Application for exclusion from grouping

About this form

Use this form to apply for an exclusion from a payroll tax group.

Before you complete this form, review:

• the process to apply for an exclusion from grouping 
• Revenue Ruling PTA-031v2 – Commissioner's discretion to exclude from a group. 

You can save the form and return to it later using your tracking code and the answer to your security question.

After you submit the form, we will email you a copy for your records.

A representative of the employer applying for an exclusion can complete the form.

Get these details ready

Before you start, check you have the required information, including:

• contact details
• financial statements for each business in the group
• evidence the businesses are run independently of each other.

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