Statutory Declaration of Taxation - Australia

Have you attempted to obtain the following from your payer?
n Your payment summary.
n A copy of your payment summary.
n A letter stating details of your income and the amount
oftax withheld.
If you have not attempted to obtain this information,
youshould do so before proceeding any further. 
You should complete this statutory declaration when you
cannotobtain orlocate the following payment summaries: 
n PAYG payment summary – individual non‑business
(NAT 0046)
n PAYG payment summary – employment termination payment
(NAT 70868)
n PAYG payment summary – superannuation lump sum
(NAT 70947)
n PAYG payment summary – superannuation income stream
(NAT 70987).
Payment summary information may
beavailableinpre‑lling service
Payment summary information is generally available through the
pre-filling service in e‑tax or by contacting your tax agent. If your 
information is not available in the pre-filling service, and you do
not have your payment summary, you should complete this
statutory declaration.
For more information on the pre-filling service, visit our
website at
You can make a declaration if you are an individual person
and the declaration relates to your own income tax return.
n Use a separate declaration for each income year
(1 July to 30 June).
n Use a separate declaration for each payment summary.
n Complete all the relevant sections. Ensure all details
about your payments and the amounts withheld are included.
If you do not complete all the details, you may not be allowed
a credit for the amount that was withheld from your payments
when your tax return is processed. If you do not know the 
required details, print ‘UNKNOWN’.
Use the information in this declaration to complete your
tax return or amendment request. If you do not have to lodge 
this declaration, you must keep it with your records.
If you have any documents showing amounts were
withheld from payments you received (for example, payslips, 
pay envelopes or time sheets), keep those documents with
this declaration.
You do not have to lodge this declaration with your tax return 
or amendment request unless you have completed it in place
of the ETP payment summary (NAT 2605) for 2007 and prior
financial years.
We are authorised by the Income Tax Assessment Act 1936 to
ask for the information on this form. We need this information to
help us correctly identify your records. Where authorised by law,
we may give this information to other government agencies that
administer laws relevant to your particular situation. It is not an
offence not to quote your tax file number (TFN).
If at any time you find your payment summary, and the
amounts shown on it are the same as the amounts you are
claiming on this declaration, keep the payment summary
with your records. However, if any of the amounts shown on
your payment summary are different to the amounts you are
claiming on this declaration, you must use the payment
summary amounts on your tax return.
If you have already lodged your tax return, you must 
request an amendment. To do this, write to us and ask us
to replace the amount you have already claimed with the
amount shown on the payment summary.
Write to us at:
Australian Taxation Office
PO Box 3004
Statutory declaration
NAT 4135–11.2012
Page 1/6
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