<?xml version="1.0" encoding="utf-8"?>
<irdInformationReturn xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
	<informationReturnSummary>
		<informationReturnReporter>
			<tin>0000000</tin>
			<branch>1</branch>
			<sender>
				<name>Name</name>
				<email>test@domain.com</email>
				<phone>0000000</phone>
				<position>position</position>
			</sender>
			<name>Name</name>
			<address>
				<address1>Address1</address1>
				<address2>Address2</address2>
			</address>
		</informationReturnReporter>
		<informationReturnStats>
			<period>201112</period>
			<action>new</action>
			<totalReportees>number</totalReportees>
			<amountReported>amount</amountReported>
		</informationReturnStats>
	</informationReturnSummary>

	<data xsi:type="pensionMiscellaneousInfoContainer">

		<pensionMiscellaneousInfo>
			<Reportee>
				<tin>0000000000</tin>
				<branch>0</branch>
				<name>Name</name>
				<address>
					<address1>Address1</address1>
					<address2>Address2</address2>
				</address>
			</Reportee>
			<SerialNumber> </SerialNumber>
			<Superannuation_Fund_Payments_Gross_Income>1.20</Superannuation_Fund_Payments_Gross_Income>
			<Superannuation_Fund_Payments_Tax_Withheld>0.00</Superannuation_Fund_Payments_Tax_Withheld>
			<Annuity_Contract_Gross_Income>0.00</Annuity_Contract_Gross_Income>
			<Annuity_Contract_Tax_Withheld>12</Annuity_Contract_Tax_Withheld>
			<Covenanted_Payments_Gross_Income>0.00</Covenanted_Payments_Gross_Income>
			<Covenanted_Payments_Tax_Withheld>0.00</Covenanted_Payments_Tax_Withheld>
		</pensionMiscellaneousInfo>

		<pensionMiscellaneousInfo>
			<Reportee>
				<tin>0000000000</tin>
				<branch>0</branch>
				<name>Name</name>
				<address>
					<address1>Address1</address1>
					<address2>Address2</address2>
				</address>
			</Reportee>
			<SerialNumber> </SerialNumber>
			<Superannuation_Fund_Payments_Gross_Income>1.23</Superannuation_Fund_Payments_Gross_Income>
			<Superannuation_Fund_Payments_Tax_Withheld>0.00</Superannuation_Fund_Payments_Tax_Withheld>
			<Annuity_Contract_Gross_Income>0.00</Annuity_Contract_Gross_Income>
			<Annuity_Contract_Tax_Withheld>0.00</Annuity_Contract_Tax_Withheld>
			<Covenanted_Payments_Gross_Income>99</Covenanted_Payments_Gross_Income>
			<Covenanted_Payments_Tax_Withheld>0.00</Covenanted_Payments_Tax_Withheld>
		</pensionMiscellaneousInfo>

	</data>
</irdInformationReturn>