ACT Revenue Office
Department of Treasury	

Application for Discount Land Rent 

IMPORTANT
•	Applicants must read the discount land rent ‘Terms and Conditions’ information at the end of this application.  Words in bold have the meaning specified in the ‘Terms and Conditions’.
•	All lessees must be applicants.  ‘Applicant’ includes all applicants; however, if there are more than two applicants, an additional application form must be completed and attached to the original.
•	All applicants must attend the required Land Rent course at the Canberra Institute of Technology before applying for Land Rent. 
•	All relevant details must be provided and the required sections of the application form completed.  Incomplete applications or applications without the required supporting information may result in the application being denied.

Applicant Details

Applicant 1 (Contact applicant)
Personal details
Title (please circle one)		Given names		Family name	
Mr  Mrs   Miss  Ms   Dr					
Current residential address					
Unit  		Street number		Street name		Suburb		State		Postcode	

Applicant 2
Personal details
Title (please circle one)		Given names		Family name	
Mr  Mrs   Miss  Ms   Dr					
Current residential address					
Unit  		Street number		Street name		Suburb		State		Postcode	

Details of the property subject to Land Rent

Street name		Suburb 	
			
State  	Postcode 		Block 	Section 	

Section 1 	Eligibility

1.	Does the total income of all applicants exceed the income threshold amount? 		Yes    No 	
			
2.	Do any of the applicants own any other property?		Yes    No 	
			
3.	Will at least one applicant be occupying the home as his/her principal place of residence?		Yes    No 	
			
4.	How many dependent children do the applicants have? (please circle one)		0 1  2  3  4  5 or more	

Section 2 	Dependent Children

Given names and surname		DOB dd/mm/yy		Given names and surname		DOB dd/mm/yy	
							
1.				4.			
							
2.				5.			
							
3.				6.			

Canberra Nara Centre  1 Constitution Avenue  Canberra  ACT  2601
PO Box 252  Civic Square  ACT  2608  
Tel:  (02) 6207 0079   Tel:  (02) 6207 0088   Fax:  (02) 6207 0090
http://www.revenue.act.gov.au/home
ABN:  45 096 207 205

Section 3 	Income Details 

All applicants must list their total income from all sources received during the current year (to date) and the year prior to the date of the application.  Non-assessable Eligible Termination Payments, such as those made for years of service under a bona fide redundancy package, are excluded.
To substantiate your income details, each applicant must provide the following (or a reason for not providing these documents):
1.	evidence of total income for the current year (to date) and the year  prior to the date of the application;
2.	a copy of the last income tax return, Centrelink statements or other income statements prior to the date of the application; 
3.	a copy of your home loan application form; 
4.	if you are self-employed, a copy of all Business Activity Statements (BAS) for the current year (to date) and the year prior to the date of application; and
5.	a current pay slip showing year to date totals, prior to the date of the application. If your pay slip does not show year to date totals please provide copies of your last four (4) pay slips.
	
Income Details for Applicant 1	
Total income as shown on	
	Name of employer
	
	Current Year (to date) Income 	
	Prior Year Income 	
Income tax returns							
	
			$		$	
Centrelink statements							
	
			$		$	
Other income statements							
	
			$		$	
Other							
				$		$	
Total							
				$		$	

Income Details for Applicant 2    NOTE:  Use an additional form if there is income from more than two applicants.   	
Total income as shown on	
	Name of employer
	
	Current Year (to date) Income	
	Prior Year Income 	
Income tax returns							
	
			$		$	
Centrelink statements							
	
			$		$	
Other income statements							
	
			$		$	
Other							
				$		$	
Total							
				$		$	

Office Use Only		Applicant 1					
	
			$		$	
		Applicant 2					
				$		$	
		Total Income for all sources 					
				$		$	

Section 4 	Declaration and Undertaking

I hereby declare that: 
1.	by signing this form I am making an application for discount Land Rent;
2.	all of the information in this application including any attachments is true and correct, and to the best of my knowledge, no information relevant to the consideration of my application has been omitted;
3.	I have attended the required Land Rent course at the Canberra Institute of Technology and provided evidence of having attended; 
4.	the income details I have provided are an indication of my usual income;
5.	I have read and understood the ‘Terms and Conditions’ for discount Land Rent at the end of my application;  and
6.	depending on the circumstances — interest may apply to any underpayment of Land Rent.
7.	I understand that giving false or misleading information is a serious offence under the Criminal Code 2002.	

