COMMONWEALTH OF AUSTRALIA Comptroller‑General of Customs Instrument of Approval No. 21 of 2015 Customs Act 1901 I, ROMAN QUAEDVLIEG, Comptroller‑General of Customs, under section 4A of the Customs Act 1901, approve the "REFUND, REMISSION OR REBATE APPLICATION" statement as the approved statement for the purposes of making an electronic application, in accordance with paragraph 163(1AA)(a) of that Act and paragraph 107(3)(a) of the Customs Regulation 2015, for a refund, rebate or remission of duty. This Instrument commences on 1 October 2015. Dated: 18 September 2015 ROMAN QUAEDVLIEG Comptroller‑General of Customs REFUND, REMISSION OR REBATE APPLICATION Approved Statement ‑ Customs Regulation 2015 paragraph 107(3)(a) Item No. Short title Information required 1 Declaration ID The number of the declaration, which relates to goods, which are subject to this application. 2 Have the goods been dealt with in accordance with the authority to deal? Indicate whether the goods have been delivered in accordance with the Authority To Deal: * Yes * No No 3 Are you entitled to a refund of GST from customs for these goods? Indicate whether the owner is entitled to a refund of GST: * Yes * No * 3 Reason Type State which circumstance under Schedule 6 of the Customs Regulation 2015, or section 23 of the Customs (International Obligations) Regulation 2015, apply to the goods. 4 Drawback Declaration ID(s) If the goods are subject to a drawback claim - the number of the drawback declaration ID. 5 Bank Account Owner Type The role of the party whose bank account will be credited should the refund application be approved: * Broker * Importer * Other 6 Bank Account BSB The BSB of the applicant's bank account in which the refund should be paid (the account). 7 Bank Account Number The account number of the account. 8 Bank Account Name The name of account holder. 9 Payee Declaration When checked indicates that the communicator has an authorisation to pay funds into a third party bank account. 10 Bank Account Selection Client Bank Account An alternate bank account where the refund can be paid. 11 Has a drawback been claimed for the goods? Indicate whether a drawback has been claimed for the goods.