Division 293 notice of assessment

Instructions and application
for
individuals
Division 293 Tax –
refund or debt release
application for former
temporary residents
NAT 74727-05.2014
WHO SHOULD COMPLETE THIS APPLICATION?
Under Subdivision 293-G of the
Income Tax Assessment
Act 1997
, you can only apply for a refund of Division 293
payments if
all
of the following criteria apply:
■
you received a departing Australia superannuation payment
(DASP)
■
you paid all or part of your Division 293 tax liability
■
you applied for the refund on the approved form.
If you do not meet all the above criteria, you are
not entitled to a refund of tax under Division 293 of the
Income Tax Assessment Act 1997
.
However, if you incurred a Division 293 tax liability during
your time in Australia, and you have not paid it, complete
this form and we will assess whether we can release
you from the liability. You will still need to have received
a DASP prior to making this application.
HOW TO COMPLETE THIS APPLICATION
Section A: Reason for application
Question 1
Why are you completing this form?
Select the reason you are completing this application.
Section B: Former temporary resident details
Question 2
Tax file number
Provide your tax file number (TFN). We are authorised under the
Taxation Administration Act 1953
to collect this TFN. You are
not required by law to provide the TFN, but it will help reduce
the risk of administrative errors that could delay the processing
of your application.
Question 3
Name
Provide your full name.
2
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Question 4
Previous name
Provide details of any previous names, if applicable. You need to
provide certified evidence of their name change – for example,
a marriage certificate, deed poll or change of name certificate
from the
b
irths, Deaths and
m
arriages registration office in your
country. These documents must be
certified
copies. If there
is insufficient space, write the details on a separate page and
include it with this form.
Question 5
Date of birth
Provide your date of birth.
Question 6
Current residential address
Provide your current residential address.
Question 7
Current postal address
Provide your current postal address.
i
f this is the same as the residential address, write ‘AS A
bove
’.
Question 8
Phone and mobile number
Provide your current phone number including your country code.
Question 9
Email address
Provide your current email address.
Question 10
Last address in Australia
Provide your last Australian postal address.
Section C: Details of your visa and passport
Question 11
Passport and visa class
Provide the passport details that you used to enter Australia
as a temporary visa holder. Include the passport number, the
name of the issuing country on the passport and the visa
class number (do not include the visa class description) that
the account holder previously used to enter Australia as a
temporary visa holder.
Question 12
Date of arrival
Enter the date that you entered Australia.
Question 13
Date of departure
Enter the date that you departed Australia.
Section D: Departing Australia super payment
(DASP) details
Question 14
Have you received a DASP
To receive a refund or to be assessed for release from current
or future liabilities under Division 293 of the
Income Tax
Assessment Act 1997
, you must have received a DASP.
i
f you have not received a DASP then do not complete this form.
Question 15
Who did you receive your DASP from
A DASP can be received from either a super provider or from
money held with us. This information will help us verify the
information you are providing to support your application.
i
f you have received a payment from both a super provider
and the AT
o
, select both options.
If you received your DASP from a super fund, provide the name
of the super fund that sent you the DASP, their A
bn
(found on
the DASP statement) and your member account number that
your DASP was made from.
Section E: Your proof of identity and supporting
documentation
When you lodge your application, you must provide
two
current
documents that prove your identity, one must be a primary
document.
Certification of personal documents
You must have all copies of your original documents certified
by an authorised person.
i
f the original document is not written
in English, there are extra steps detailed below.
The authorised person certifying your documents must sight
the original and certify on the copies that each page is a true
copy by writing or stamping on each page ‘certified true copy’
followed by:
■
their signature
■
their printed name
■
their qualifications (for example, ‘Justice of the Peace’)
■
the date.