ATO National Tax Equivalent Regime

ATTACHMENT 3 - PAYG INSTALMENT REPORT

PAYG instalment report

NTER PAYG instalment for the instalment month/quarter from _ _ / _ _ /202 _ to _ _ / _ _ /202 _
1. Name of NTER entity:
2. Postal address of NTER entity:
3. Contact person who completed this form:
4. Contact telephone number:
5. Contact email address:
6. PAYG instalment calculation:
A. Instalment income:	$
B. Instalment rate given by the NTER Administrator:	%
*C. Varied instalment rate:** *Please attach an explanation of why you have chosen to vary your rate.	%
D. PAYG Instalment: (6A x 6B) or (6A x 6C)	$
*7. Credit from instalment rate variation you wish to claim:** * Please attach calculations of the amount of the credit.	($ )
8. Amount payable to the NTER entity's Treasury or Revenue Office: (6D - 7)

Declaration: I declare that the information given on this form is true and correct, and that I am authorised to make this declaration.

Name: ..............................................

Signature: ........................ Date: ..........................

[ History: Attachment 3 amended

•: April 2014 (Version 9), with effect from the instalment month and instalment quarter starting on 1 January 2014, by inserting reference to instalment month
•: February 2012 (Version 8), with effect from 1 February 2012, by replacing the version provided of the approved form of the PAYG instalment report. For the former version of this approved form, see March 2010 (Version 7)
•: January 2022 (Version 12), with effect from 27 January 2022, by updating the version provided of the approved form of the PAYG instalment report with the date '202_'). ]

Prior versions of the ATO National Tax Equivalent Regime, from Version 6, can be requested from atolawsupport@ato.gov.au , if required.