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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
Week Number
Start Date (dd/mm/yyyy) End Date (dd/mm/yyyy) Hours paid in week 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 of January 2017.
My agreement was signed After 1st of January 2017.
I Declare,
I am authorised to make this declaration.
As the employer we have complied with the terms and conditions specified in the relevant wage subsidy Agreement
At the date of this claim, the employee who is the subject of this claim is employed in the position detailed in the relevant agreement and has worked an average of 20 hours per week since commencing employment including any periods of approved leave (whether paid or unpaid).
As the employer we intend to continue to employ the employee who is the subject of this claim for an average of 20 hours per week on an ongoing basis.
At the date of this claim, the employee who is the subject of this claim is employed in the position detailed in the relevant agreement and has worked at least 15 hours per week over the previous Claim Period including any periods of approved leave (whether paid or unpaid).
As the employer we intend to continue to employ the employee who is the subject of this claim for at least 15 hours per week on an ongoing basis.
No other government wage subsidies, for the employee who is the subject of this claim, are being received.
All information provided in this claim form is true and correct.

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