Expense Payment Benefit Declaration - Residential Phone Benefits and/or Dedicated Data Line Benefits

For the Fringe Benefits Tax Year Ended 31 March 2023

I declare that residential phone benefits / dedicated data line benefits (delete if not applicable) were provided to me by Ministerial and Parliamentary Services, Department of Finance during the period 1 April 2022 to 31 March 2023.

Your name:

Your email:

I also declare that, to the best of my knowledge, the percentage of expenses that were business related was:

Residential Phone %:

Dedicated Data Line %:

Note: This declaration should only be completed for residential telephone and/or dedicated data line benefits.
The taxable value of an expense payment fringe benefit may be reduced by the percentage declared by you as
‘otherwise deductible’. A benefit is otherwise deductible if the employee would have been entitled to claim an income tax deduction had the employee, rather than the employer, paid for the expense. The business related percentage of expenses may need to be substantiated in the event of an audit by the Australian Taxation Office. Substantiation can include a diary of phone usage or copies of phone bills identifying those calls that were business related.
If the business related percentage is different for residential phone benefits and for dedicated data line benefits, please complete two separate declarations.

By signing this form, I acknowledge that:

I understand that knowingly giving false or misleading information is a serious offence under the Criminal Code Act 1995.

I have read and understood the Privacy Collection Notice (see below).

Privacy Collection Notice: The Department of Finance (the Department) uses and discloses personal information collected in this form to facilitate the administration of the parliamentary business resources framework, and for employment purposes including to facilitate the management of your employment and for workforce planning purposes. The Department handles your personal information in accordance with the Privacy Act 1988. Personal and sensitive information may be disclosed to your employing Parliamentarian or other third party entities relevant to your employment, for workforce planning purpose or for improving culture in Commonwealth Parliamentary workplaces, including, but not limited to, the Independent Parliamentary Expenses Authority (IPEA), the Department of Parliamentary Services, the Parliamentary Workplace Support Service (PWSS), or will be disclosed as otherwise authorised or required by law. Details of the related expenditure may be tabled in Parliament, published on the Department’s website, or provided to the Special Minister of State, IPEA, or publicly, as authorised by law. More information is available at https://maps.finance.gov.au/maps-privacy-statement.