Company/Organisation Name*

    Tax File Number*

    Australian Business Number

    Registered Address

    Post Code

    AUTHORISED PERSON DETAILS

    Full Name*

    Email*

    Telephone/ Mobile*

    OTHER INFORMATION -

    For which month have you experienced or are likely to experience a reduction in turnover of 30% or more?*

    Do not include yourself in the count of eligible employees. You may apply as business Participant below.

    Number of eligible employees who have been or will be remunerated $1,500 or more (this may include wages, tax and salary-sacrificed super) for each JobKeeper fortnight. if No employees put 0*

    Are you intending to register an eligible business participant*?
    YesNo

    BANK DETAILS FOR JOB KEEPER PAYMENTS

    Account Name*

    BSB*

    Account Number*

    Other details (if any)

    Do you meet all of the following? *
    1. Does the entity’s business participant meet all of the following?*
    - relevant individual is not employed by the entity at any time in the fortnight
    - relevant individual actively engaged in the entity’s business
    - relevant individual aged 16 or over (or 18 year if beneficiary in the case of the Trust)
    - relevant individual is not currently receiving parental leave pay, dad and partner pay
    - relevant individual is not currently totally incapacitated for work and receiving payments under an Australian workers’ compensation law in respect of their total incapacity to work
    - relevant individual is an Australian resident (within the meaning of section 7 of the Social Security Act 1991), or a resident for income tax purposes and was the holder of a special category (Subclass 444) visa.
    - relevant individual is not an employee (other than a casual employee) of another entity

    * compulsory
    "Liability Limited by a scheme approved under Professional Standards Legislation"