
Yes Provide the details for each entity in the table below No Go to Question 24
A B C D
Name of entity ABNValue of interest(percentage of share or unit holding)
Does the entity in column A pay any wages?
Yes No
Yes No
Yes No
Yes No
24. Do any of the shareholders, unit holders, partners or beneficiaries of this entity have an interest in any other entity during the period 1 July 2009 to current date?
Yes Provide the details for each other entityin the table below
No Go to Question 25
A B C D
Name of shareholder, unit holderor partner
Name of entity and ABN in which the interest is held
Value of interest (percentage of share or unit holding)
Does the entity in column B pay any wages?
Yes No
Yes No
Yes No
Yes No
25. If this entity is a corporation, did any of the directors hold directorships in other corporations during the period 1 July 2009 to current date?
Yes Provide the details for each other entityin the table below
No Go to Question 26
Name of director Name of corporation and ABN Appointment date(dd/mm/20yy)
Resignation date(dd/mm/20yy)
26. Does this entity use any other business to provide it with administration services? Yes Provide the details for each provider
in the table below No Go to Question 27
Name of provider ABN Address of provider
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27. Does this entity provide administration services to any other business?
Yes Provide the details for each business in the table below No Go to Question 28
Name of business to whomadministration services are provided ABN Address of business
28. Is this entity grouped with any other entity for payroll tax purposes?To help you answer this question, go to www.osr.nsw.gov.au/taxes/payroll/grouping
Yes Provide the other entities’ details in the table below No Go to Question 30
Name of entity ABN Client ID(if registered)
Date first joined group (dd/mm/20yy)
1.
2.
3.
4.
29. Insert the taxable wages paid by other group members listed at Question 28 in the table below. Note: Provide copies of financial statements for each entity for the last five (5) financial years.
Other Group MembersEntity no. 2010 2011 2012 2013 2014
NSW01/07/2009
to 31/12/2009
($)
01/01/2010 to
30/06/2010($)
01/07/2010 to
31/12/2010($)
01/01/2011to
30/06/2011($)
01/07/2011 to
30/06/2012($)
01/07/2012to
30/06/2013($)
01/07/2013to
* /2014($)
1.
2.
3.
4. TotalNSW
Interstate
1.
2.
3.
4. Total Interstate
Total
* Insert the last completed month (mm) for which the taxable wages have been paid.
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Contractors30. Does this entity make any payments for labour provided by contractors, subcontractors or consultants?
Yes Go to Question 31 No Go to Question 32
31. Are any of your payments to contractors, subcontractors or consultants exempt from payroll tax?Note: To help you answer this question, read the factsheet ‘NSW Payroll Tax Information for Contractors and Employment Agents’ at: www.osr.nsw.gov.au/info/publications/taxes/payroll
Yes Complete the table below No Go to Question 32
Name of contractor, subcontractor or consultant ABN Nature of services provided
by contractorEntity type(Note 1)
Exemption No. (Note 2)
Total amounts paid ($)
2010 2011 2012 2013
Total
Note 1: Insert the applicable letter as follows: C for corporation, T for trust, P for partnership, S for sole trader.
Note 2: Insert the relevant exemption number (1 to 9) as referred to in the ‘NSW Payroll Tax Information for Contractors and Employment Agents’ factsheet.
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Taxable wages32. Complete the taxable wages in the table below:
2010 2011 2012 2013
NSW wages(A-K)
01/07/2009to
31/12/2009($)
01/01/2010to
30/06/2010($)
01/07/2010to
31/12/2010($)
01/01/2011to
30/06/2011($)
01/07/2011to
30/06/2012($)
01/07/2012to
30/06/2013($)
A. Salaries
B. Commissions
C. Bonuses
D. Taxable allowances
E. Directors fees
F. Superannuation paid to employees/directors
G. Employee super salary sacrifice
H. Taxable fringe benefits value(Note 1)
I. Liable contractor payments
J. Less workers Comp payments paid to employees(Note 2)
K. Total NSW wages (A to I less J)
L. Add Interstate wages
M. Add other group members NSW wages (from Question 29)
N. Add other group members interstate wages (from Question 29)
O. Total Australian Wages(items K to N)
NSW wages and super paid to apprentices and trainees included in A and F above
Note 1: Taxable fringe benefits value is the aggregate of the type 1 and type 2 fringe benefits multiplied by 1.8692.Attach copies of your FBT returns for the 2010–13 FBT years.
Note 2: Payments made by an insurance company to an employee on workers compensation are not liable wages. Make up payments, being the difference between the compensation payments and the employee’s regular pay paid by the employer, are liable as a wage.
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33. For the current financial year, insert monthly taxable wages (including superannuation contributions) paid up to the last completed month.
MonthYour total NSW taxable wages (including apprentices and trainees) ($)
Your NSW apprentice and trainee wages (to calculate your rebate) ($)
Your interstate taxable wages
($)July 2013
August 2013
September 2013
October 2013
November 2013
December 2013
January 2014
February 2014
March 2014
April 2014
May 2014
June 2014
Total
34. If you are liable for payroll tax but not registered, please state why you were not registered. The reason(s) you provide here will be used to decide what level of penalty tax (if any) should be imposed.
To be entitled to a full remission of penalty tax, you will need to demonstrate to us that you took reasonable care to comply with your payroll tax obligations or that any tax default occurred because of circumstances beyond your control.
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Penalty Tax Remission
The Taxation Administration Act 1996 states that penalty tax and interest is payable if you do not register and pay payroll tax when you were first required to do so.
However, if you did not register when you should have and you disclose all your taxable wages in this questionnaire, we may remit some or all of the penalty tax that would otherwise be payable.
To be entitled to any remission you must: fully and accurately complete and return this questionnaire together with all requested
documents, including financial statements and FBT returns, and complete Question 34 and demonstrate that your tax default was beyond your control or that
you have taken reasonable care in the conduct of your payroll tax affairs.
ChecklistI have answered all questions.I have attached copies of financial statements (including grouped businesses, if applicable).
I have attached copies of FBT returns, if applicable (including grouped businesses).
DeclarationI, declare that all information provided is true and correct in every particular.Name (Print) Position Signature Date / /
Privacy statement
Information collected from you on this form is required by the Office of State Revenue (OSR) to determine if you have a liability or entitlement. The information may be provided to third parties with your consent or as required or permitted by law. OSR will correct or update your personal information at your request. Read more about privacy at www.osr.nsw.gov.au
Contact details
(02) 9762 7550
GPO Box 4042, Sydney NSW 2001 Fax: (02) 9762 7500
Office of State Revenue: ISO 9001 – Quality Certified | Department of Finance & Services
© State of New South Wales through the Office of State Revenue, 2013. This work may be freely reproduced and distributed for most purposes, however some restrictions apply. Read the copyright notice at www.osr.nsw.gov.au or contact OSR.
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