Individual Tax Return Checklist 2015
Personal Details
Title: (Mr., Mrs., etc.)
Given Name:
Date of Birth:
Occupation:
Number of Dependent
Children:
Residential Address:
Postal Address:
Family Name:
Other Given Name(s):
Contact Number:
Tax File Number:
Email Address:
Spouse Details
Title: (Mr., Mrs., etc.)
First Name:
Date of Birth:
Occupation:
Family Name:
Other Given Name(s):
Tax File Number:
Bank Details
Account Name:
Institute Name:
BSB:
Account Number:
Declaration:
I, ___________________________________, hereby declare that all information provided in this form and
the attached documents are true and correct and I undertake to inform you of any changes
therein, immediately.
Signature: _______________________________
For Authorized Personnel:
Received By:
Processed By:
Signature:
Level 1
110 Hay Street
Subiaco WA
6008
Date: _____________________________
Date:
Checked By:
Signature:
Tele: (08) 9388 0041
Mob: (0413) 742 664
Email: sabbott@iinet.net.au
PO Box 128
West Perth WA
6872
SECTION A
Income
Please provide Y (yes), N (No) or N/A (Not applicable) in the provided space.
1
Did you earn income from any of the following where tax was withheld:
 Salary and wages
 Commissions
 Bonuses
 Income from part-time or casual work
 Parental leave pay
 Dad and partner pay
 Foreign Employment
 Amounts for lost salary or wages paid under
- an income protection policy
- a sickness or accident insurance policy, or
- a worker’s compensation scheme?
2
Did you receive any of the following payments?
 Employment allowances (e.g. car allowance, meal allowance etc.)
 Tips, gratuities
 Consultation fees
 Payments for voluntary and other services
 All payments from which tax was not withheld (e.g. commissions,
bonuses, casual job income, insurance payments etc.)
3
Did you receive any lump sum payments from your employer?
 Unused annual leave or
 Unused long service leave?
4
Did you receive an Employment termination payment (ETP)?
This also covers:
 Death benefit ETPs
 Foreign ETPS
 Later termination payment
5
Did you receive any of the following Australian Government payments?
 Newstart allowance
 Youth allowance
 Austudy payment
 Parenting payment (partnered)
 Partner allowance
 Sickness allowance
 Special benefit
 Widow allowance
 Exceptional circumstances relief payment
 Interim income support payment
 An education payment of any of the following when you were 16 years or
older:
- ABSTUDY living allowance
- Payment under the Veterans’ Children Education Scheme
- Payment shown as ‘MRCA Education Allowance’ on your payment
summary
 Other taxable Commonwealth education or training payment
 An income support component from a Community Development
Employment Project (CDEP)
 Disaster recovery allowance
Y, N
or
N/A
6
Did you receive any of the following Australian Government payments?
 Age Pension
 Bereavement allowance
 Carer Payment
 Disability support pension, if you have reached age-pension age
 Education entry payment
 Parenting payment (single)
 Widow B pension
 Wife pension, if either your or your partner was of age-pension age
 Age service pension
 Income support supplement
 Defense Force income support allowance (DFISA) where the pension,
payment or allowance to which it relates is taxable
 DFISA-like payment from the Department of Veterans’ Affairs (DVA)
 Invaliity service pension, if you have reached age-pension age
 Partner service pesion
7
Did you receive Australian annuities or superannuation income streams?
Did you receive ‘superannuation income stream lump sum’ in arrears?
8
Did you receive any Australian superannuation lump sum payments or
superannuation death benefit payments?
This payments include:
 Superannuation funds
 Approved deposit funds
 Retirement savings account providers
 Life insurance companies
Did you receive the lump sum payment as a death benefit but you were not a
dependant of the deceased?
9
Did you receive any attributed personal service income?
This relevant if you:
 Received a PAYG payment summary – business and personal services
income showing an ‘X’ against ‘Personal services attributed income’, or
 Had personal services income attributed to you.
