Tax Data Collection Form
(For individuals only)
Note: Please complete details only if changed from prior year
Personal Information
Name:
Has your name changed since the last tax return?
Are you a resident of Australia for income tax purposes?
If you are working in Australia on a 457 Visa and you receive a LAFHA, you are NOT a resident of Australia.
Have you lived in Australia for the full twelve months: July 2014 - June 2015?
If NO, Specify the dates you lived in Australia
Current address:
City:
State:
Home Phone:
Postcode:
Business Phone:
Mobile Phone:
Email:
Do you have a spouse/de facto?
If married/de facto in 2014/2015, what date did this occur?
If we don’t complete Spouse’s return please provide the following details:
Spouse’s taxable income:
Spouse’s FBT:
Spouse's negatively geared rental losses
If divorced/separated, what date did this occur?
Bank Details
Bank where account held:
Account Name:
BSB:
Account Number:
Dependent Children
Do you have any dependent children? If yes please provide details below:
Name
DOB
Income $
Name
DOB
Income $
Name
DOB
Income $
Name
DOB
Income $
Name
DOB
Income $
Income Details
What is your occupation?
Have your earned income as an employee and received a PAYG summary? If yes please provide details below and Group Certificates.
Payer
Gross $
Tax withheld $
Payer
Gross $
Tax withheld $
Payer
Gross $
Tax withheld $
Please list any Directors Fees, Tips/Gratuities, Etc:
Payer
Amount $
Have you received an ETP (Eligible Termination Payment)? If yes please provide details below and ETP Statements.
Payer
Amount $
Payer
Amount $
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Bank Interest
Bank
Account #
Gross Interest $
Your Share
Dividend Reinvestment
* PLEASE PROVIDE COPIES OF ALL DIVIDEND STATEMENTS TO ENSURE YOUR DATA IS RECORDED APPROPRIATELY
Hin Number
Payer
Official Owner of Share/s
Date
Unfranked $
Franked $
Imp Credit $
W/H Taxes $
Imp Credit $
W/H Taxes $
Any additional shares that haven’t received a dividend this year? If yes please provide details below.
Payer
Date
Unfranked $
Franked $
Trust Distribution
If there are any trusts that we don’t prepare a tax return for on your behalf please provide a copy of the tax return.
Name of Trust
Gross Distribution $
Do you have any other business income earned in your personal name? (Not including income earned in other etc. that you also run and / or
control)
trusts/companies/partnerships,
Type of Income
ABN
GST Registered
Yes
No
Please provide detailed business income and expenses. Please forward a copy of your summarised documentation.
Share Sales
* PLEASE PROVIDE A COPY OF BUY & SELL CONTRACTS
Have you sold any shares or other assets that may have incurred a capital gain or loss? If yes please provide details below.
Company Name
Date Bought
Purchase Price $
Date Sold
Sale Proceeds $
Share Purchases
* PLEASE PROVIDE A COPY OF BUY CONTRACTS
Have you purchased any shares
Company Name
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If yes please provide details below.
Date Bought
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Purchase Price $
Number of Shares
Number of
Shares
Managed Funds
* PLEASE PROVIDE A COPY OF ALL ANNUAL TAX STATEMENTS
Fund Name
Date Bought
Purchase Price $
Date Sold
Sale Proceeds $
Property Purchases
* PLEASE PROVIDE A COPY OF THE PURCHASE CONTRACT AND STATEMENT OF ADJUSTMENTS ON SETTLEMENT
Property Address
Date Signed Contract
Purchase Price $
Property Sales
* PLEASE PROVIDE A COPY OF THE SALE CONTRACT AND STATEMENT OF ADJUSTMENTS ON SETTLEMENT
Date Signed
Contract
Property Address
Purchase
Price $
Date Signed
Sale Contract
Sale
Proceeds $
Commission
on Sale $
Expenses Details – Motor Vehicle
Please complete your Motor Vehicle details if you have a valid basis for a claim:
(please provide details for every car owned and finance contract if applicable)
Name car is registered in
Registration
Make
Model
Date of Purchase
Engine Size
Odo Reading at 01/07/14
Odo Reading at 30/06/15
Log Book Percentage (if applicable)
You must complete a logbook for a consecutive 12 week period.
Date Log Book was last completed
Is the car:
Business KM’s
Cost of Car
Leased
Monthly Repayment $
Hire Purchase
Interest for the Year $
Personal Loan
Monthly Repayment $
If you have purchased a car between 01/07/14 and 30/06/15 please provide documentation
Date of Purchase
Purchase Price $
If you have sold a car between 01/07/14and 30/06/15 please provide documentation
Date of Sale
Km’s at Sale
Sale Proceeds
If you have a logbook please provide the following additional details: (A log book must be kept for 5 years, the updated).
What did you pay for registration?
What did you pay for insurance?
What did you pay for roadside assistance?
What did you pay for repairs? $
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Fuel cost for the year (actual receipts must be kept) $
Details:
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Legal/
Advertising $
Expenses Details – Motor Vehicle Continued.
Have you incurred any travel expenses relating to your work?
Taxi’s
Public Transport
Please describe reason, dates and cost for "other travel":
Reason
Dates
Cost $
Reason
Accommodatio
n
Postage
Airfares
Meals
Car Hire
Etc.
Dates
Cost $
Phone
Expenses Details - Work Related Uniforms
If you wear a uniform and it is not supplied by your employer please provide the following:
Date
Cost $
What type of uniform?
If you dry-cleaned your uniform please advise amount and keep receipts. $
Occupational Expenses – outdoor workers, etc. if you purchased protective items, e.g. sunscreen, sunglasses, sun hats, etc. Please provide details.
Date
Cost $
Details
Date
Cost $
Details
Date
Cost $
Details
Expenses Details - Work Related Self Education Expenses (formal courses)
Describe how the self education expenses are related to your income producing activities:
Student Fees – amount $
