Living Away From Home Eligibility Checklist

Details

Employer: *

Applicant Name: *

Usual Residential Address (include state and postcode) *

New Residental Address (include state and postcode) *

Your email address: *

Your phone number: *

Name of Whizdom representative you are working with: *

Eligibilty Checklist

1. Was it required by your employer or contract to live away from home, while you were residing in your usual residence? *

2. Was your intention to return to your usual residence when you accepted this job? *

3. Does your employer or contract have a fixed term/completion date for you to live away from home to conduct your work? *

4. Is this period no greater than 12 months based on your employer/contractor’s requirement? *

5. Is this period greater than 21 days based on your employer/ contractor’s requirement? *

6. Do you have ownership interest in your usual residence? *

7. Will you keep your usual residence at unconditional use of the usual residence while you receive LAFHA? *

8. Will you be subletting your usual residence while you receive LAFHA? *

9. Have you claimed LAFHA in past two years? *

10. Will your partner/ de-facto relocate with you? *

11. Will any adult dependants (except your partner/ de-facto) relocate with you? If Yes, how many? *

Number of adult dependents *

12. Will any children relocate with you? If Yes, how many? *

Number of children *

Comments

Declaration

I declare the following:

The information I have provided in this checklist is true and accurate.
I have read and understood the information regarding salary packaging as advised on the Whizdom website/ Whizdom salary sacrifice manual & factsheets of salary sacrifice.
I understand that any changes to the package (i.e. employment status, extended periods of leave, banking details, personal details and contact details) must be made in writing to Whizdom. Employee withdrawal from salary packaging must be made in writing to Whizdom giving 10 days’ notice. Reconciliation of funds will be finalised and any held balance will be either paid out or returned to payroll as determined by employee and employer. If my contract terminates before the full amount is able to be salary sacrificed, any outstanding amount will be settled in my final pay.
I acknowledge the information provided by Whizdom does not constitute financial or taxation advice. Whizdom recommends that employees seek independent financial advice from a qualified financial advisor or accountant.
Whizdom accepts no liability should I incur additional income tax or other costs, now or in the future, as a result of this salary sacrifice claim. I agree to reimburse Whizdom the fullcost of any Fringe Benefits Tax liability or penalty incurred as a result of this salary sacrifice claim.

Please note: This expense(s) should not be claimed again in your personal income tax return, as the ATO would consider it to be double-dipping.

By signing this form, you agree the information has been checked and accurate and provides Whizdom Pty Ltd the authority to implement the details of the request.

Signed: *

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Date of Agreement *

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