Business Activity Statement Form - GST Payment and PAYG Income Tax Instalment

Complete the Business Activity Statement form for GST payment and PAYG income tax instalment. Follow the instructions carefully and choose the appropriate option. Print clearly and use black pen.

METHODS OF PAYMENT
BPAY®
Contact your financial institution to make this payment from
your cheque or savings account. You will need the details
listed below.
Biller Code: 75556
Reference: Your EFT code (shown on the front
of your payment slip directly above the barcode)
Credit card
Payments can be made online or by phone, visit our
website at ato.gov.au/howtopay or phone [phone].
A card‑payment fee applies.
Other payment options
For more information about other payment options, you can:
n visit our website at ato.gov.au/howtopay
n phone us on 1800 815 886.
Payments cannot be made in person at any of our branches
or shopfronts.
NAT 14168-03.2014[JS 29448]
V
Form due on
ABN
Document ID
Payment due on
Business activity
statement
Contact phone number
Authorised contact person
who completed the form
GST accounting method
OR
Option 3: Pay GST instalment amount quarterly
G21$
Reason code for variationG24
Write this amount at 1A in the Summary section
over the page (leave 1B blank)
OR if varying this amount, complete G22, G23, G24
Write the G23 amount at 1A in the Summary section over
page and then complete the other sections (leave 1B blank)
Estimated net
GST for the yearG22$ , , .00
Varied amount payable
for the quarter
G23$ , , .00
PAYG tax withheld
Total salary, wages and
other paymentsW1 $ , , .00
Write the W5 amount at 4 in the Summary section over
the page and then complete the other sections
Amount withheld from
payments shown at W1W2 $ , , .00
Amount withheld where
no ABN is quotedW4 $ , , .00
Other amounts withheld
(excluding any amount
shown at W2 or W4)
W3 $ , , .00
Total amounts withheld
(W2 + W4 + W3)W5 $ , , .00
Office use only
Goods and services tax (GST)
OR
Option 1: Calculate GST and report quarterly
Report GST on sales at 1A and GST on purchases at 1B in the
Summary section over the page and then complete the other sections
Total sales
(G1 requires 1A completed)G1 $ , , .00
Export salesG2 $ , , .00
Other GST-free salesG3 $ , , .00
Capital purchasesG10$ , , .00
Non-capital purchasesG11$ , , .00
Does the amount shown at
G1 include GST? Yes No
Complete one of the three options below(place in ONE option box only)X
Option 2: Calculate GST quarterly and report annually
Total sales
(G1 requires 1A completed)G1 $ , , .00
Report GST on sales at 1A and GST on purchases at 1B in the
Summary section over the page and then complete the other sections
Does the amount shown at
G1 include GST? Yes No
When completing this form:
n print clearly using a black pen
n round down to whole dollars (do not show cents)
n if reporting a zero amount, print ‘0’ (do not use NIL)
n leave boxes blank if not applicable (do not use N/A, NIL)
n do not report negative figures or use symbols such as +, −, /, $.
141680314
x
1 5 7 2 9 8
x
1 7 6 5 4 0
6 6 2 3 5
6 6 2 3 5

PAYG income tax instalment
Your payment or refund amount
9 $
OR
Option 1: Pay a PAYG instalment amount quarterly
T7 $
Reason code for variationT4
OR if varying this amount, complete T8, T9, T4
Write the T9 amount at 5A in the Summary section
Estimated tax for the yearT8 $ , , .00
Varied amount payable
for the quarterT9 $ , , .00
Option 2: Calculate PAYG instalment using income times rate
Reason code for variationT4
OR
New varied rateT3 . %
T2 %
Write the T11 amount at 5A in the Summary section
PAYG instalment incomeT1 $ , , .00
T1 x T2 (or x T3)T11 $ , , .00
F1 $
Fringe benefits tax (FBT) instalment
Reason code for variationF4
Write the F1 amount at 6A in the Summary section
OR if varying this amount, complete F2, F3, F4
Write the F3 amount at 6A in the Summary section
Estimated FBT
for the yearF2 $ , , .00
Varied amount payable
for the quarterF3 $ , , .00
Estimate the time taken to compl
this form. Include the time taken
collate any information.
HRS MINSReturn this completed form toDeclaration: I declare that the information given on this form is true and correct, and that
I am authorised to make this declaration. The tax invoice requirements have been met.
Signature Date / /
Taxation laws authorise the ATO to collect information including personal information about individuals who may complete this form. For in
personal information go to ato.gov.au/privacy. Activity statement instructions are available from ato.gov.au or can be ordered by phonin
, , .00
Is 8A more than 8B?
then write the result of 8A minus 8B at 9. This amount is
payable to the ATO.
then write the result of 8B minus 8A at 9. This amount is
refundable to you (or offset against any other tax debt you
Yes,
No,
Amounts the ATO owes you
1B $GST on purchases , , .00
Wine equalisation tax
refundable1D $ , , .00
Luxury car tax refundable1F $ , , .00
Credit from PAYG income tax
instalment variation5B $ , , .00
Credit from FBT
instalment variation6B $ , , .00
1B + 1D +1F + 5B + 6B + 7D8B $ , , .00
Fuel tax credit
(Do not claim in litres)7D $ , , .00
If you are using GST Option 3 leave 1B, 1C, 1D, 1E,
Amounts you owe the ATO
Summary
GST on sales
or GST instalment1A $ , , .00
Wine equalisation tax1C $ , , .00
Luxury car tax1E $ , , .00
PAYG tax withheld4 $ , , .00
PAYG income tax
instalment
5A $ , , .00
6A $ , , .00FBT instalment
, , .00Fuel tax credit over claim
(Do not claim in litres)7C $
1A +1C + 1E + 4
+ 5A + 6A + 7C , , .008A $
Complete one of the two options below(place in ONE option box only)X
Payment or refund?
If we do not have your current financial institution
account details your refund may be delayed.
Write the T7 amount at5A in the Summary section
X
2 5 0 0
6 6 2 3 5
1 6 7 9 0