A Office Lee only 1000 41890314 Business activity statement PAYG tax withheld PAYG income tax instalment Toinl salary wages and W1 $ 1 0 0 0 0 054 Complete Option 1 OR 2 [indicate one choice with X) other payments X Option 1: Pay a PAYG instalment amount quarterly Amount withheld from May ments shown at WI W2 $ 2 0 6 0 0 04 T7 S 5,000.00 Amount withheld where W4 $6.50 Write the 17 amount at 5A in the Summary section below no ABN in quoted OR if varying this amount, complete Ta, T9, 14 amounts withheld coduding am amount shown at 12 or Wil Warled amount payable for the quarter TO S Total amounts withheld W5 $ 2 0 0 0 0.04 Write the 19 amount at 5A in the Summary section below Reason code for variation T4 Write the WS amount at 4 in the Summary section below OR Option 2: Calculate PAYG instalment using income times rate Henson for varying (924 & T4) Code Obligation Change in investments 21 PAYG only PAYG inclement income Itspa Current business structure not continuing 22 GST & PAYG Significant change in trading conditions 23 GST & PAYG 12 Internal business restuching 24 GST & PAYG CR Change in legislation or product mix 25 GST & PAYG How Theed rie Financial market changes 26 GST & PAYG Use of income tax losses 27 PAYG only Write the 711 amount at 5A in the Summary section below Heusch code for variation T4 Summary Amounts you owe the ATO GET on sales or GST insteadment 1A $ 126 5 509 Amounts the ATO owes you Do not complete LB if using GST instalment amount (Option 3] PAYG income tax in talment BA $ 1 / 5 6 6 0.08 Credit tri Part income Ex 58 Deferred company fund Insteadment 7 1A+4 - 54 17 84 $ 712532 2 00 Payment or refund? Is BA more than 88? then write the result of at minus but a1 3. This amount is payable to the ATO Your payment or refund amount indicate with X then write the rocult of 88 minus BA na. This amount Is refundable to you for offact against any other the debt you havey ()Do not use symbols such as +. -, /,5 Declaration i declare that the information given on this form is true and correct, and that Return this completed form to HAS MINS I am authorised to make this declaration. The tax imioice requirements have been mel. Estimate the time tokes to complete Signature The born, Inclage the Time taken la collect any information Taxation laws authorise the ATO to collect information including personal information about individuals who may complete this form, For information about privacy and _Funeral moringdo go to glogow mu privacy, bety ty element ins quctions are ayalacle from ula gov au or can be urpergo by phoning 13 20 Dby Aniradian Tration Ullice