Surname:
First Name:
Tax File Number
Date of Birth
Current Address
Preferred Telephone No:
Email Address: *
Occupation:
Income 1
PAYG Group Certificates, Jobsearch, Austudy, Pensions, Allowance or other Government Benefits.
Did you receive any of this income ?
Yes No
Name Only
Income 2
Employee Share Scheme Income, Superannuation Lump Sums, Annuities or Elligible Termination Payments ?
Did you receive any of this type of income ?
Yes No
Name Only
Interest Received
Please ensure that interest from all bank accounts is included. If you have a joint account only show your share of bank interest
Do you have any bank accounts?
Yes No
Please write the name of your bank and your share of bank interest for all your bank accounts.
Did you receive any Dividends ?
Yes No
Please write the name of each company; unfranked dividend; franked dividend; and imputation credit bank for each share holding.
Yes No
Did you receive income from other sources such as Managed Fund Investments, Partnership or Trust Distributions, Capital Gains or Losses, or Foreign Income? If yes please write a short description and we will discuss this with you.
Other Issues
Yes No
Deductions
List all expenses that you have made during the year that you believe may be a tax deduction. If you require more space, please provide further information under the heading : Other Comments.
We will contact you in regards to rebates, offsets and other deductions that you may be entitled to claim.
Type of Expenditure
Amount
Motor Vehicle Expenses
In general a tax deduction is not allowed for driving between home and work unless you satisfy certain criteria. If you believe that you are entitled to claim you car, please complete as little or as much of this section as you like and we will discuss your options with you.
Model:
Engine Capacity (Litres):
Did you keep a logbook?
Yes No
How many km’s did you drive between workplaces?
Other Comments
Travel Expenses
Travel expenses include any travel (apart from car travel) that you have incurred that are related to your employment. If you believe that you are entitled to claim travel expenses, please complete as little or as much of this section as you like and we will discuss your options with you.
Taxi/Bus/Train
Overseas
Inter-state
Other Comments
Self Education Expenses
In order to claim self education expenses the course must have a connection with your current employment. If you believe that you are entitled to claim Self Education Expenses, please complete as little or as much of this section as you like and we will discuss your options with you.
Textbooks/Stationery
Internet/Telephone Expenses
Travel Expenses
How many hours do you study from home per week?
Do you drive between work and the place of study?
Professional Development Courses/Seminars
In order to claim uniform expenses, the clothing must be either specific to your occupation such as police uniform; protective in nature; such as mechanics overalls; compulsory such as McDonalds uniform or have some other characteristic that makes it a uniform. Please note that normal business attire is not deductible. Also under this section you can claim sun protection expenses for outside work. If you believe that you are entitled to claim Clothing Expenses, please complete as little or as much of this section as you like and we will discuss your options with you.
Protective Clothing
Laundry
Dry Cleaning
Clothing Alterations
Sun Protection Expenses
Other Expenses
The other expenses section is a catch all category that include a range of deductions. Please cast your eye over the below list and if you believe that you have incurred any of the below expenses for work purposes, please complete as little or as much of this section as you like and we will discuss your options with you.
Telephone Mobile
(Please specify % for work usage)
Internet Expenses
(Please specify % for work usage.)
How many hours do you work from home per week?
Stationery
Computer Expenses
Tools/Materials
Computer Expenses
Briefcase/Luggage
Union Fees/Memberships
Books/Magazines/Journals
Donations
Did you purchase any desks, chairs, bookshelves or other work related items that exceed $500?
Parking/Tolls that you were not reimbursed for
Previous Tax Agents Fee’s and Other Professional Fee’s
Other Expenses
Please write any other deductions in the other comment text box above.
Medical Expenses
Yes No
If, yes please summarize.
Private Health Insurance
Do you have a Health Fund?
Yes No
If yes, please summarise
Other Offsets and Rebates
Are you entitled to the other offsets such as spouse or dependants, senior or pensioner offset, private health insurance or educational tax refund ?
Yes No
If yes, please summarise
Final Comments
Yes No
If yes, please summarise
Please enter the 4 letter security code you see in the box.
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