10
Was any interest paid or credited to you from any source in Australia?
Gross interest includes:
 Interest from savings accounts, term deposits and cash management
accounts
 Interest the Australian Government paid or credited to you
 Interest from children’s accounts you opened or operated with funds that
you used as if they were yours
 Amounts withheld by financial institues where you did not provide your
TFN to.
11
Were you paid or credited with dividends from sharesby Australian
company?
Dividends and distributions include:
 Dividends applied under a dividend reinvestment plan
 Dividends that were dealt with on your behalf
 Bonus shares that qualify as dividends
 Distributions by a corporate limited partnership
 Dividends paid by a coporate unit trust, public trading trust or listed
investment company.
12
Employee share schemes (ESS)
Did any of the following apply to you?
 You received a discount on ESS interests acquired under a ‘taxed-upfront
scheme’
 A ‘deferred taxing point’ occurred in respect of ESS interests you acquired
at a discount under a ‘tax deferred scheme’
 A ‘cessation time’ occurred during the financial year in relation to an ESS
interest you acuired before 1 July 2009 under an employee share scheme,
and you had not elected to be taxed upfront on the discount.
SECTION B
Deductions
Please provide Y (yes), N (No) or N/A (Not applicable) in the provided space.
D1
Did you have any work-related car expenses?
Work related car expenses are expenses you incurred as an employee for a car
you:
 Owned
 Leased, or
 Hired under a hire-purchase agreement
D2
Did you have any work-related travel expenses?
They include:
 Public transport, including air travel and taxi fares
 Bridge and road tolls, parking fees and short termm car hire
 Meal, accommodation and incidental expenses you incur while away
overnight for work
 Expenses for motorcycles and vehicles carrying capacity of one tonne or
more, or nine or more passengers, such as untility trucks and panel vans
 Actual expenses (such as any petrol, oil and repairs costs) you incur to
travel in a car that is owned or leased by someone else.
Did you have any work-related clothing laundry or dry-cleaning expenses?
You can claim expenses you incurred as an employee for work-related:
 Protective clothing
 Uniforms
 Occupation-specific clothing, and
 Laundering and dry-cleaning of clothing listed above
D3
D4
Did you have any work-related self-education expenses?
To claim a deduction here, you must have met one of the following conditions
when you incurred the expense:
 The course maintained or improved a skill or specific knowledge
required for your work activities at that time
 Ypu could show that the course was leading to, or was likely to lead to,
increased income from your work activities at that time
 Other circumstances existed which established a direct connection
between the course and your work activities at that time
D5
Did you have any other work-related expenses?
These include:
 Union fees and subscription to trade, business or professional
associations
 Certain overtime meal expenses
 Professional seminars, courses, conferences and workshops
 Reference books, technical journals and trade magazines
Y, N
or
N/A



D6
Safety items such as hard hats, safety glasses and sunscreens
The work-related proportion of some computer, phone and home office
expenses
Tools and equipment and professional libraries
Low-value pool deduction
This question is about claiming a deduction for the decline in value of low-cost
and low-value assets that you:
 Used in the course of producing income you show on your tax return, and
 Allocated to what is called a low-value pool.
Assets you can allocate to a low-value pool include assets you use:
 In your work as an employee, or
 To gain rental income
* Low-cost assets are depreciating assets that cost less than $1,000.
* Low-value assets are depreciating assets that are a not low-cost asset but which, on 1 July 2013, had
been written off to less than $1,000 under the diminishing value method.
D7
Did you have any interest deductions?
Did you incur expenses in earning the interest you declared at item 10 in section
A?
Expenses include:
 Bank or other financial institution account-keeping fees for accounts held
for investment purposes
 Fees for invesment advice relating to changes in the mix of your
investments
 Interest you paid on money your borrowed to purchase incomeproducing investments
D8
Did you have any dividends deductions?
