PAYG payment summary - individual non-business

Payment summary for year ending 30 June 2019

Payee details NOTICE TO PAYEE

Fook Ngo If this payment summary shows an amount in the total
tax withheld box you must lodge a tax return. If no tax
139 Railway Avenue
was withheld you may still have to lodge a tax return.
Laverton VIC 3028 For more information on whether you have to lodge, or
about this payment and how it is taxed, you can:
- refer to Tax Pack
- phone 13 28 61 between 8.00 am and 6.00pm(EST),
Monday to Friday, or
- visit www.ato.gov.au

Day/Month/Year Day/Month/Year
Period of payment 01/07/2018 to 30/06/2019

Payee's tax file number 424 290 842 TOTAL TAX WITHHELD $ 391

Type Lump sum payments Type

Gross payments $ 18,561 S A $ 0

CDEP payments $ 0 B $ 0

Reportable fringe benefits amount FBT year 1

$ 0 D $ 0
April to 31 March
Is the employer exempt from FBT under
No Yes
section 57A of the FBTAA 1986?

Reportable employer superannuation contributions $ 0 E $ 0

Total allowances are not included in Gross Payments
Total allowances $ 0 above. This amount needs to be shown separately in
your tax return.

Deductions:
RAFFWU SNR $ 318

Payer details
Payer's ABN or withholding payer number 45 004 189 708 Branch number 001
Payer's name COLES SUPERMARKETS AUST PTY LTD

Signature of authorised person ADALENE PANDELI Date 30/06/2019

NAT72710B-12.2008 Employee number : 00425855