"Loan Contract for Purchase of a Car"
Paul D Teefy CPA PO Box 288 Ashmore City Q 4214 Ph 07 55030088 email@example.com Fax 07 55030299 Individual Tax Return for July 2009 to June 2010 Name Date / // / Occupation Address Email Telephone Office Use Please circle either YES or No and provide the requested details Only held/sighted As Advised Advised Nil Receipts Item 1 Salary and Wages Did you receive a PAYG Summary (Group Certificate) from your Yes No employer ? If yes, ensure you bring them all in. Item 2 Allowance, earnings, tips, directors fees etc Did you have any earnings or fees that were not included on a PAYG Yes No Summary? If yes, bring in the details. Items Did you receive any Lump Sums or Employment Termination (ETP's) Yes No 3&4 from your employer ? If yes, bring in Payment summary (Group Certficate) from your employer. Items 5,6,7 & 8 Did you receive any Government Pension or allowance, Yes No Superannuation Pension, Annuity, Lump sum or similar payment ? If yes, bring in the PAYG Payment Summary or statement and any letters which accompanied the payment. Item 10 Did you receive interest from your Bank Accounts, Building Society Yes No Investments or private loans ? If yes, please check with the Bank etc before coming in to ensure that all your interest is included. Most Banks can give you a computer readout of interest on request. Item 11 Did you receive dividends from the shares you own ? Yes No If yes, ensure that you have all of the details including the Franked Dividends, Franking Credits and Unfranked Amounts on each amount received. ( Include Dividend Reinvestment Plans)-Ask us for a Dividend Worksheet or download from www.pdteefy.com.au N.B. If you own shares you also need to retain details of the purchase date and cost of all your shares for future Capital Gains Tax Calculations. This includes shares purchased through dividend reinvestment. - Ask us for a Capital Gains Record Sheet or download from www.pdteefy.com.au Notes: D:\Docstoc\Working\pdf\bb9b48b5-49c0-4854-ba2b-50bfd75cb9d0.xls 1 Paul D Teefy CPA PO Box 288 Ashmore City Q 4214 Ph 07 55030088 firstname.lastname@example.org Fax 07 55030299 Office Use Only Advised Nil As Advised held/sighte Receipts d Item D1 Did you use your car for work related use ? Yes No If yes, please provide the following details. Engine Size What is the engine size of the vehicle? < 1.6 Litre < 2.6 Litre over 2.6litre Total Klms How many klms did you travel for work? Fuel If you have kept a log book detail the amount of expenses: $ Registration $ Insurance $ Repairs & maintenance $ Lease or Loan Payments $ Total % Business Use What is the percentage business use calculated in your log book? % If you have purchased a new vehicle this year which you use for work provide details of the purchase cost and details of any loan or lease ( i.e. purchase contract + loan contract). Item D2 Did you have work related travel and accommodation expenses ? Yes No If yes, bring in the receipts. What was the reason for the travel? Item D3 Did you have work related uniform, occupation specific or protective clothing? Yes No If yes, bring in the receipts for the items Item D4 Did you have work related self education ? Yes No If yes, you must establish the link with your existing work and then you can claim course fees, books, travel etc but not HECS. Bring in your receipts for these items. Item D5 Did you have other work related expenses ? Yes No If yes, bring in your receipts or provide details below. Union Fees $ Telephone - Business Use $ Internet - Business Use $ Subscriptions and Memberships $ Replacement of Tools/ Work Related Items $ Stationery - Business Use $ Assets purchased for work use $ Other work related expenses $ D:\Docstoc\Working\pdf\bb9b48b5-49c0-4854-ba2b-50bfd75cb9d0.xls 2 Paul D Teefy CPA PO Box 288 Ashmore City Q 4214 Ph 07 55030088 email@example.com Fax 07 55030299 Office Use Only Advised Nil As Advised held/sighte Receipts d Item D7 Yes No & D8 Did you have deductions against your dividend and interest income? If yes, bring in the details Item D9 Did you make any gifts or donations to registered charities ? Yes No If yes, bring in the receipts Item D10 Did you pay a tax agent to prepare an income tax return last year? Yes No If yes, bring in the receipts Medical Were you covered by a private health insurance fund ? Yes No If yes, bring in the year end statement which the fund sent you. Income Test Yes No Did you pay child support during the year If yes, bring in the details of the amount you paid. Yes No Offsets Did you have a