Salary Packaging Application Form -...

Salary Packaging Application Form Remote Area Benefits Only

Remote Area Salary Packaging Application Form. 03.17

Please complete all sections

Personal Information

Title: First Name: Middle Name:

Surname: Date of Birth: / /

Payroll Identification Number:

Payroll Cycle: q Weekly q Fortnightly q Monthly q Other

Address:

Suburb: State: Postcode:

Your contact details: Work Mobile Home

Email:

Employer Name:

Account name

BSB number – Account number

ALL EMPLOYEES MUST COMPLETE THE DECLARATION AT THE END OF THIS FORM.

Benefit Allocation

Please select the item/s to be included in your salary package and complete the required pages.

Note

1. This is the annual administration fee applicable to your salary package, please refer to your Employer Policy at www.maxxia.com.au. Contact our Customer Care Centre on 1300 123 123 for the User Name and Password.

* FBT year commences on 1 April each year.

Benefit Allocation per FBT year * Notes

Remote Area Reimbursement of Interest $ .

Remote Area Rental Assistance $ .Remote Area Reimbursement on Purchasing or Building a Property $ .

Remote Area Residential Fuel (Gas and Electricity) $ .

Administration Fee $ . 1

TOTAL $ .




Remote Area Reimbursement of Interest

Description An employee may salary package the interest payments accrued on a housing loan provided:• The accommodation is in a remote area and the employee is employed in a remote area;• The accommodation is the employee’s usual place of residence;• The employee is a current employee; and• The ATO requirements for a FBT concession are met (refer to employee guide for detailed information).Note: This benefit does not provide for the payment of loan repayments. Where the loan has a redraw/draw-down facility, the facility cannot be accessed for any other purpose other than in relation to the construction or purchase of the home.

Impact on Cap • An FBT concession of 50% is available where the employee meets the conditions for this benefit.• The taxable value is reduced by 50% and gross-up factor of 1.8868 applied when calculating the

impact on the salary packaging cap. For example, packaging $10,000 interest incurred will use up $9,434 of the cap ($10,000 x 50% x 1.8868).

GST The payment of this benefit is not subject to GST and Input Tax Credits are not available.

Claim and Substantiation A completed Remote Area Claim Form must be submitted to Maxxia together with a statement from the financial institution clearly identifying the amount of interest paid on the loan.

Remote Area Rental Assistance

Description An employee may salary package the rental payments for private rental provided:• The accommodation is in a prescribed remote area and the employee is employed in a remote area;• The accommodation is the employee’s usual place of residence;• The employee is a current employee; and• The ATO requirements for a FBT concession are met (refer to employee guide for detailed information).

Impact on Cap

• An FBT concession of 50% is available where the employee meets the conditions for this benefit.• The taxable value is reduced by 50% and gross-up factor of 1.8868 applied when calculating the

impact on the salary packaging cap. For example, packaging $10,000 rent paid will use up $9,434 of the cap ($10,000 x 50% x 1.8868).


Claim and Substantiation

A completed Remote Area Claim Form must be submitted to Maxxia together with:1. a current tenancy agreement and2. rental/bank statements evidencing to Maxxia that a regular payment to the landlord or real estate

agent is established.

Part A: Remote Area Benefits

Below are the remote area benefits available. Please ensure you understand the eligibility requirements, substantiation and impact on your overall package.




Remote Area Reimbursement on Purchasing or Building a Property

Description An employee may salary package the costs incurred in purchasing or building a property provided:• The property/land purchased is in a remote area and the employee is employed in a remote area;• The property is the employee’s usual place of residence (or will be after construction);• The employee is a current employee; and• The ATO requirements for a FBT concession are met (refer to employee guide for

detailed information).

Impact on Cap

• An FBT concession of 50% is available where the employee meets the conditions for this benefit.• The taxable value is reduced by 50% and gross-up factor of 1.8868 applied when calculating

the impact on the salary packaging cap. For example, packaging $10,000 of purchase costs will use up $9,434 of the cap ($10,000 x 50% x 1.8868).


Claim and Substantiation A completed Remote Area Claim Form must be submitted to Maxxia together with:1. A copy of Offer and Acceptance and Settlement Statement showing the purchase date

and costs incurred;2. Statements/invoices substantiating other costs such as stamp duty, lending fees

and charges.

