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PAYG tax withheld PAYG income tax instalment Total salary, wages and Complete Option 1 OR 2 (indicate one choice with X) other payments Wi $

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PAYG tax withheld PAYG income tax instalment Total salary, wages and Complete Option 1 OR 2 (indicate one choice with X) other payments Wi $ 2 0 0 0 6 3 q X Option 1: Pay a PAYG instalment amount quarterly Amount withheld from W2 $ 2 0 0 0 0.54 T7 S 5,000.00 Amount withheld where Write the T7 amount at 5A in the Summary section below OR If varying this amount, complete TB, 19, 14 Ulcer amounts withhold Eximaled bes forthe year To $ ||2 2 0 dope excluding any amount chom al Wa or Will W3 $ 6-4 Varied amount payable Write the TO amount at 5A in the Summary section below Total amounts withheld (W2 + W4 + 15) WS $ 2 0 0 0 0 04 Acesson cado for wriation T4 Write the WS amount at 4 in the Summary section below OR Option 2: Calculate PAYG instalment using income times rate Reason for varying (624 & T4) Code Obligation Change in investments 21 ParG only Current business structure not continuing 22 GST & PAYG Significant change in trading conditions GST & PAWG Internal business restructure 24 GST & PAYO 25 how theied mye Change in legislation or product mix GST & PWG Financial market changes 26 GST & FAYG Use of income tax losses 27 PAYG only While the 711 amount at 5A in the Summary section below Summary Amounts you owe the ATO Amounts the ATO owes you GST on Live or GST instalment Do ny complete 18 i yang GST instalment amount (Option 3) Credit from Paris income bu 58 Deferred comparynnn 7 $ 717010 1A 4 4 + 54 +7 84 $ 1 2 5 0 0 2 53 Payment or refund? Is 8A more than BB? Then write the result al BA minus BB al g. This amount is papable to the ATO Your payment or refund amount find carte with KI then mile the result ol do mines Unaly. This amount is 9 $ No, refundable to you for offset against any other tax debt you hang Do not use symbols such as +, =, 1, $ Declaration I declare that the information given on the form is true and compact and that Rebim this completed farm to HAS MINS fin author bed to make this declaration. The tax magic: requirenone have been mot Estimate the time taken to complete Signature Tiantion laws put orise the ATO to collect Information including personal Information about individuals who may complete this form. For Information about privacy and

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