The information I supply in this form is true and correct.
I will notify the Office of State Revenue within 28 days if:
  • the home ceases to be used as my home for any reason other than sale or short-term holiday
  • there is a change in use of the home that may affect my exemption entitlement.
Under the Taxation Administration Act 2001, it is an offence to give false or misleading information. Failing to notify of changes that affect an exemption is also an offence. Maximum penalty: $11,000.00
As the authorised person, I confirm that the information submitted is true and correct.

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