Stamp Duty Exemption

Certain types of general insurance are exempt from duty.

I hereby declare that I am 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). 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.

Aggregated turnover is your Australia wide annual turnover plus the annual turnovers of any business entities that are your affiliates or are connected with you. 2. A fraudulent declaration may invalidate your insurance contract. 3. The declaration covers all policies issued 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 that balance. 6. Revenue NSW may also be able to clarify your queries relating to the law and your obligations.

Please sign before submitting

Preview of Stamp Duty Exemption Form

Date: 21 Dec 2024

DECLARATION TO CLAIM THE NSW DUTIES ACT 1997 SMALL BUSINESS STAMP DUTY EXEMPTION:

This declaration covers policies effected or renewed during the year ended 30 June 2024.

I declare that at the time the above policies are effected or renewed, I am/will be a “small business” as defined in section 259A of the Duties Act 1997 (NSW)

I have read and understand the Guidance provided above with this Declaration and do not have any questions

Insured Name:

ABN:

I declare the above as the Insured or if not the Insured, do so with the authorisation of the Insured to declare on their behalf.

Print Name:

Contact Number:

Email:

Signed,

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