Employment termination payment with an invalidity segment worksheet

Use this worksheet (PDF) if you are making an employment termination payment that has an invalidity segment.

Last updated 23 September 2014

This form is available for download Employment termination payment with an invalidity segment worksheet (NAT 71949, PDF 241KB)This link will download a file

Complete a separate worksheet for each recipient.

Do not use this worksheet for payments relating to:

a death benefit
a genuine redundancy, or
an early retirement payment.

QC21093