Income Tax Return Form

Document Sample
Income Tax Return Form Powered By Docstoc
					                                                                                                         2/13-15 Bridge Street
                                                                                                           Sydney, NSW, 2000

                                                                                                               GPO Box 3183,
                                                                                                           Sydney, NSW, 2001

                                                                                                            T: +61 2 8005 3420
                                                                                                            F: +61 3 9525 5587
                                                                                               E: taxreturns@jobcapital.com.au
                                                                                                     W: www.jobcapital.com.au




                           Income Tax Return Form
Please tick the relevant box
                I would like to have my return prepared then sent to me for signing
                I would like to have my return prepared then contacted for an appointment
                I would prefer to be contacted
                Phone        Mail      Email        Fax           Other



Title                                                                          1 a) Are you a resident for tax
                                                                               purposes?
Name
                                                                                        YES                   NO
Mobile No.

Business No.                                                                   1 b) Have you been in Australia for the
                                                                               full financial year?
Home Address
                                                                                        YES                   NO



Post Code                                                                      2) Are you on an Australian visa?

Email                                                                                   YES                   NO

Date of Birth                                                                  Type of visa?

Occupation                                                                     Date of visa?

                                                                     Please attach your Medicare Levy exemption certificate,
3) Are you entitled to use the Medicare system?                      NB if you would like to be exempt from Medicare you
                                                                     will need this certificate in the event of an audit and
                                                                     must contact Medicare on 1300 300 271, to attain a
         YES                    NO                                   copy.
Employment Information
Employer 1


Company Name                                                  City/Town


Employers Phone No.                              * Must Complete


4) Do you have your PAYG/final payslip?

               NO

               YES


5) If no, do you want us to source replace ements?

               NO

               YES


Start date                                                    City/Town


6) Are you a member of a Superannuation Fund?

               NO

               YES


Name of Fund                                                  Membership Number


Employer 1 PAYG Payment Summary
Occupation Gross Wages        Tax Deducted             Allowance




Employer 2


Company Name                                                  City/Town


Employers Phone No.                              * Must Complete
7) Do you have your PAYG/final payslip?

               NO

               YES


8) If no, do you want us to source replace ements?

               NO

               YES


Start date                                                      City/Town


9) Are you a member of a Superannuation Fund?

               NO

               YES


Name of Fund                                                    Membership Number


Employer 2 PAYG Payment Summary
Occupation Gross Wages         Tax Deducted              Allowance




10) Would you like to use EFT for a direct credit of your refund?

               NO
               As per last year
               YES
                                                          BSB

                                              Account Number

                                       Name The Account Is In

                                                         Bank
  11) Did you have a spouse at 30 June 20___?

                NO
                As per last year
                YES
                                                         Name

                                                  Date of Birth

                                         20___ Taxable Income



  12) Do you have dependant children?

                NO
                As per last year
                YES



                           Child 1   Child 2      Child 3         Child 4     Child 5

Name
Date of Birth
Days cared for (eg 365)
  y            ( g    )


  13) Did you or your spouse receive FBT Part B through the Family Assistance Office in 20___?

                NO

                YES



  14) Do you have Australian approved Private Health Insurance cover?
                                                               If so, please attach "end of financial year" statement.

                NO
                As per last year
                YES
                                                         Name

                                           Membership Number

                                                 Type of Cover

                                                 Days Covered

                                        30% Reduction Rebate
15) Do you have a HECS debt? (Higher Education Contributions Scheme)

             NO

             YES
                               Balance As At 30 June 20___   $



16) Do you have a SSL? (Student Supplement Loan)

             NO

             YES
                               Balance As At 30 June 20___   $




17) Have you completed quarterly or Annual PAYG Installment activity statements (IAS)?

             NO
                                                                       Date                Amount ($)
             YES




18) Have you made personal superannuation contributions on top of Employer support?

             NO

             YES
                                               Total         $




19) For your spouse?

             NO

             YES
                                               Total         $




20) Have you paid combined family medical expenses less reimbursement from Medicare or Private Health
Insurance greater than $1,500.00?

             NO

             YES
                                               Total         $
21) Was your prior year tax return prepared by another tax agent or yourself?

             NO (myself)

             YES (tax agent)
                                                Please provide complete copy of your prior return



Income

22) Have you received a payment summary from your employer?

             NO

             YES
                                                Please attach a copy



23) Have you received a payment summary from Centerlink or any other Government Body?

             NO

             YES
                                                Please attach a copy



24) Have you earned any Bank interest?

             NO

             YES

                     Bank                  Amount ($)                  TFN / TAX           Joint A/C Percentage




25) Have you received any dividends?

