Tax form INDIVIDUAL TAX RETURN To complete Individual income tax return, following interview sheet should be completed and supporting documents should be attached where applicable. The checklist provides a general list of major issues that should be addressed. (The checklist is not designed to be an exhaustive list of all issues that may warrant consideration.) Name(Required)Surname(Required)EmailMobile/PhoneDate of Birth(Required)Tax File NumberBank Details: BSBAccount NumberBank Account Holder/s NameBank or Financial Institution NameCurrent Address: Street Number and NameSuburb/townStatePostcodeEvidence of IdentityMax. file size: 2 GB. Please include an evidence of identity(Eg. Passport, Driving license, student id Card etc..)Final tax return: if you know this is your final tax return? Yes No Obtain and attach PAYG payment summaries and if applicable paid parental leave payments Yes No NA Allowances And EarningsAllowances, earnings, tips, director’s fees etc. Yes No NA Employer Lump Sum Payments for Unused annual and long service leave paid out on termination of employment*Obtain and attach a copy of “statement of termination” Yes No NA Employment termination Payment (ETPs)Obtain and attach ETP payment summaries Yes No NA Government allowances such as Newstart, Youth and austudy payment Yes No NA Australian Government pensions and other allowances Yes No NA Attributed personal services incomeObtain all payment summaries – personal services attributed income and details of any other personal services attributed to the taxpayer. Yes No NA Australian annuities and superannuation income streams Yes No NA Australian superannuation lump sum payments Yes No NA Attributed personal services Income Yes No NA Gross interest Yes No NA Dividends Yes No NA Obtain and attach dividends statementsEmployee Share Schemes (ESS) Yes No NA Obtain and attach Employee Share Schemes statementSupplementary Income or Loss Yes No NA If you are not sure, please call 01234567890 or email admin@hraccountants.com.au for details.DeductionsWork related Car expenses Have you used Car for employment or Business purpose Yes No Have you maintained log book for 12 Consecutive weeks in last 5 years to ensure business use ( Percentage) of the vehicles. Yes No If yes print …..% of the vehicle used for employment or business purpose.Motor vehicle expenses worksheet:- Vehicle Details Vehicle make and modelVehicle Registration / Plate NoPurchase datePeriod of vehicle use fromTotal kilometers% of business useTotal kilometer driven during F/YMotor Vehicle Expenses :- If you do not have log book, please leave BlankRegistration FeeInsuranceRepairs and maintenanceFuel & oilDepreciationInterest on LeaseOther ExpensesTotalD2. Work related Travel Expensesa. Domestic travel Yes No b. Overseas travel Yes No Please give small description of work related travels such as location, purpose, date, and duration of the travel.Air fare or Car hire ExpensesMealsAccommodationOther Incidentals ExpensesD3. Work related uniform, occupation specific or protective clothing, laundry and dry cleaning expensesProtective clothing and safety foodwearCompulsory UniformOccupation specific clothesLaundry and dry Cleaning expensesD4. Work related self-education Circumstance where these expenses are allowable1. Self-education enables the taxpayer to maintain or improve skill and knowledge Yes No 2. Self-education leads to, or is likely to leads to, and increase in a taxpayer’s income Yes No 3. If taxpayers is employed as a trainee or apprentice which required to complete this course Yes No Expenses relating to self-education that may be claimed• Student union, services and amenities fee• Course fees• Text books, professional and trade journals• Stationery, photocopying, ink cartridges• Home office expenses• Interest on borrowings to purchase a computer• Decline in value of computer and technical tools• Repairs to computers and printers• Secretarial expenses e.g. typing of assignments• Travel – between home to study and work to study• Software relating to study• Accommodation and meal expenses if travelling away from home overnight• Internet expensesTotalD5. Other work related expenses•Professional registration /renewal fee• Union Fee• Seminars• Overtime Meals• Home Office• Subscriptions• Telephone/Mobile• Briefcase• Calculator• Electronic Organiser• Depreciation on assets costing>$300• Write off of assets not exceeding $300D6. Low-value pool deductionD7. Interest Deduction, (ATO interest)D9. Gifts or DonationsD10. Cost of managing tax affairsD. Total supplement DeductionTotal DeductionL1. Tax Losses of earlier yearsTaxable Income and LossesTax OffsetsT1. Seniors and Pensioners (Includes self-funded retirees)T2. Australian Superannuation income streamTotal Tax OffsetsMedicare levy related itemsWhat is your visa subclassHave you applied Permanent Visa ? Yes No If yes: Give visa lodgement date.Are you Medicare facility entitlement: Yes No M1. Medicare levy reduction or exemptionNumber of dependent children and studentsExemption – Full 2.0% levy exemption days( if you are not sure, leave it blank, we will contact you for more details)Exemption – Half 2.0% levy exemption days( if you are not sure, leave it blank, we will contact you for more details)M2. Medicare levy surcharge (MLS)Were you and all your dependents covered by private patient Hospital cover? Yes No If yes, Please attach the statement:Max. file size: 2 GB. Spouse DetailsNameSurnameDate of BirthMarried dateDivorce dateNote: please ask any question you are not sure???Death DatePlease Specified your best time to contactDateTimeBest Contact NumberThank you for using online service. We will keep in touch shortly.Attributed personal services income UploadMax. file size: 2 GB. file must be less than 2mb Allowed file types: gif jpg jpeg png txt pdf doc docx xls xlsx xml. Note: consider application of the personal services income (PSI) attribution rules in relation to any income derived by an interposed entity that is personal services income (PSI) of the individual. (PSI is included in the individual’s personal income tax return. PSI is income that is mainly a reward for an individual’s personal efforts or skills).Signature(Required)
