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Wage Subsidy Claim Form

Wage Subsidy Claim Form

* Required Fields
Weekly   
Fortnightly
Weekly Wage Information
Period
Start Date
End Date
1
Employee's first day
Date employee's first pay period ends
2, 3, ...
Pay period start date
Pay period end date
Period Number
Start Date (dd/mm/yyyy) End Date (dd/mm/yyyy) Paid Hours Gross Wages Paid Approved Absence Hrs*

Note: Approved Absence refers to all paid or unpaid sick leave, annual leave, leave without pay, rostered days off or business closures.

Comments:
Preferred payment option:
Electronic Funds Transfer
Cheque
Before we continue, please select from the following:
My agreement was signed Prior to 1st October 2019
My agreement was signed After 1st October 2019.
Please Note:
  • All Wage Subsidy payments are GST inclusive. Agreed amounts will be reduced by the GST portion if the employer is not registered for GST.
  • The total value of the wage subsidy for the employment position, together with any concurrent state or territory government wage subsidy, must not exceed 100% of the participants at any point duringwage over the period of the wage subsidy agreement period.
  • The Employer or their Authorised Representative must complete all sections of this form and initial and date any changes made to the information on this form if resubmitted after the original date of claim.
  • All periods of approved leave recorded in payroll evidence, count towards the Participant’s 20 hours of work per week requirement.
  • Approved leave is defined as;
    • Leave that the Employer agrees to and must provide as part of the minimum employment entitlements set out in the National Employment Standards (NES) under the Fair Work Act 2009
    • Leave approved by the Employer that the Participant is entitled to under the relevant award, registered agreement or contract of employment (these leave entitlements cannot be less than the NES)
    • Leave agreed to by the Employer at the time the participant requests it
  • Approved leave cannot be used to supplement reduced hours of work.
  • A Wage Subsidy Participant declining shifts or not turning up to rostered work hours is not approved leave.
  • Employers must supply further evidence to support claims involving periods of approved leave on request.
I Declare,
I am the person who is authorised to make this declaration.
As the employer we have complied with the terms and conditions specified in the relevant agreement.
The employee who is subject to this claim has worked an average of at least 20 hours per week since commencing employment, including any periods of approved leave whether paid or unpaid (not applicable to the 4 week Kickstart claim). If worked hours average less than 20 hours per week after 4 weeks, they must be increased to average at least 20 hours per week before further claims can be made.
The employee who is subject to this claim has worked an average of at least 20 hours per week since commencing employment, including any periods of approved leave whether paid or unpaid. If worked hours average less than 20 hours per week after 4 weeks, they must be increased to average at least 20 hours per week before further claims can be made.
All instances of approved leave hours included in claims meet the approved leave definition noted above.
As the employer we intend to continue to employ the employee, who is the subject of this claim on an ongoing basis.
This wage subsidy placement is a sustainable, ongoing position, offering an average of 20 hours per week over the 26 week duration of the wage subsidy agreement, and expected to last more than 26 weeks.
No other State Government or Australian Government Wage Subsidies for the employee who is subject of this claim are being received.
The information provided in this claim form is true and correct.

Is the Employee, who is the subject of this claim, still currently employed in the position detailed in the relevant agreement?

Yes No

X