Please complete this form if one or more of the following applies to you or your business:
If none of the paragraphs above apply to you or your business - you must complete a 2016 AML/CTF compliance report form, available by logging in to your AUSTRAC Online account.
Note: If you sold the business in 2016 but provided a designated service during that year you are still required to provide a 2016 AML/CTF compliance report.
HINT: Type the reference exactly as it appears on your letter to ensure AUSTRAC can correctly identify you.
Please select ONE of the options below and complete any additional information as prompted.
I/my business am/is not required to lodge a compliance report for the 2016 reporting period (1 January 2016 to 31 December 2016) because we (tick the most applicable):
sold the business during 2016 and have submitted a request to be removed from the Reporting Entities Roll.
Date of sale* (DD/MM/YYYY):
Contact details of new owner:
ceased business during 2016 and have submitted a request to be removed from the Reporting Entities Roll.
Date business ceased* (DD/MM/YYYY):
merged or were acquired by another business during 2016.
Date of merger/acquisition* (DD/MM/YYYY):
Contact details of controlling entity:
are a member of the following designated business group and another member of the group has lodged the group's 2016 AML/CTF compliance report:
Name of designated business group:
Other (please specify):
* Note: If you provided a designated service during 2016 you still need to provide an AML/CTF compliance report for that year.
I declare that: