PAY- AS-YOU-EARN (PAYE)Employee Declaration

Address :First Name:

Middle Name:

Last Name:

Section A: Employee Details

T.I.N.:First Name:

Middle Name:

Last Name: Date marriage registered:

Employer:

T.I.N.:Name:

Branch:

Section D: Details of allowances claimed:

Section B: Employee's spouse details

Section C: Employer details

Section E: Declarations:

Child allowance - child 5

Type of Allowance Amount ($)

Child allowance - child 1

Child allowance - child 2

Child allowance - child 3

Total Claimed:

I, declare that this PAYE declaration is true and correct in every detail.

Date:Signature:

EMPLOYEE :

EMPLOYER : I, declare that I am the employer of the person named on this form and that I will deduct tax from emoluments paid to the person in accordance with the rates prescribed by the Commissioner, taking into account the amount of total allowances on this form.

Date:Signature:

Position:

IT IS A SERIOUS OFFENCE TO MAKE A FALSE STATEMENT TO THE COMMISSIONER

T.I.N.:

Child allowance - child 4

Spouse allowance

Superannuation

Life insurance

Date of Birth

IRS458 [Revised: 02-Oct-2006]

Revenue Collection Division

Name