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Declaration

GAIC: Consolidated Form

Fields marked with * are required

Receipt details

Your form has been successfully submitted. Please keep a copy of this acknowledgement for your records.

Reference number:

When contacting the State Revenue Office in relation to this application, please quote this Reference number.

Submission date and time:

To save or print a copy of the completed form and acknowledgement go to the "File" menu and select "Save as" or "Print".

Collection statement

This information is collected by the SRO for the general administration of the Growth Areas Infrastructure Contribution and will help us determine your GAIC liability. If you do not provide the information required and your liability is incorrectly assessed, you may be required to pay penalty and interest. The information collected may be used for the purposes of other SRO legislation. Where authorised by law to do so, we may also disclose this information to other government agencies including the ATO, State and Territory revenue offices and law enforcement agencies. You can find out more about how we use and protect your information in our Privacy Policy, available at www.sro.vic.gov.au.

Declaration

I declare that I am authorised to make this declaration.

The information provided on this form and in any attached documents is complete and correct. I understand that penalties apply for giving false or misleading information or omitting information.

The Electronic Transactions (Victoria) Act 2000 establishes the regulatory framework for transactions to be completed electronically. This form requires you to complete an electronic signature via tick-box before lodgment. By ticking the box you indicate your approval of the contents of this electronic communication.

Date

Signature

Date (DD/MM/YYYY)

First name

Middle name(s)

Family name

Position (if applicable)

Organisation (if applicable)

Mobile number

Phone number

Email

Applicant

GAIC: Consolidated Form

Fields marked with * are required

Is the application in relation to a business entity?

Individual

Business

Individual

Title

Other

First name

Middle name(s)

Family name

Business

Name of company

Trading name (if different from company name)

ABN

ACN

Postal address

Country

Australian address

What is the type of address?

Street

PO Box

Lot number

Floor/Level type

Floor number

Flat/Unit type

Unit number

PO Box number

Post office name

Lot number

Street number

Street name

Street type

Suburb/Town

State

Postcode

International address

Street address/Postal address

Suburb/Town

State

Postcode/Zipcode

Overseas Address

Contact

Mobile number

Phone number

Email

Relationship to the land

I am:

the owner of the land

a representative of the owner of the land

the purchaser of the land

a representative of the purchaser of the land

involved in the significant acquisition of an interest in the landholder(s)

Details of land

GAIC: Consolidated Form

Fields marked with * are required

This information can be found on the Certificate of Title.

What is the type of address?

Street

Lot number

Floor/Level type

Floor number

Flat/Unit type

Unit number

Lot number

Street number

Street name

Street type

Suburb/Town

State

Postcode

Title

Volume

Folio

Lot

Plan

Plan type

Area of land (in hectares)

Municipality

Municipality property number

Other municipality

Parish / Township name

Section or portion number

Crown allotment

Ownership details

GAIC: Consolidated Form

Fields marked with * are required

Is the owner of the land a business entity?

Yes

No

Individual

Title

Other

First name

Middle name(s)

Family name

Business

Name of company

Trading name (if different from company name)

ABN

ACN

Postal address

Country

Australian address

What is the type of address?

Street

PO Box

Lot number

Floor/Level type

Floor number

Flat/Unit type

Unit number

PO Box number

Post office name

Lot number

Street number

Street name

Street type

Suburb/Town

State

Postcode

International address

Street address/Postal address

Suburb/Town

State

Postcode/Zipcode

Overseas Address

Contact

Mobile number

Phone number

Email

Purchaser details

GAIC: Consolidated Form

Fields marked with * are required

Is the owner of the land a business entity?

Yes

No

Individual

Title

Other

First name

Middle name(s)

Family name

Business

Name of company

Trading name (if different from company name)

ABN

ACN

Postal address

Country

Australian address

What is the type of address?

Street

PO Box

Lot number

Floor/Level type

Floor number

Flat/Unit type

Unit number

PO Box number

Post office name

Lot number

Street number

Street name

Street type

Suburb/Town

State

Postcode

International address

Street address/Postal address

Suburb/Town

State

Postcode/Zipcode

Overseas Address

Contact

Mobile number

Phone number

Email

Significant acquisition

GAIC: Consolidated Form

Fields marked with * are required

The following documents and information must be attached with this statement/submission: 1.A full copy of the share/unit sale agreement relating to the significant acquisition. 2.A copy of the relevant certificate of title for every land held by the land rich landholder in the contribution area at the date of the significant acquisition. 3.A full copy of the landholder's historical register of all shares or unit holders. 4.The landholder's statement of financial position (balance sheet) for the year immediately preceding the year in which the significant acquisition occurred.

