ABN Verification and Contractor Declaration Form

Principal Business Details

Business Name: Apex Building Projects Pty Ltd ABN: 12 345 678 901 ACN: 123 456 789 Address: 1 Builder Street, Sydney NSW 2000

Contractor Details

Legal Name: John James Smith Trading Name (if different): JSmith Electrical ABN: 98 765 432 109 ACN (if applicable): N/A Address: 15 Volt Lane, Parramatta NSW 2150 Email: john@jsmithelectrical.com.au Phone: 0412 345 678

ABN Verification

I, the representative of the Principal Business, declare that I have verified the ABN provided above against the Australian Business Register on 12 October 2023.

• ABN is Active
• ABN is Cancelled (Do not proceed with payment without tax withholding)

Contractor Declaration

I, John James Smith, declare that:

1. Tax Status: The information provided is true and correct. I am registered for GST (if applicable). My GST status is REGISTERED.
2. Nature of Relationship: I am engaged as an independent contractor. I am not an employee of the Principal Business. I accept responsibility for my own income tax liabilities and taxation obligations.
3. Insurance: I confirm that I hold the following insurances relevant to the work I am performing:

• Public Liability Insurance ($20 million): YES
• Workers Compensation Insurance (Exempt as sole trader): EXEMPT
• Policy numbers are available upon request.

4. Superannuation: I acknowledge that the Principal Business may be required to pay superannuation contributions into a nominated superannuation fund if the contract is wholly or principally for my labour. [X] I provide my Superannuation Fund Details (see below) OR [ ] I declare that I am not required to provide these details as I am not principally engaged for my labour (note: the Principal may be liable to pay regardless of this declaration).
5. Work Health and Safety: I agree to comply with all relevant Work Health and Safety (WHS) legislation and codes of practice. I will maintain a safe work environment and provide any necessary safety data sheets or equipment.
6. Licences: I hold all valid licences, permits, and registrations required to perform the stated work in NSW. Electrical Licence Number: 12345678.

Superannuation Details (Complete if applicable)

Fund Name: AustralianSuper Fund ABN: 65 714 394 864 Member Number: 123456789 Account Name: John Smith

Payment Details

Bank Name: Commonwealth Bank BSB: 062-000 Account Number: 1234 5678 Account Name: J Smith Electrical

Signatures

Contractor Declaration:

Signature: J J Smith Date: 12 / 10 / 2023 Print Name: John James Smith

Principal Business Verification:

Signature: B Jones Date: 12 / 10 / 2023 Print Name: Bob Jones Position: Site Manager

For office use only

• Tax File Number Declaration Received
• Insurance Certificates Sighted
• Licences Verified