Signature Date Country Code Country Code - Must be a valid ISO 3166 two character code House No. / Street / PO Box Address Line1 House No. / Street / PO Box - House No. / Street / PO Box Unit/Flat/Building Address Line2 Suburb Postcode State Address Usage Address Usage - Address Usage Code = POS (Postal Address) Telephone area code Electronic contact service line Telephone number Telephone Usage Code Telephone Usage Code - Telephone Usage Code = 03 (contact) Client Name DGE name Group member name Administrator name Excess deduction group member name Client Name - The legal name by which the entity is registered. DGE name - The legal name by which the entity is registered. Group member name - The legal name by which the entity is registered. Administrator name - The legal name by which the entity is registered. Excess deduction group member name - The legal name by which the entity is registered. Name Type Name Type - Name Type = MN (Main Name) Address Details Line 4 Contact name Contact name - For personal certificates this value should match the person name on the authentication token. Group status for next return Group status for next return - Identifies employer status for the Next period. It is one of the three values defined below. * Designated group employer (DGE) - the one member of a group chosen by the members or nominated by the Commissioner of State Revenue under the Payroll Tax Act 1971 who can claim the deduction. * Group member - a member of a group of employers, but is not the DGE of the group * Non-grouped employer - an employer who is not a member of a group. Have you ceased to employ? Cease date Cease date - Appears only if the answer to will you cease to employ from the next period is yes. Must be the day after the period end date specified for the return which for an Annual will be 30 June. Any other date should prompt a change to a final return form. Has an administrator been appointed? Has an administrator been appointed? - For example, Receivers and Managers, Liquidators and Administrators. Administrator appointed date Has an administrator ceased? Administrator cease date Allowances Bonuses Commissions Wages for apprentices Fringe benefits Annual liability Annual liability - The Payroll tax amount is the taxable amount multiplied by the current Payroll tax rate Payroll Tax liability/credit Total (liability/credit) Periodic paid or payable Part periodic period before change of status Total liability Part periodic period before change of status - Amount of assessed liability for the part period that started at the beginning of the periodic period and ended on the day the change of status occured. Total liability - E. less Total periodic amounts Date of payment Total Queensland taxable wages Other non taxable wages Total Queensland non taxable wages Did you pay wages that are taxable in other states or territories of Australia? Did you pay wages that are taxable in other states or territories of Australia? - Exists to allow the form to dynamically display relevant interstate wage fields. Total interstate wages Total interstate wages - Displays only when indicator for interstate wages is checked. Used to calculation the annual deduction. Total Queensland taxable wages for all group members Total Queensland taxable wages for all group members - Displays only for DGE type employers Used to calculate the annual deduction. Total interstate wages for all group members Total interstate wages for all group members - Displays only for DGE type employers Used to calculate the annual deduction. Address Details Line 3 Approved form name In submitting this return I declare that the information is correct Declaration Statement Payee details Payee details - Commissioner of State Revenue Excess deduction seq no Excess deduction indicator Excess deduction Deduction Taxable amount Taxable amount - The taxable amount is the total Queensland Taxable wages less the Deduction Name Use Code Name Use Code - Name Use Code = Contact Adddress Details Country Name Address Details Overseas Address Indicator Have you changed your employer status? Payroll Tax amount Unpaid Tax Interest (UTI) Unpaid Tax Interest (UTI) - Unpaid Tax Interest is a penalty for late payment of returns. It is the daily UTI amount, multiplied by the number of UTI days applicable. UTI days UTI days - The number of days between Unpaid Tax Interest (UTI) start date and the expected payment date inclusive of both dates. SBR report code Gross salary and wages Gross salary and wages - Queensland taxable wages are wages that are taxable under the Payroll Tax Act 1971, and have not been included in other fields within this section (except for the total field), or have been included in the non taxable wages section Contractors Directors fees Termination payments Shares and options Apprentice and trainee wages Wages for trainees Approved form number Employer superannuation contributions Total group Australian wages Total group Australian wages - Displays only for DGE type employers Used to calculate the annual deduction Less deduction Declaration Type Does the group pay more than $5 million in annual taxable wages throughout Australia? Does the group pay more than $5 million in annual taxable wages throughout Australia? - Does the group pay more than $5 million in annual taxable wages throughout Australia? Signatory Identifier Calculated rebate PTAFRQLD Lodge Request [Abstract]