I/We have already provided the document related to this acquisition as part of a Section 83 Landholder Acquisition Statement.

What date was the Section 83 Landholder Acquisition Statement lodged?

Date (DD/MM/YYYY)

Please note that if a Section 83 Landholder Acquisition Statement has been lodged for the same acquisition under the Duties Act 2000 and any of the required documents listed above have already been provided in relation to that lodgement, the same supporting documents do not need to be provided again.

Is the person completing this statement:

the person/representative of the person who made/or is making the significant acquisition

the landholder/representative of the landholder in which the significant acquisition was/is being made

Name of private / listed company or trustee of private / wholesale / public unit trust scheme

ABN

ACN

Name of private / wholesale / public unit trust scheme

ARSN (Australian Registered Scheme Number)

Contact person details

Title

Other

First name

Middle name(s)

Family name

Address of registered office details

Country

Australian address

What is the type of address?

Street

PO Box

Lot number

Floor/Level type

Floor number

Flat/Unit type

Unit number

PO Box number

Post office name

Lot number

Street number

Street name

Street type

Suburb/Town

State

Postcode

International address

Street address/Postal address

Suburb/Town

State

Postcode/Zipcode

Overseas Address

Mobile number

Phone number

Email

The significant acquisition for which this Statement has been prepared was made on

Date (DD/MM/YYYY)

Please note that if a Section 83 Landholder Acquisition Statement has been lodged for the same acquisition under the Duties Act 2000 and any of the required documents listed above have already been provided in relation to that lodgement, the same supporting documents do not need to be provided again.

Please indicate the relevant circumstances:

a single acquisition that is a significant interest in a landholder

a relevant acquisition that results from the aggregation of acquisitions of interest in a landholder, or

an acquisition of remaining interest in a landholder

Relevant acquisition - aggregation of acquired interests

GAIC: Consolidated Form

Fields marked with * are required

Details of the entity that made the relevant acquisition

The entity that acquired the significant interest is:

an individual

a company / business entity

Individual

Title

Other

First name

Middle name(s)

Family name

Business

Name of company

Trading name (if different from company name)

ABN

ACN

Postal address

Country

Australian address

What is the type of address?

Street

PO Box

Lot number

Floor/Level type

Floor number

Flat/Unit type

Unit number

PO Box number

Post office name

Lot number

Street number

Street name

Street type

Suburb/Town

State

Postcode

International address

Street address/Postal address

Suburb/Town

State

Postcode/Zipcode

Overseas Address

Mobile number

Phone number

Email

Interest acquired

Per cent of interest acquired

Details of the entities from whom the interest was acquired

Entity acquired from

The entity that the significant interest was acquired from is:

an individual

a company / business entity

Individual

Title

Other

First name

Middle name(s)

Family name

Business

Name of company

Trading name (if different from company name)

ABN

ACN

Mobile number

Phone number

Email

Did the above entity from whom the significant interest was acquired defer a GAIC payment in relation to the interest in the landholder?

Yes

No

Purpose of application

GAIC: Consolidated Form

Fields marked with * are required

I am:

applying for a certificate of no GAIC liability on the land

applying for an exemption from the GAIC on this land

electing to defer the GAIC liability on this land

other

Comment

/255

Certificate of No GAIC Liability

•A certificate of No GAIC Liability confirms that the party is not liable to pay GAIC in respect of a GAIC event. It is issued when the SRO is satisfied the event is an excluded event or the land will not be or is not subject to the GAIC in respect of a circumstance specified in the Planning and Environment Act 1987 (the Act).  •Upon the issue of a Certificate of No GAIC Liability, the SRO will issue a notice to the applicant which notifies the Registrar of Titles that a transfer of land or a plan of subdivision may be registered.  •The Registrar of Titles will register a transfer of land or a plan of subdivision upon receipt of a relevant notice from the SRO. · A building surveyor may issue a building permit, in respect of land with a GAIC recording, upon the receipt of a Certificate of No Liability.

