|
INCOME |
Applicable to me |
| Yes |
No |
| Salary and Wages |
|
|
| Any other income including: |
|
|
| • Other
allowances, benefits, earnings, tips, directors fee, etc |
|
|
| • Kilometer
reimbursement for car expenses |
|
|
| Eligible Termination Payments |
|
|
| Newstart, Sickness or other
Commonwealth allowances |
|
|
| Commonwealth pensions and
other allowances |
|
|
| Other Australian pensions or
annuities |
|
|
| Reportable Fringe Benefits
amount |
|
|
| Interest |
|
|
| Dividends together with
imputation credits |
|
|
| Personal services income |
|
|
| Income from partnerships
and/or trusts |
|
|
| Net income or loss from
business |
|
|
| Net farm management deposits
or withdrawals |
|
|
| Sale of shares or real estate
(other than place of residence) include date purchased and sold,
purchase and sale price |
|
|
| Foreign income |
|
|
| Rental income |
|
|
| Bonuses from life assurance or
friendly society policy |
|
|
| DEDUCTIONS |
|
|
| Work related car expense
claims: (please complete a travel diary and bring to interview) |
|
|
| Other work related travel
expenses: (airfares, meals, accommodation, etc) |
|
|
| Uniform/protective clothing
expenses, dry cleaning & sun protection |
|
|
| Self education expenses: |
|
|
| • Union
Fees |
|
|
| •
Stationery / Text books / Journals / Photocopying |
|
|
| • Course
fees |
|
|
| • Travel |
|
|
| • Telephone |
|
|
| Other expenses: |
|
|
| • Home
office exp (gas, power, wood) or average no of hrs worked at
home/week (complete home office use diary) |
|
|
| • Home
office equipment purchased during the year (included date purchased
and amount) |
|
|
| • Computer
software (include date purchased and amount) |
|
|
| • Telephone
/ mobile phone (please complete telephone diary) |
|
|
| • Tools and
equipment |
|
|
| •
Subscription and union fees |
|
|
| • Journals,
periodicals, books |
|
|
| •
Undocumentable expenses (please complete undocumentable diary) |
|
|
| • Expenses
in relation to allowances |
|
|
| • Seminars
and conferences |
|
|
| •
Stationery and postage |
|
|
| Interest and dividend expenses |
|
|
| Superannuation (self employed
only): Full name of fund:
Policy No.: |
|
|
| Gifts of $2.00 or more to
eligible funds |
|
|
| Expense relating to rental
income |
|
|
| TAX OFFSETS |
|
|
| Spouse (without child)
|
|
|
| Senior Australians |
|
|
| Superannuation contributions,
eligible for Government Co-Contribution |
|
|
| Private Health Insurance |
|
|
| Superannuation contributions
on behalf of spouse |
|
|
| Annuity and pension rebate |
|
|
| Zone or overseas forces
|
|
|
| Out of pocket medical expenses
(over $1500 after medical insurance) |
|
|
| Parent, in-law invalid rebate |
|
|
| Baby Bonus |
|
|
| Family Tax Benefit |
|
|
| RISK |
|
|
| Do you have Current Will, and
Enduring Power of Attorney and appropriate insurance cover? |
|
|
