EXAMPLE: Business activity statement ‘My Business’ has chosen Option 1 for reporting GST. Refer to the completed cash receipts and cash payments books on pages 44 and 42 for the source of the figures used in the ‘Option 1’ GST calculations. Front of activity statement

A
Office use only

O

When completing this form, please • use a BLACK pen only (to help with processing) • leave boxes blank if not applicable (do not use N/A, NIL) • show whole dollars only (do not show cents) • do not use symbols such as +, –, /, $

Complete Option 1 OR 2 OR 3 (indicate one choice with an X)

X

PL E
2 6 , 0 0 0 .00
No

Goods and services tax (GST)

Option 1: Calculate GST and report quarterly
Total sales

Option 2: Calculate GST quarterly and report annually
Total sales G1 Does the amount shown at G1 include GST? (indicate with X)

G1 $

,

OR

N LY
Document ID ABN Form due on Payment due on GST accounting method Contact phone number Contact person who completed the form

My Business 2003 Bass Road Mt Pleasant NSW

Business activity statement

41890404

0 2 5 5 5 1 2 3 4 5 my name

$
Yes

,
No

,

.00

M
, , , ,

Does the amount shown at G1 include GST? (indicate with X) Export sales Other GST-free sales

X

Yes

G2 $ G3 $ G10 $ G11 $

,

.00

Report GST on sales at 1A and GST on purchases at 1B in the Summary section over the page Option 3: Pay GST instalment amount quarterly

SA

8 , 3 5 0 .00 OR

Capital purchases

1 6 , 5 0 0 .00 1 , 6 9 0 .00

G21 $

350

Non-capital purchases

Report GST on sales at 1A and GST on purchases at 1B in the Summary section over the page

Write the G21 amount at 1A in the Summary section over the page (leave 1B blank) OR if varying this amount, complete G22, G23, G24
Estimated net GST for the year Varied amount for the quarter

G22 $ G23 $

, ,

, ,

.00 .00

Write the G23 amount at 1A in the Summary section over the page (leave 1B blank)
Reason code for variation
NAT 4189-4.2004

G24

Methods of payment
Bpay: contact your financial institution to make this payment from your cheque or savings account. Quote biller code 75556 and your EFT code (shown on the front of the payment slip) as the customer reference number. Direct credit: you can electronically transfer funds to the Tax Office’s direct credit bank account using online banking facilities. Use BSB 093 003, Account number 316 385 and your EFT code. Phone 1800 815 886 for assistance if required. Direct debit: have your payment deducted from your financial institution account (not credit cards). Phone 1800 802 308 for a direct debit request form and/or details. Mail payments: mail the payment slip together with your cheque or money order using the envelope provided. Please do not use pins or staples. Do not send cash. See below for cheque information. post office: payments can be made at any post office by cash, cheque or EFTPOS (where available and subject to daily limits). A $3,000 limit applies to cash payments. Your payment slip must be presented with your payment. Cheques/money orders should be for amounts in Australian dollars and payable to ‘Deputy Commissioner of Taxation’. Cheques should be crossed ‘Not Negotiable’. payments cannot be made by credit card, or in person at any Tax Office branch or shopfront.

Back of activity statement
PAYG tax withheld
Total salary, wages and other payments Amount withheld from payments shown at W1 Amount withheld where no ABN is quoted Other amounts withheld (excluding any amount shown at W2 or W4) Total amounts withheld (W2 + W4 + W3)

PAYG income tax instalment
, , , , , ,9 ,2 , , ,2

W1 $ W2 $ W4 $ W3 $ W5 $

0 0 .00 0 5 .00
.00 .00

Complete Option 1 OR 2 (indicate one choice with X) ✓ Option 1: Pay a PAYG instalment amount quarterly T7 $ T8 $ T9 $

Write the T7 amount at 5A in the Summary section below OR if varying this amount, complete T8, T9, T4
Estimated tax for the year Varied amount for the quarter Reason code for variation

1,100

Refer to PAYG instalments – how to complete your activity statement (NAT 7393) for information on how to use these options.
.00 .00

, ,

, ,

0 5 .00

Write the W5 amount at 4 in the Summary section below

OR

Option 2: Calculate PAYG instalment using income times rate

N LY
T4 T1 $ , T2 T3 T11 $

Write the T9 amount at 5A in the Summary section below

O

Refer to the completed worker payment record on page 17 for the source of these figures. Refer to the completed cash receipts and cash payment books on pages 42 and 44 for the source of the figures used at labels 1A and 1B. Summary
GST on sales or GST instalment PAYG tax withheld PAYG income tax instalment Deferred company/fund instalment

PAYG instalment income

, %

.00

5.00

OR New varied rate

. ,

% , .00

E

T1 x T2 (or x T3)

Write the T11 amount at 5A in the Summary section below

Amounts you owe the Tax Office 1A $ 4 $

PL
1 , 6 0 0 .00
,2

Reason code for variation

T4

Amounts the Tax Office owes you
GST on purchases

, , , , ,

1B $

,

1 , 5 9 5 .00
.00

M

0 5 .00
.00

Do not complete 1B if using GST instalment amount (Option 3)
Credit from PAYG income tax instalment variation

5A $ 7 $

1 , 1 0 0 .00
,

5B $

,

,

SA

1A + 4 + 5A + 7

8A $

2 , 9 0 5 .00

1B + 5B

8B $

,

,

.00

Payment or refund?
Is 8A more than 8B?
(indicate with X)

X

Yes, No,

then write the result of 8A minus 8B at 9. This amount is payable to the Tax Office. then write the result of 8B minus 8A at 9. This amount is refundable to you (or offset against any other tax debt you have).

Your payment or refund amount 9 $

1 , 3 1 0 .00 , Do not use symbols such as +, –, /, $
HRS MINS Please estimate the time taken to complete this form. Include the time

Declaration 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.

Please return this completed form to

Signature Date / / taken to collect any information. Activity statement instructions are available from www.ato.gov.au or can be ordered by phoning 13 28 66. The Tax Office is authorised by the tax laws to collect this information to administer those laws and may pass information to other government agencies. More information about privacy and access to your tax information is available from www.ato.gov.au

PAYMENT ADVICE 60

000 156 03 97 999 999 999

My name

Australian Taxation Office Locked Bag 1793 PENRITH NSW 1793