First Name*

Last Name*

Date of Birth*(in DD/MM/YYYY)

Tax File Number*

Email*

Telephone/ Mobile*

Postal Address*

Post Code

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 should enrol as a sole trader 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 enrolling as a sole trader*?
YesNo

BANK DETAILS

Account Name*

BSB*

Account Number*

Other details (if any)

ID DOCUMENTS - Passport*

Do you meet all of the following? *
1. you are actively engaged in the entity’s business & had an ABN on 12 March 2020
2. you are aged 16 or over
3. you are not currently receiving parental leave pay, dad and partner pay
4. you are not currently totally incapacitated for work and receiving payments under an Australian workers’ compensation law in respect of their total incapacity to work
5. you are 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.
6. you are not an employee (other than a casual employee) of another entity
7. a trustee in bankruptcy has not been appointed to your property
8.had assessable income in 2018-2019 income year and provided notice to the Commissioner on or before 12 March 2020 OR made a supply in 1 July 2018 – 12 March 2020 and provided notice to the Commissioner on or before 12 March 2020

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