Allpoints Accounting Pty Ltd
Phone:
(03) 9739 8510
Small Business & Taxation Specialist
Fax:
(03) 9739 8661
2/176 Boronia Road
Boronia Victoria 3155
E-mail: alltax@allpointsaccounting.com.au
2011 Personal Income Tax Worksheet
TAXPAYER DETAILS
Title
Tax File Number
Surname
ABN if applicable
First Name
Work Telephone
Other Name/s
Mobile Telephone
Preferred Name
Home Telephone
Occupation (not Title)
)
(
)
Date of Birth
Residential
Address
Postal
Address
Suburb
Suburb
State
(
Postcode
Country
State
Postcode
Country
E-mail Address
Spouse (Full Name)
Date of Birth
Tax File Number
Taxable
Income
(Note: If you remarried during the year, then please provide as much specific relevant information as possible.)
Dependent Children (Full Name)
Taxable
Date of Birth
Tax File Number
Income
under 25 years during 2010/11
Are you a veteran? If so, then you will need to submit your identification details to our office for tax offset purposes.
Did you own or have an interest in assets located outside Australia that had a total value of AUD$50,000 or more
at any time during 2010/11?
YES
NO
TAX REFUND BY ELECTRONIC FUNDS TRANSFER (EFT)
BSB Number (6 digits)
Account Number
Account Name
AUTHORITY / PRIVACY DECLARATION
Please note: We are unable to prepare income tax returns for clients who have not completed this authority.
I hereby authorise Allpoints Accounting Pty Ltd to prepare my income tax return for the year ended 30 June 2011 from the
information that I have supplied and in accordance with my instructions. I have read the 2011 Personal Income Worksheet, 2011
Income Tax Return Checklist and other worksheets that apply to my 2011 Income Tax Return. I also authorise the obtaining or
verification of tax-related details from my financial advisor and/or my financial institutions should this be required for the purpose of
preparing my 2011 income tax return.
Name: …………………………………………………………………..…
Dated: ………………………………………………………………..……
2011 Personal Income Tax Worksheet
……………………………………………………………………
Signature of Taxpayer
Page 1
2011 PERSONAL INCOME TAX WORKSHEET
SALARIES & WAGES (including ETP payments)
Received from
Gross Earnings
Tax Deducted
We need a copy of your PAYG payment summary or statement of income including ETP statements.
ALLOWANCES / GIFTS / HONORARIUMS / DIRECTORS FEES / CASUAL EARNINGS
Received from
Gross Earnings
Tax Deducted
We need a copy of your payment summary or statement of allowances.
GOVERNMENT PENSIONS & ALLOWANCES (e.g. Age Pension, Newstart, Austudy, Youth Allowance, etc.)
Received from
Gross Earnings
Tax Deducted
We need a copy of your Payment Summary or statement of allowances.
AUSTRALIAN ANNUITIES/SUPERANNUATION INCOME STREAMS, & LUMP SUM PAYMENTS FROM SUPER FUNDS
Received from
Gross Amount
Tax Deducted
We need a copy of all documents relating to the tax status of your amounts received, including any Payment Summaries or
statements of allowances, and details of any tax deductible amounts (“UPP”), and eligibility for tax offsets.
INTEREST INCOME
Name of Financial Institution
Account Number
100%
of Interest
100% of TFN Tax
Deducted
Your %
Share
Please ensure you include all interest credited to your account for the 2010/11 year.
DIVIDENDS
Name of Company
Date
Received
100% of
Unfranked
Dividend
100% of
Franked
Dividend
100% of
Franking
Credit
100% of TFN
Tax
Deducted
Your %
Share
Please ensure you include all dividends including dividend re-investment. Most companies pay two dividends each year.
OTHER INVESTMENT INCOME - Trusts, Stapled Securities, Public Funds (e.g. BT, Colonial, IOOF, MLC, Skandia, etc)
1.
2.
Provide copies of your Annual Tax Statements (for year ending 30 June 2011) from public fund investments.
If you are a beneficiary of a private trust, provide a copy of the distribution statement from the trust tax return.
CAPITAL GAINS TAX EVENTS – This question must be answered
Did you dispose of any assets during the 2010/11 tax year?
YES
NO
(If you answer “yes” to this question, please complete our 2011 Capital Gains Tax Worksheet.)
2011 Personal Income Tax Worksheet
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2011 PERSONAL INCOME TAX WORKSHEET
Generally no tax deduction is allowed in respect of work related expenses unless the claim can be substantiated by documentary
evidence such as receipts and invoices. If your total work related expense claims are under $300, receipts are not required.
It is necessary to make an apportionment between work and private use for expenses.