Did you incur expenses in earning the dividend income you declared at item 11 in
section A?
Expenses include:
 Fees for investment advice relating to changes in the mix of your
investments
 Interest paid on money borrowed to purchase shares or similar
investments
 Costs of relating to managing your investments, such as travel and
buying specialist investment journals or subscriptions
D9
Did you make a gift or donation of $2 or more to an approved organisation?
Your receipt should show whether your donation is tax-deductible.
D10
Did you incur expenses in managing your tax affair?
The cost of managing your tax affairs includes:
 Preparing and lodging your tax return and activity statements
 Fees paid to a recognised tax adviser for preparing and lodging your tax
return
 Travel to obtain tax advice from a recognised tax adviser
 Buying tax reference material
 Dealing with ATO about your tax affairs
 Appeals made to the Administrative Appeals Tribunal or courts in
relation to your tax affairs
 An interest charge the ATO imposed on you
Section C
Medicare Levy Related Items
Please provide Y (yes), N (No) or N/A (Not applicable) in the provided space.
M1
Y, N
or
N/A
Do you have private health insurance?
Section D
Supplement income
Please provide Y (yes), N (No) or N/A (Not applicable) in the provided space.
13
Did you receive income from partnerships and trusts?
14
Did you receive any personal service income (PSI)?
15
Were you a sole trader for the financial year?
Did you have an Australia Business Number (ABN)?
16
Did you have any capital gains?
17
Did you receive income generated from foreign entities?
18
Did you have any foreign income source or foreign assets or property?
19
Did you receive any rental income?
20
Did you receive any bonus from life companies and friendly societies?
21
Did you receive income from Forestry Managed Investment Scheme (FMIS)?
22
Did you receive any other income?
This includes:
 A non-qualifying component of an ETP
 Lump sum payments in arrears
 Foreign exchange gains
 Royalties
 Taxable scholarships, bursaries or grants
 Any assessable balancing adjustments on depreciating assets
 Jury service fees
Y, N
or
N/A
Section E
Supplement deductions
Please provide Y (yes), N (No) or N/A (Not applicable) in the provided space.
D11
Did you have deductible amount of undeducted purchase price of a foreign
pension or annuity?
D12
Did you make any personal superannuation contributions?
D13
Did you have any deduction for project pool?
D14
Did you have any deduction from Forestry Managed Investment Scheme
(FMIS)?
D15
Did you have any other deductions?
Section F
Losses and Tax Offsets
Please provide Y (yes), N (No) or N/A (Not applicable) in the provided space.
L1
Do you have any tax losses from earlier income years?
T1
Do you think you are eligible for any tax offsets?
Y, N
or
N/A
Y, N
or
N/A
Before you get back to us, please check if you have included the following
documents.
1
If you answered ‘Yes’ to any question in Section A, please provide PAYG payment
summaries, formal documentations and/or statements for each relevant
component.
2
If you answered ‘Yes’ to any question in Section B, please provide substantial
receipts, invoices, statements and/or evidence of documentation for each relevant
component.
3
If you answered ‘Yes’ to any question in Section C, please provide your private
health insurance details.
4
If you answered ‘Yes’ to any question in Section D, please provide relevant PAYG
payment summaries, formal documentations and/or statements for each relevant
component.
5
If you answered ‘Yes’ to any question in Section E, please provide substantial
and/or evidence of documentation for each relevant component.
6
If you answered ‘Yes’ to L1 Section F, please provide individual tax return of
relevant financial years.
7
If you answered ‘Yes’ to T1 Section F, please provide details and amount of the tax
offsets you might be eligible for.
8
Please attach a copy of your individual tax return from your last lodgment.
Y, N
or
N/A
Please do not hesitate to contact us should you assistance in completing this form.
Suite 4, Level 1
110 Hay Street
Subiaco WA 6008
T: 08 9388 0041
M: 0413 742 664
E: sabbott@iinet.net.au