Course Fees (excl HECS payments) – amount
$
Travel – amount $
Text books – amount $
Other please specify
Amount $
Expenses Details - Work Related Self Education Expenses (seminars and courses)
Provide details of what type of course and how it relates to your profession:
Seminar or Course Fees – Amount $
Travel – Amount $
Other please specify – Amount $
Expenses Details – Home Office Expenses
How many hours according to your 4 week diary did you spend on work related activities in your office – (please ensure you have completed a 4
week diary for each year)
Hours spent per week
Number of weeks of the year
Expenses Details - Work Related Self Education Expenses (formal courses)
Please provide your claimable telephone, mobile, internet and computer information: please ensure you have completed a 4 week diary for each
year)
Home Phone (total amount
$)
Work %
Claimed Amount $
Mobile (total amount $)
Work %
Claimed Amount $
Internet (total amount $)
Work %
Claimed Amount $
If you have allowable deductions in the following area's please list separately:
Books Journals and Magazines
Details
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Amount $
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Expenses Details – Home Office Expenses Continued.
Professional body fees/union fees
Details
Amount $
Stationery, Printing and Postage
Details
Amount $
Expenses Details – Occupation Expenses
Please ensure you have completed a 4 week diary for each year
Tools, Equipment, Office Furniture purchases, etc.
Date
Details
Amount $
% Work Related
Claimed
Details
Amount $
% Work Related
Claimed
Computer
Date
Other Claims e.g. Income Protection Insurance
Date
Details
Amount $
Interest paid on investments other than rental properties
Purpose of Investment:
Financial Institution
Whose Name
%
$
Interest $
Bank Charges $
Financial Institution
Whose Name
%
$
Interest $
Bank Charges $
Financial Institution
Whose Name
%
$
Interest $
Bank Charges $
Margin Loan
Other Loan
Prepaid Interest
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Expenses Details – Accounting Fees – Travel to Accountant Schedule
Accounting and Tax Agent Fees if we did not prepare $
If you used your own vehicle to visit accountant please provide the following details:
(please note on longer trips we would expect to see accommodation and meal costs)
Whose name is the car registered in?
What is the make, model and rego of your car?
What is the engine capacity of your car?
Opening Odometer at the start of trip
Closing Odometer at the end of trip
Totalled kms travelled to visit accountant
Name of Hotel/Motel/Location (if staying at friends note your host’s location)
Dates Stayed
Cost $
Meals
Details
Date Incurred
Cost $
Date Incurred
Cost $
Miscellaneous Expenses
Details
Expense Details – Private Health Insurance
Please provide a copy of your statement if you have private health insurance from 1st July 2014 – 30th June 2015
Fund
Policy No#
Premium $
Have you claimed 30% rebate?
Yes
No
Expense Details – Medical expenses tax offset
Only complete if you have claimed the medical expenses tax offset in your 2013 and 2014 tax returns or the medical expenses relate to a disability
aid, attendant care (for a person with a disability) and/or aged care.
Out of pocket expenses, NET medical expenses exceed $2,260, the amount of rebate is 20% of the excess over $2,218. Single income has to be
under $90,000 or Family under $180,000. For income thresholds above this, the tax offset is calculated as 10% of the net medical expenses
exceeding $5,233
Eligible medical expenses cover doctors, nurses, chemist, dentist, and optometrist. Premiums towards Private Health Insurance CANNOT be
claimed. (Please note that reimbursed is from Medicare and your health insurance)
Please note that this is for all dependent family members.
Fees $
Reimbursed $
Doctors
Chemist
Dentist
Optometrist
Hospitals
Naturopath
Other
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Net Medical Expenses $
Superannuation
Have you personally contributed funds to superannuation? (e.g. self-employed).
If Yes, you must provide a section 82AAT notice from your superannuation fund
Fund Name
Policy #
Amount Paid $
TAX FREE (CONCESSIONAL) CONTRIBUTIONS CAP - HAVE YOU LOOKED AT YOUR SGC TO ENSURE THEY ARE NOT OVER THE $
25,000 CAP?
The concessional cap depends on how old you are on 30 June 2015. If you are under 50 years of age, your cap is $30,000.
If you are 50 or older, your cap is $35,000.
Concessional contributions include:

employer contributions

salary sacrificed contributions, and

personal contributions that are allowed as a personal superannuation deduction in your income tax return
Expense Details – Donations
Donations - only to registered or qualified charities
Name of Charity
Date Paid
Amount Paid $
Nil Returns
Please advise details of any other entities with a TFN that may require a NIL return
Entity Name
Entity TFN:
Important Note to SAS – Is this Deductible?
Please provide a brief summary if there are some items you feel SAS may need some additional information or background on.
Please put down anything you may feel is deductible and your reasons why so we can look at it for you.
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PLEASE MAKE SURE YOU PROVIDE THE FOLLOWING IF APPLICABLE
 PAYG Payment Summaries (Group Certificates)
 Private Health Insurance Statements
 Employment Termination Payment (ETP) Statements
 Loan Statements from 1st July – 30th June
 All dividend and share documentation
 Trust Distribution documentation
 Property Purchase and Sale Documentation (including contract and statement
of adjustments)
 Motor Vehicle purchase and/or sale documentation
 Motor Vehicle Finance Contract
 Section 82AAT notice from your Superannuation Fund
 Any other applicable documentation
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