Easy Lodge Form
       ACT Revenue Office
          ABN: 45 096 207 205	Lodgment No: (Office Use)

	
YOU MUST BE A REGISTERED EASY LODGE CLIENT TO USE THIS FORM
GIVING FALSE OR MISLEADING INFORMATION IS A SERIOUS OFFENCE	
Client No:		Client Name:		
						
Contact Name:		Email:		
						
Revenue Type:	RLI  or  RLA	Please Circle		Date Executed:	         /       /	
Transaction Type:	AGREEMENT				
						
Consideration:	$	Unencumbered Value:	$	
						
Transferee Details						
Name:		
						
Address:		
						
Property Details						
SUBURB:					
						
Section:	                  	                Block:		                  Unit:			
						
Is there a requirement to lodge an independent valuation?	(See Revenue Circular DAA010.1)	
No   	Yes   	If Yes  Date of valuation:	      /      /		
	If Yes  Has the valuation been attached?	Yes   	
					
Payment Amount made for this assessment:	$    			
						
DECLARATION FOR ACQUISITION OF DUTIABLE PROPERTY	
To your knowledge:			
•		is any transferor of the property related* to any transferee?	No    	Yes   	
•		is the property being sold for less than its dutiable value?	No    	Yes   	
•		are there any other instruments or arrangements under which other dutiable property was or will be acquired as part of this transaction now lodged?	No    	Yes   	
•		did the vendor use a Real Estate Agent/Auctioneer to sell this property?	No    	Yes   	
* As defined as ‘related person’ in the Duties Act 1999			
Name of authorised person completing this form (Please Print):		
		
Signature:		Date:	       /      /		

Check attachments:	Contract of Sale 	Transfer Document  	Payment 	
This form is Approved form AF2014-30     under Section 139C of the Taxations Administration Act 1999