Remote Area Residential Fuel (Gas and Electricity)

Description An employee may salary package fuel costs (gas and electricity) incurred in relation to their residence provided:• The residence is in a remote area and the employee is employed in a remote area;• The residence is the employee’s usual place of residence;• The employee is a current employee; and• The ATO requirements for a FBT concession are met (refer to employee guide for detailed information).

FBT

• An FBT concession of 50% is available where the employee meets the conditions for this benefit.• The taxable value is reduced by 50% and gross-up factor of 2.0802 applied when calculating the

impact on the salary packaging cap. For example, packaging $5,000 of residential fuel costs will use up $5,200.50 of the cap ($5,000 x 50% x 2.0802).

GST The Goods and Services Tax applies to gas and electricity and Input Tax Credits are available.

Claim and Substantiation

A completed Remote Area Claim Form must be submitted to Maxxia together with invoices/receipts from the fuel suppliers confirming amount paid.




Part B: Employer Declaration

For the benefit to be allowed, an authorised representative of the employer must sign the ‘Employer Declaration’. If the employer representative does not sign the declaration, the benefit will not be made available to the employee.

It is acknowledged that the following terms and conditions have been met in relation to the provision of the nominated Remote Area

benefit to :

1. The accommodation is in a remote area as defined by the Fringe Benefits Tax Assessment Act 1986;2. The employee is a current employee. 3. The employee’s usual place of employment is in a remote area.

Employment start date in remote area:

Please acknowledge the criteria have been met by ticking the relevant box below.

q Remote Area Reimbursement of Interest The employee has provided and I have sighted the loan agreement for the property.

q Remote Area Rental Assistance The employee has provided and I have sighted the rental agreement for the property.

q Remote Area Reimbursement on Purchasing or Building a Property The employee has provided and I have sighted the land/house purchase agreement.

q Remote Area Residential Fuel (Gas and Electricity)

Employer DeclarationIt is further acknowledged that until such time as Maxxia is advised to the contrary, the employee to whom this declaration relates continues to reside in the remote area.

Employer Representative Name:

Employer Representative Signature:

Position: Date: / /




Part C: Employee Declaration

I understand and accept the terms and conditions of my Employer’s salary packaging program and the Maxxia reimbursement terms and conditions (see www.maxxia.com.au).In addition, I understand and confirm that:

i. I will not submit a claim for reimbursement of an expense where I have been previously reimbursed for the expense by my employer;

ii. I am aware of the requirements for claiming Remote Area Benefits and the impact of these benefits on my salary and packaging cap;

iii. I will meet any costs including FBT liability arising from the implementation of my salary package;

iv. I am aware that it is recommended that I obtain independent financial advice prior to commencing salary packaging to ensure that my salary packaging arrangements are of a manifest benefit to me;

v. I undertake to retain and maintain all records in relation to any payments made by Maxxia for a period of five years (5). I also undertake to make these records available to Maxxia or my Employer if requested; and

vi. In making this election, I have not relied on any financial information or advice provided to me by my Employer or any of its employees.

Employee Signature: Date: / /

Upon completion please forward the Application Form to:

Maxxia Pty LtdLocked Bag 18Collins Street EastMELBOURNE VIC 8003

Or Fax 1300 733 444

Or Email [email protected]

DISCLAIMERMaxxia provides administration and referral services on behalf of employers. It does not provide any form of financial, taxation or financial product advice to employees on the relative merits of package programs or on any other basis. Some information on taxation matters may be provided to illustrate possible advantages, but is of a general nature only. You should seek your own independent professional advice on how packaging programs may impact your particular financial, taxation and welfare benefit circumstances. Maxxia may receive commissions or rebates in connection with some services it provides or arranges to be provided by third parties. By appointing and utilising Maxxia services, you consent to its receipt of such commissions and rebates. Tax laws regarding the treatment of salary benefits may change, which could adversely impact your financial, taxation or welfare benefit decisions.PRIVACYMaxxia is committed to protecting the privacy and rights of its customers. Our Privacy Policy contains important information about how we collect, hold, use and disclose personal information. It explains what happens if we cannot collect your personal information, as well as how you can access and correct the personal information we hold about you, or make a complaint. If you do not wish to receive promotional material from us, or would like a copy of our Privacy Policy, please contact us on 1300 123 123. Our Privacy Policy is also available at maxxia.com.auMaxxia Pty Ltd ABN 39 082 449 036 Authorised Representative (No. 278683) of McMillan Shakespeare Limited (AFSL 299054)

Salary Packaging Application Form -...

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