When to use the form

Employers

Before you enrol to receive JobKeeper payments, complete section A and provide this form to your eligible employees (refer to criteria below).

This form will be used to:
■ notify eligible employees that you (their employer) intend to participate in the JobKeeper scheme
■ ask eligible employees if they agree to be nominated by you as their primary employer so that you can receive JobKeeper payments for them.

You do not need to send this form to the ATO. You will, however, need to keep the completed version of this form (generally for 5 years) to document that your employee has agreed to be nominated by you to receive JobKeeper payments for them.

Employers must ensure they comply with any Privacy Act 1988 (Cth) obligations when using this form.

Employees

Complete section B, C and D of this form and submit this form as soon as possible.

Important:

If you have not submitted this form, you employer cannot include you as an eligible employee to receive JobKeeper payments for you.
■ If your employer intends to enrol to participate in the JobKeeper scheme for a fortnight beginning on 30 March 2020 or 13 April 2020, you should submit this form before the end of April 2020 to ensure that your employer is eligible to receive JobKeeper payments for those fortnights.
■ If your employer intends to enrol to participate in the JobKeeper scheme for a subsequent fortnight, you should submit this form as soon as possible after they give the form to you to ensure that your employer is eligible to receive JobKeeper payments.
■ Only one employer or eligible business can receive the JobKeeper payment for you. If you have multiple employers, you must choose a permanent employer. If you are a long‑term casual employee that is eligible with no permanent employer, you can nominate your casual employer.
■ If you have already agreed for another employer or eligible business to receive JobKeeper payments for you, you cannot nominate this employer. Taxation law authorises the ATO to collect information and to disclose it to other government agencies. For information about your privacy, go to ato.gov.au/privacy

What is the JobKeeper payment?

Under the JobKeeper payment, businesses impacted by the Coronavirus are able to access a subsidy from the government to continue paying their employees. Affected employers are able to claim a fortnightly payment of $1,500 per eligible employee, or for one eligible business participant from 30 March 2020, for a maximum period of 6 months.

Find out more:

ato.gov.au/general/gen/JobKeeper-payment

To be an eligible employee, you need to meet these requirements:
■ You are currently employed by the employer outlined in section A (including those stood down or re-hired).
■ You were employed by the employer outlined in section A at 1 March 2020.
■ As at 1 March 2020, you were a permanent or fixed term employee, or a casual employee employed on a regular and systematic basis during the period of 12 months ending on 1 March 2020.
■ If you are a casual employee as mentioned above, you are not employed by any other employer on a permanent or fixed term basis, or you are only employed by any other employer on a casual basis.
■ You were at least 16 years of age as at 1 March 2020.
■ As at 1 March 2020 you were:
– residing in Australia and an Australian citizen or permanent resident, or
– an Australian resident for income tax purposes and a Subclass 444 (Special Category) visa holder.
■ You are not in receipt of a JobKeeper payment as a sole trader, nor is another employer or eligible business in receipt of a JobKeeper payment for you.
■ You are not currently receiving parental leave pay or dad and partner pay, and
■ You are not currently totally incapacitated for work and receiving payments under an Australian workers’ compensation law in respect of your total incapacity to work.

In making this nomination I:
(i) agree that I meet the eligibility requirements listed above, and
(ii) confirm that I have not agreed to be nominated by any other employer/entity and have not given another entity a nomination form for the purpose of this scheme.

I declare that the information I have provided is true and correct.

There are penalties for deliberately making a false or misleading statement.