PRIVATE TREATY WOOL MERCHANTS of AUSTRALIA INC

ABN: 44 672 992 152

Unit 9, 42-46 Vella Drive, Sunshine West Vic 3020

Tel: 03 9311 0103 Fax: 03 9311 0138

www.woolindustries.org/ptwma.htm

Company Name:

Month:

ABN:

A) First Hand Taxable Wool Bought Privately:

Levy Payable On Above @ 16.5c Per Bale :

(please round total to nearest whole cent)

*The total levy includes GST payable by PTWMA

$ *

B) Wool Bought Privately From Non-PTWMA Members : (tax already paid)

Total Number Of Bales (A + B):

PAYMENT DUE AT THE END OF MONTH

If paying electronically, please fax or email remittance advice on day of payment

to Melissa Mulley on 03 9311 0138 or

melissa.mulley@woolindustries.org

If you require banking details please

contact Melissa Mulley on 03 9311 0103

If paying by cheque, please print this form and

remittance and send to:

PTWMA

SUNSHINE WEST VIC 3020

IMPORTANT: Please Print This Form For Your Accounts Department Before Clicking Submit.