Excluded event (s.201RB)

s.201RB(c) A dutiable transaction involving a non-dutiable lease under the Duties Act 2000
s.201RB(d)(i) a subdivision of land where a planning permit relating to that subdivision was granted before the relevant day and had not expired at the time a statement of compliance was issued
s.201RB(d)(ii) a building permit application where the planning permit relating to the building work was granted before the relevant day and had not expired at the time that application was made
s.201RB(d)(iii) a dutiable transaction where a contract relating to that transaction was entered into before the relevant day
s.201RB(d)(iv) a significant acquisition

Circumstances where GAIC is not imposed (s.201SA)

s.201SA(a) Dutiable transaction relating to land to land with a habitable dwelling of total area between 0.41 hectares and 10 hectares
s.201SA(b) Dutiable transaction relating to land of a total area between 0.41 hectares and 5 hectares
s.201SA(c) Dutiable transaction relating to land with a restrictive covenant or section 173 agreement prohibiting or limiting development or use
s.201SA(d)  A GAIC event in respect of any land if that land had a total lot area of 0.41 hectares or less; both on the relevant day and at the time the GAIC event occurs, or at the time of a GAIC event is either:  5.a lot in a plan of subdivision authorised by a planning permit referred to in section 201RB(d)(i); 6.a lot created by an excluded subdivision of land referred to in section 201RF(f) or (g).

Excluded subdivision of land (s.201 RF)

s.201RF(a) to s.201RF(a) To solely create a lot for a utility installation create a lot for a utility installation
s.201RF(b) To provide solely for transport infrastructure or any other public purpose
s.201RF(ba) To provide solely for a lot for a school or a proposed school
s.201RF(c) Subdivision by public authority or municipal council (no new lots)
s.201RF(d) Subdivision by public authority (consolidation or retention of lots without access)
s.201RF(e) To realign common boundary between two lots
s.201RF(f) To create a lot (not exceeding two hectares) to excise and existing dwelling
s.201RF(g) To create one lot in contribution area and the other lot outside the contribution area

Excluded building work (s.201RG)

s.201RG(1)(a) Demolition of all or part of a building
s.201RG(1)(b) Construction of a single dwelling
s.201RG(1)(c) Repair or reinstatement of an existing building
s.201RG(1)(ca) Building work related to a school or proposed school
s.201RG(1)(d) Building work below the statutory threshold

GAIC exemptions

•GAIC exemptions only have the effect of postponing the GAIC liability to a subsequent GAIC event unless an appropriate exemption applies to the subsequent GAIC event. •Certain dutiable transactions relating to the land in the contribution area are exempt from GAIC (see Subdivision 2 of Division 3 of the Act). These exemptions are administered by the State Revenue Office (SRO) and include a number of applicable duty exemptions (see table below). You may use this form to apply for an exemption from the GAIC and the corresponding GAIC Exemption Certificate or, a GAIC Exemption Certificate if a GAIC exemption has already been granted. •Exemptions to pay GAIC may also be granted by the Governor in Council or the Hardship Relief Board in limited circumstances (see Subdivisions 3 and 4 of Division 3 of the Act). A separate application must be made to the Governor in Council or the Hardship Relief Board. Application forms and the relevant guidelines can be found on the Growth Areas Authority website. You may use this form to apply for a certificate of exemption if you have been granted an exemption by the Governor and Council or the Hardship Relief Board.  •Where GAIC has been deferred, or is subject to a stage payment approval, GAIC exemptions do not apply to a subsequent dutiable transaction which may result in the liability rolling over to the subsequent transferee as defined in the Act.

All sections below, unless stated otherwise, relate to the Planning and Environment Act 1987

s.201 TA Dutiable transaction for no consideration
s.201 TB Applicable exemptions of Duties Act 2000 (See below)
s.201 TC Land dealings involving public authorities and council including acquisition
s.201 TD Transfer of land by owner to superannuation fund or to the beneficiaries
s.201 TG Exemption notice from Governor in Council or Minister
s.201 TJ Exemption notice from the Hardship Review Board

Applicable duties exemptions under Duties Act 2000

s.32 Transfers arising from mortgages on land
s.33(2-3, 5) Change in Trustees
s.34(1)(a-b) Property vested in an apparent purchaser
s.35(1)(a-c) Transfer to and from a trustee or nominee
s.40 Transfer of property from one superannuation fund to another
s.41 Transfers to trustees or custodians of superannuation funds or trusts
s.42(1-3) Deceased estates
s.43(3) Marriage and domestic relationships
s.44 (1-4) Breakdown of marriage and domestic relationships
s.45 Charities or friendly societies
s.45A Health centres or services
s.46(1), 46(2)(a-c) Co-operatives
s.47(2) Diplomatic representatives of a foreign government
s.48(a-d) Bankruptcies and administrations
s.48A Amalgamation of industrial organisations
s.50A Conversion of land use entitlements to different form of title
s.51 Crown and public rights of way
s.52 Government bodies
s.54 Joint tenants and tenants in common
s.55 Equity release programs
s.56(1) Transfer of farm to a relative or charity
Please note- if your application for an exemption is in accordance with Section 201TB of the Act, your application will not be process until the dutiable transaction is assessed under the Duties Act 2000.