You should only claim the work-related component. This is the amount that you should show below.
TRAVEL EXPENSES
SELF-EDUCATION EXPENSES
OTHER WORK RELATED EXPENSES
Road Tolls
Student Union Fees
Union Fees
Car Hire
Course Fees (but not HECS)
Seminars & Conferences
Airfares
Textbooks & Course Notes
Books & Journals
Taxis
Postage & Stationery
Postage & Stationery
Accommodation
Photocopying
Income Protection Insurance
Parking
Parking
Sun Protection Expenses
Public Transport
Public Transport
Tools & Materials
Meals
Telephone
Telephone
Other Travel Expenses
Internet Service Provider Charges
Internet Service Provider Charges
CLOTHING & UNIFORMS
Motor Vehicle (use motor vehicle worksheet)
Motor Vehicle (use motor vehicle worksheet)
Purchases
Computer items under $300
Computer items under $300
Dry Cleaning
Software items under $300)
Software items under $300)
Home Laundry
Other equipment items under $300
Other equipment items under $300
Repairs & Alterations
Other Expenses
Other Expenses
Other Expenses
Home Office Expenses
Gas & Electricity
Home Office Expenses
Gas & Electricity
Contents Insurance
Contents Insurance
Cleaning
Cleaning
Sub-Total
Sub-Total
x % of total floor area
Total
x % of total floor area
Total
EQUIPMENT PURCHASES (i.e. Items costing more than $300 e.g. Computer Hardware & Computer Software)
Date
Purchased
Description
Total
Price
Business
Usage %
Self
Education
Work
Related
%
%
%
%
%
GIFTS TO CHARITIES, etc. (Joint donations must be apportioned. Receipts must be marked “tax deductible” & include your name/s)
Name of Charity, Aid or Cultural Fund
Date Paid
Donation Amount
Your Claim
TAX AGENT FEES (for tax agent fees actually paid during 2010/11 – you can include postage & travel costs)
Name of Tax Agent
Amount
PRIVATE HEALTH INSURANCE DETAILS
Provide us with a copy of your annual statement from your private health insurance fund.
Health Fund ID
Membership Number
2011 Personal Income Tax Worksheet
Period Covered
Ancillary, Hospital or Combined
Page 3
2011 PERSONAL INCOME TAX WORKSHEET
MEDICAL EXPENSES TAX OFFSET
A medical expense rebate is allowed on certain medical, dental, optical and pharmaceutical expenditure. Refer to Page 4 of the 2011
Income Tax Return Checklist for further details. Does such expenditure (net of Medicare and private health fund reimbursements /
rebates) exceed $1,500? If so, provide the totals of your medical expenses below.
Gross Medical Expenses
Refunds from Medicare etc.
Net Medical Expenses
INCOME TESTS (NEW)
New income tests have been introduced for the 2010/2011 tax year. These tests will be used to assess your tax offset entitlement,
Medicare levy surcharge, and HELP or SFSS repayment amount. Some of these Income Tests will use information provided in other
sections of this worksheet.
Did you make any Child support payments during the 2010/2011 tax year?
(If yes please provide details)
EDUCATION TAX REFUND
If you are eligible to receive the Family Tax Benefit (Part A) for the year ending 30/06/2011 and, in relation to your children, you
incurred eligible education expenses (School textbooks & paper based school learning materials, prescribed trade tools, computers,
printers, USB flash drives, home internet connection, software for educational use) you can claim a refund of 50% of your expenditure,
up to $375 refund for each primary school child , and $750 refund for each secondary school child. (Other items such as Fees,
uniform, tutoring, musical instruments, sports equipment are not eligible)
Name of Child ............................................ Primary / Secondary
Eligible Expense
Amount
Name of Child ............................................. Primary / Secondary
Eligible Expense
Amount
Name of Child ............................................. Primary / Secondary
Eligible Expense
Amount
Deadline for tax returns
Supplementary Worksheets
For taxpayers who employ the services of Registered Tax Agents, the
ATO allows generous automatic extensions beyond the normal lodgement
deadline of 31stOctober for individual tax returns. However, we request
that you get your information to us as soon as possible; if you need
an extension beyond 31st January 2012 please contact us (e-mail is best).
We have separate worksheets for the following:
● Rental Property
● Business
● Capital Gains
● Foreign Earnings
● Motor Vehicle
● Family
● Family Tax Benefit
Storage of Tax Records
It is your responsibility to maintain your own taxation records for a period
of five years after the assessment of a tax return.
I agree to receive the above newsletter/s via e-mail as noted above.
Signature:
Date:
E-mail address:
Contact us on 9739 8510 for a personal and confidential appointment.
2011 Personal Income Tax Worksheet
Page 4