spouse during the year? If we are NOT preparing your spouse's tax return, provide the following details. - Spouse's full name - Date of Birth - Taxable Income $ - Details of any Trust income not included in taxable income $ - Reportable Fringe Benefits $ - Government Pensions and Allowances $ - Exempt pension Income $ - Reportable superannuation contributions $ - Any tax free Military Rehabilitation and Compensation pensions $ - Foreign income $ - Net investment loss ( financial investments & rental property) $ - Child support your spouse paid $ - Taxed element of superannuation lump sum where tax rate = 0 $ Item T6 Education Tax Refund You can claim if you received Family Tax Benefit A AND incurred eligible expenses for primary or secondary school students. Eligible expenses are for computers, computer related equipment, home internet, educational software, textbooks, stationery and prescribed trade tools. For more information ask for a Fact Sheet or download from www.pdteefy.com.au Are you eligible to claim the Education Tax Refund? Yes No If Yes, provide the following details. $ - Amount of eligible expenses - Number of Primary School Students - Number of Secondary School Students Item M1 How many dependent children or students do you have ? D:\Docstoc\Working\pdf\bb9b48b5-49c0-4854-ba2b-50bfd75cb9d0.xls 3 Paul D Teefy CPA PO Box 288 Ashmore City Q 4214 Ph 07 55030088 firstname.lastname@example.org Fax 07 55030299 Office Use Only held/sight Receipts Advised Advised Nil As ed Item 13 Did you receive any distributions from Partnerships, Trusts or Managed Portfolios? Yes No If yes, then you will need to bring in these details from the Trust or Fund Manager. Some of these are not available until September so wait to gather all the information before making an appointment to do your Tax Return. Items 14 & 15 Did you earn any income from business or contract activities? Yes No If yes, bring in the details of all your income and expenses. Item 18 Did you have any Capital Gains or Losses from sale of Shares or Property or other investments during the year? Yes No If yes, you need to bring in details of any items sold, the date you purchased it, the price you paid and any additional expenditure spent on the asset during your ownership, the sale price and the date you sold it. If you reinvested dividends on shares you will need to track each of these to determine the purchase price of each share sold. N.B. If you own shares, property or other investments you also need to retain details of the purchase date and cost of all your investments for future Capital Gains Tax Calculations. - Ask us for a Capital Gains Record Sheet or download from www.pdteefy.com.au Item 20 Did you receive any Foreign Sourced Income OR own or have a share Yes No in assets located outside Australia valued at more than $50,000 If yes, bring in details of all overseas income and assets and any related expenses - The ATO is targeting this area. Please ensure you do not overlook any overseas income. Item 21 Did you own a Rental Property ? Yes No If yes, bring in all relevant income and expenditure for the property. Ask us for a rental schedule questionnaire to assist you with these details or download it from www.pdteefy.com.au Item T9 Did you have Net Medical expenses greater than $1500 ? Yes No This means the medical expenses you have paid less any refunds you received from Medicare and /or your Private Health Insurance Fund. If yes, bring in the receipts for the expense and the details of your refunds. Statements can be obtained from Medicare and Private Health Funds.You will need to contact Medicare and/or your private fund to request these statements. If you regularly use the same chemist they can provide a statement. Items Did you make any personal superannuation contributions or T7 & D13 contributions on behalf of your spouse? Yes No If yes, bring in the details. D16 Have you paid premiums for Income Protection or Sickness and Yes No Accident Insurance? If yes, bring in the details Other Have you received any income from Life Insurance Company Bonuses, Forestry Managed Investment Scheme Income or any other source? Have you acquired shares under an employee share scheme? Have you invested in an Australian Film or Forestry Yes No Investment? Did you live or work in a remote or isolated area? Did you serve overseas in the Defence Forces? If yes, bring in the details Yes No Have you received any other income during the year? If yes, bring in the details D:\Docstoc\Working\pdf\bb9b48b5-49c0-4854-ba2b-50bfd75cb9d0.xls 4