Certificate of Exemption

•A Certificate of Exemption confirms that a person is exempt from the liability to pay the GAIC in relation to the land on the certificate.  •Upon issuing a GAIC Certificate of Exemption the SRO will provide the applicant with a notice which notifies the Registrar of Titles that a transfer of land or a plan of subdivision may be registered.  •The Registrar of Titles will register a transfer of land or a plan of subdivision upon receipt of a relevant notice from the SRO.  •A building surveyor may issue a building permit, in respect of land with a GAIC recording, upon the receipt of a Certificate of Exemption.

Election to defer

•A person liable for a GAIC in respect of the dutiable transaction relating to land may elect to defer the payment. GAIC can be deferred up to 100 per cent. •The liable person must lodge the Election to Defer Form before the day on which the GAIC becomes payable.  •An election to defer a GAIC takes effect from the time the liability to pay GAIC arises. •For a significant acquisition, an election to defer GAIC will be taken to have been made by all persons who are jointly and severally liable for the GAIC for that acquisition. •Where a deferral is being sought, contact the State Revenue Office (SRO) for further information.   Please note- the SRO is unable to process an election to defer until a GAIC event has occurred. You may submit this form for a future GAIC event, however it will not be processed until the GAIC event has taken place. 

Liability to pay non-deferred GAIC

 •A person who has deferred the payment of a GAIC must pay any non-deferred part of GAIC by the due date. •Failure to pay any non-deferred GAIC constitutes a tax default under the Taxation Administration Act 1997 (TAA). The whole of the GAIC will become immediately payable as if the election of the deferral had never been made. •Interest and/or penalty tax may apply or be imposed in accordance with the TAA. 

Indexation and interest applying to deferred GAIC liability

 •A deferred GAIC liability is subject to indexation and/or interest. •Indexation of a deferred GAIC is to be calculated at the end of each financial year after the GAIC liability arose based on the Consumer Price Index. •The payment of interest is calculated on a daily basis for the period that the interest is payable on the deferred GAIC Liability at the 10-year bond rate in accordance with Part 9B of the Planning and Environment Act. The interest rate for the current financial year is available on the SRO website.

Electing to defer the GAIC liability on this land

GAIC: Consolidated Form

Fields marked with * are required

Details of GAIC event

Indicate the GAIC event that is proposed to occur (or has occurred) in respect of the land:

Dutiable transaction

Significant acquisition

Per cent (%) applicable

Date of GAIC event (DD/MM/YYY)

Date of GAIC event •In the case of a dutiable transaction relating to land, other than a significant acquisition, the GAIC event occurs at the time at which the transaction would be taken to have occurred under Chapter 2 of the Duties Act 2000. •In the case of a subdivision of land, the GAIC event occurs when a statement of compliance is issued for that subdivision.  •In the case of an application for a building permit, the GAIC event occurs when the application is made. •In the case of significant acquisition, the GAIC event occurs on the particular day of the acquisition or, if the acquisition occurs over a period of time, on the last day of that period.

Amount of the GAIC liability

Amount of GAIC liability in respect of this dutiable transaction (if known)

Election to defer

I/We elect to defer the GAIC liability

Per cent (%) of GAIC to defer

Supporting documentation

GAIC: Consolidated Form

Fields marked with * are required

Supporting documents

Please provide documentation to support your GAIC application

File:

Declaration

Receipt details

Collection statement

Declaration

Applicant

Individual

Business

Postal address

Australian address

International address

Contact

Relationship to the land

Details of land

Title

Ownership details

Individual

Business

Postal address

Australian address

International address

Contact

Purchaser details

Individual

Business

Postal address

Australian address

International address

Contact

Significant acquisition

Contact person details

Address of registered office details

Australian address

International address

Relevant acquisition - single acquisition of a significant interest

Details of the entity that acquired the significant interest

Individual

Business

Postal address

Australian address

International address

Details of the entities from whom the significant interest was acquired

Entity acquired from

Individual

Business

Details of the land to which the significant interest relates

Land

Title

Total area of land

Relevant acquisition - aggregation of acquired interests

Details of the entity that made the relevant acquisition

Individual

Business

Postal address

Australian address

International address

Interest acquired

Details of the entities from whom the interest was acquired

Entity acquired from

Individual

Business

Relevant acquisition - aggregation of acquired interests - other interests

Previous acquisition

Details of the entity that made the relevant acquisition

Individual

Business

Postal address

Australian address

International address

Details of the entity from whom the interest was acquired

Entity acquired from

Individual

Business

Interest acquired

Details of the land to which the significant interest relates

Land

Title

Total area of land

Subsequent acquisition - acquisition of remaining interest

Details of the entity that made the relevant acquisition

Individual