雇主必须马上给所有符合条件的员工提供这份表格，目的是通知他们您要加入申请该补助的大军啦，同时让他们说明他们是否愿意跟您走。

表格的A部分由雇主填写，B,C,D部分由员工填写。

Employer Details:雇主信息：

1. Employer name 雇主名称

2. Employer Australia business number (ABN)雇主的ABN

Employee Details:员工信息：

1. Full name 姓名

2. Date of birth (DD/MM/YYY) 生日

3. Address 地址

4. Preferred contact details 联系方式

a. phone number 电话号码

b. email address 邮箱地址

Employee eligibility requirements员工必须符合的条件

To be an eligible employee, you need to meet these requirements:

· You are currently employed by the employer outlined in section A (including those stood down or re-hired).                                                        您目前还是这位雇主的雇员（包括被停薪留职和重新召回的员工）

· You were employed by the employer outlined in section A at 1 March 2020.

您是该雇主2020年3月1日就雇佣的员工

· As at 1 March 2020, you were apermanent employee, or a casual employee employed on a regular or systematic basis during the period of 12 months ending on 1 March 2020.

在2020年3月1日您是永久性的员工，或者是在2020年3月1日之前的12个月中经常性地有规则性地为该生意服务的临时工

· If you are a casual employee as mentioned above, you are not permanently employed by any other employer, or you are only employed by any other employer on a casual basis.

做为临时员工，您不是其他雇主的永久性员工，或者您还为其他雇主做临时工

· You were at least 16 years of ageas at 1 March 2020.

您在2020年3月1日已经16岁了

· As at 1 March 2020 you were:  2020年3月1日您是

o residing in Australia and an Australian citizen or permanent resident, or o an Australian resident for income tax purposes and a Subclass 444 (Special Category) visa holder.

居住在澳洲的澳洲公民或者永久居民，或者是澳洲的税务居民并持有新西兰444签证者

· You are not in receipt of a JobKeeper payment as a sole trader, nor is another employer or eligible business in receipt of a JobKeeper payment for you.

您没有以个体经营者来申请该补贴，也没有其他雇主为您申请该补贴

· You are not currently receiving parental leave pay or dad and partner pay, and

您目前没有拿政府发放的新生父母津贴或者父亲津贴，并且

· You are not currently totally incapacitated for work and receiving payments under an Australian workers’ compensation law in respect of your total incapacity to work.

您目前没有因完全失去工作能力而领取工伤保险的赔偿金

☐Yes, I agree to be nominated by the employer outlined in section A for the purpose of the JobKeep scheme.

是，我同意由表格A部分的雇主提名申请JobKeeper补贴

In making this nomination I:

选择这项提名，我

(i) agree that I meet the eligibility requirements listed above, and

认同我是符合以上条件的，同时

(ii) confirm that I have not agreed to be nominated by any other employer/entity and have not given another entity a nomination formfor the purpose of this scheme.

确认我没有被其他雇主提名或者给与其他雇主这项提名来参加该补贴。

OR

或者

☐ No, I do not agree to be nominated by the employer outlined in section A for the purpose of the JobKeeper scheme.

不，我不同意通过在表格A部分的雇主来提名参加该补贴。

I declare that the information I have provided is true and correct.

我申明以上我提供的信息是真实和准确的。

Date (DD/MM/YYY)

日期（日、月、年）

Signature (electronic/email is OK)

签字（电子签字或者邮件也可以）

Important: There are penalties for deliberately making a false or misleading statement.

重要：对于蓄意提供虚假或者误导信息者将会有惩罚