             NO

             YES

TFN/TAX            Company                  Unfranked                  Franked              Imputation Credit
26) Have you received any income from managed funds or cash management trusts?

             NO

             YES
                                               Please provide complete copy of
                                               ANNUAL TAX & CAPITAL GAINS STATEMENTS


27) Have you sold any shares?

             NO

             YES
                                               Please provide complete copy of
                                               STATEMENT/BUY & SELL CONTACTS


28) Do you have any investment property?

             NO

             YES
                                               Please attach all relevant documents or a summary of all income &
                                               expenses


29) Do you have income from small business?

             NO

             YES
                                               Please attach all relevant documents or a summary of all income &
                                               expenses


25) Have you received any Foreign Source income?

             NO

             YES
                                               Please attach all relevant documents




26) Have you received any other assessable income?

             NO

             YES
                                               Please attach all relevant documents
Income

NB - Do not provide any expense already reimbursed by employer
This is for non-reimbursed expenses only


27 a) Did you do any Motor Vehicle travel?                            27 b) Have you maintained a log book?

              NO                                                                   NO (Go to A)

              YES                                                                  YES (Go to B)



A)

                                              Estimated Bus. KLM's

                                                      Registration

                                              Make & Model of Car

                                                   Litres in Engine

                                             30% Reduction Rebate

             Please g              p
                    give a brief explanation on how travel relates to business:




B)

                                                       Log Book %

                                                      Registration

                                              Make & Model of Car

                                                             Fuel

                                                 Registration & Ins

                                                  Interest on Loan
                                           MV. Lease Payments

                                             Repairs & Services

                                           Date Car Purchased

                                                 Purchase Cost

            Please give a brief explanation on how travel relates to business:




28 a) Did you undertake any other work related travel?


              NO

              YES
                                                       Airfares

                                               Accommodation

                                                          Meals

                                                    Incidentals



28 b) Did you maintain a travel diary?

              NO
              YES
                                                Days Travelled

                                                           Taxi

                                                        Parking

                                                           Tram

                                                          Train
29 a) Did you have to wear a uniform or protective clothing?

              NO
              YES
                                            Uniform Purchased

                                 Protective Clothing Purchased

                                                Non Slip Shoes

                                              Protective Shoes

                                                     Sunscreen

                                                   Dry Cleaning



29 b) Did you have to launder your uniform?

             NO

             YES




30) Did you incur costs for self education relating to your work?

             NO

             YES

                                       Course Fees (not HECS)

                                                   Union Fees

                                                        Travel

                                      Stationary, Photocopying

                                                         Books

                                                     Institution

                                                 Course Name

            Please give a brief explanation on how self education relates to your current employment:
31) Did you have other work related expenses?

              NO

              YES




                                     Amount ($)    Business %      Claimable Deduction           Date Purchased**

Seminars
Stationary
Laptop**
Computer**
Computer Software**
Home Telephone
Mobile Telephone
Internet Charges
Tools & Equipment
Subscriptions & Union
Journals & Periodicals

                                     ** Please provide date of purchase and itemise expenses exceeding $300.00


32) If this is your first year with Job Capital, are you depreciating items on your last years returns?

              N/A
              No
                                                   Please attach
              YES
                                                   COPY OF DEPRECIATION SCHEDULE


33) Do you ever work from home and have you maintained a logbook?

              NO

              YES
                                                Hours Per Week

                                           Total Weeks Worked
34) Have you taken out an investment loan to purchase shares or managed funds?

             NO

             YES

                     Bank                      Interest             Bank Charges




35) Have you made any gift, charity purchases or donations of $2 or more to an eligible organisation?

             NO

             YES

                     Name                     Amount ($)




36) Do you have any home protection insurance?

             NO

             YES
                                                  Total        $



37) Did you incur Tax Agent fees last year?

             NO

             YES
                                                  Total        $



38) Did you incur any fees for investment/business advice?

             NO

             YES
                                                  Total        $
39) Did you invest in any tax effective products?

              NO

              YES
                                                    Total         $



40) Do you have further deductions?

              NO

              YES

                                                Details                                              Amount ($)




Comments




I declare that the information I have given in this questionniare including any attachments are true and corrcet. I have
the necessary receipts and/or other records - or expect to obtain the necessary written evidence within a reasonable
time of lodging my tax return to support my claims for deductions and rebates.


Taxpayer Signature


 X ______________________________________                                                            Date     /    /

Once you have completed the questionnaire please attach payment summary and any relevant documentation and
forward to:

Job Capital
GPO BOX 3183
Sydney, NSW, 2001
Australia
T: +61 2 8005 3420
F: +61 3 9525 5587
M: +61 425 325 505
E: jburston@jobcapital.com.au

    j b   it l
www.jobcapital.com.au