Form Ir880 - Paid Parental Leave (Ppl) Application Page 5

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Which work verification do you need?
Did you tick employee or self-employed at question 10?
Have you worked for only one employer for the last 52 weeks
Do you have a chartered accountant or tax advisor?
up to the due date or the date the child came into your care?
Can just one employer verify
that you have worked for
them for at least an average
of 10 hours per week for any
Are you:
26 of the last 52 weeks?
(This can be your current or
• a doctor rotating between
a previous employer)
different district health
boards, or
• a teacher who was
employed by different
boards of trustees in a state
Can the same
school or integrated school
employer verify
that you earned
the income you
have provided in
this application?
Employer's declaration
Statutory declaration
Chartered accountant and tax advisor
After signing below you must take this
After signing below you must complete
form to your employer and have them
the statutory declaration on page 5 of this
After signing below you must take this
complete the declaration on page 4 of this
form to your chartered accountant or
tax advisor and have them complete the
People authorised to take this declaration
declaration on page 4 of this application.
• Your employer is required to fill in the
• a Justice of the Peace
employer's declaration on this form.
To verify your application, your
• a person enrolled as a barrister and
Your employer will declare that you
chartered accountant or tax advisor
solicitor of the High Court
have worked the required hours and
must be a member of an organisation
• a registered legal executive (fellow of
number of weeks to qualify, and that
who has approved advisor status with
the NZILE)
the income you have declared is
Inland Revenue.
• a notary public
• a registrar or deputy registrar of the
These organisations are:
• When your employer has filled in
High Court, District Court, Court of
• Chartered Accountants Australia
the employer's declaration, they'll
Appeal or Supreme Court
New Zealand (CA ANZ)
give the form back to you to send
• a member of parliament
to Inland Revenue along with your
• other government officer authorised to
• Accountants and Tax Agents
supporting documentation.
take statutory declarations.
Institute of New Zealand (ATAINZ)
Please call the Ministry of Business,
You can usually find a list of JP's or
Innovation & Employment on 0800
other people authorised to take a
• CPA Australia
if your employer won't fill in the form.
statutory declaration in the Yellow Pages
Applicant’s declaration - applicant must complete this section
I declare the information I supply in this application is true and correct to the best of my knowledge.
I confirm that I choose to receive paid parental leave instead of parental tax credit for the child in this application.
And I understand:
if I return to work before I have received all of my paid parental leave payments (except for Keeping in Touch hours), I must notify
Inland Revenue immediately because I’ll no longer be entitled to receive PPL and
there are penalties of up to $15,000 for providing false or misleading information or failing to provide information with the intention to mislead.
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