Applicant 1					
Name 		Signature 		Date (dd/mm/yy)	

Applicant 2					
Name		Signature 		Date (dd/mm/yy)	
					
NOTE:  All applicants must sign.

Office Use Only	Delegate name		Signature		Date	
						
	Unimproved value		Rates account number		Approved		
	$		#		Rejected               		

Terms and Conditions for an application for Discount Land Rent 
NOTE:   Each applicant MUST read and understand this information before completing and submitting the application form.
Conditions
•	Applications to receive discount land rent may only be made on a single dwelling house lease granted under the Planning and Development Act 2007.  	
•	Applications for discount land rent may be made before the grant of the lease or at any time during the term of the lease.	
•	Applications for discount land rent received during the term of the lease, if approved, will take effect from the start of the next year.	
•	To qualify for discount land rent, all applicants must meet the following discount eligibility criteria:
-  the lessee, or any of the lessees, must not own other real property; and 
-  the total income of the lessee, or all of the lessees, must not exceed the income threshold amount; and
-  if a certificate of occupancy is issued for the lease – the lessee, or at least 1 of the lessees, must live on the parcel of land under the lease. 	
•	All applicants must attend the required Land Rent course at the Canberra Institute of Technology prior to applying for Land Rent, at no cost to the applicants, and provide evidence of their attendance.	
•	All approved applicants must lodge an Annual Land Rent Review Form to demonstrate their continued eligibility to receive discount land rent. 
An applicant who is determined to no longer be eligible to receive discount land rent because the total income of the applicant, or all of the applicants, exceeds the income threshold amount, will commence paying Land Rent at the standard rate at the beginning of the next year.
Loss of eligibility due to one of the applicants becoming the owner of other real property or if all the applicants stop living on the parcel of land under the lease, will result in Land Rent being payable at the standard rate, effective from the 1st quarter after the circumstance has occurred.   	
•	Applicants acknowledge that if a land rent lease is transferred, land rent will be payable at the standard percentage of the unimproved value of the parcel of land under the lease.	
•	Applicants acknowledge that interest will accrue on the amount of unpaid Land Rent at the determined rate, from the day the amount becomes payable until the day the amount is paid.  If an amount remains unpaid for part of a month then interest is payable for the whole of the month.  For example:
Andrew’s land rent is due on 1 April.  He doesn’t pay it until 15 May.  Andrew has to pay interest worked out for the overdue period from 2 April to 15 My.  Because of the operation of section 22 (2) the Land Rent Act 2008, Andrew has to pay interest for the period 2 April to 1 June. 	
•	Applicants acknowledge that any outstanding land rent or interest will be held as a charge against the parcel of land under the lease.	
•	Applicants acknowledge that all outstanding Land Rent and interest must be paid in full prior to the property being sold.	
•	Applicants will be notified in writing as to whether or not they have been successful in their application.	
•	Applicants are required to notify the ACT Revenue Office within 30 days of any change of details.	
•	Applicants acknowledge they have had the opportunity to obtain independent financial advice prior to signing the application for discount land rent.	
•	Applicants acknowledge that giving false or misleading information is a serious offence under the Criminal Code 2002 and the ACT Revenue Office may prosecute any applicant found to have provided false or misleading information in an application	

Terms 
Applicant	refers to all individuals, who appear on the lease and who on completion of the purchase will be an owner of that property	
Discount Land Rent	means land rent discounted under part 3 of the Land Rent Act 2008 (Land rent - discount)	
Interest	means the determined rate under the Taxation Administration Act 1999, section 139	
Year	means a financial year	
Dependent Child	has the same meaning as in the Social Security Act 1991 (Cth)	
Income Threshold Amount	means the income threshold amount with reference to the number of dependent children the applicants  have as specified in the instrument applicable at the time of application: see the instrument at www.revenue.act.gov.au 	
Total Income	means the total income of all persons named on the lease, transfer or agreement for transfer of the subject property	
Individual 	has the same meaning as in section 160 of the Legislation Act 2001	
Lessee	in relation to a proposed land rent lease, includes a person proposed to be a lessee under the lease	

Privacy
All information collected by the ACT Revenue Office is protected by secrecy provisions in Acts administered by the Office and only used for the purposes of those Acts. In addition, personal information provided to the ACT Revenue Office is protected by the Privacy Act 1988 (Commonwealth).  Information (including personal information) is not disclosed to any third party unless authorised by law or with the consent of the person involved.