NSW Stamp Duty Exemption Declaration Form Declaration(Required) I hereby declare that I am or will be a Capital Gains Tax small business entity (within the meaning of section 152-10 (1AA) of the Income Tax Assessment Act 1997 of the Commonwealth) for policies commenced in the financial year during which this declaration applies. I am a small business individual/partnership/company and/or trust, which is carrying on business, and the business has an aggregated turnover of less than $2 million.Name(Required) First Last Date(Required) DD slash MM slash YYYY Name of Insured/Company NameIf different from above Mobile(Required)Email(Required) Australian Business No. (ABN) of Insured(Required) Notes: 1. Aggregated turnover is your Australia wide annual turnover plus the annual turnovers of any business entities that are your affiliates or are connect with you. 2. A fraudulent declaration may invalidate your insurance contract. 3. The declaration covers all polices issues to you during the financial year ended 30 June 2024. 4. An insurer will place reliance on your declaration in charging the applicable insurance duty. 5. False declarations may result in penalties up to $11,000 by Revenue NSW plus the insurance duty not paid and penal interest on the balance. 6. Revenue NSW may also be able to clarify your queries relating to the law and your obligations.Signature(Required)CAPTCHA
