baggetta & co accountants financial planners self managed super funds 2013 Individual Tax Return Checklist

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1 baggetta & co accountants financial planners self managed super funds 2013 Individual Tax Return Checklist Provide all supporting documentation to substantiate your claims Such as copies of receipts, tax invoices, bank statements, payment summaries, contracts, agreements and other relevant correspondence. MR/MRS/MS/MISS(please circle) FULL BIRTH NAME: First Names:.. Surname:.. Physical Address:... Postal Address:.. Current Telephone (M):...(W):. (H):. .. Current Occupation:. Spouse s Full Name: (Page 8 MUST ALSO be completed if spouse exists). Spouse s Date of Birth. Number of child(ren) dependents for Medicare Levy Surcharge purpose. Name of child dependent: Date of Birth: Name of child dependent: Date of Birth: Name of child dependent: Date of Birth: Name of child dependent: Date of Birth: Are you an Australian Resident NO YES Did you become or cease to be an Australian Resident during the year NO YES In the case of a tax refund, please supply the following information as this is now COMPULSORY as per the ATO for taxpayers receiving a refund. Account Name BSB Account Number Supporting documentation to provide: Do you have a current HECS/HELP or SFSS debt? NO YES *HECS/HELP/SFSS statement Did you make any PAYG Instalments during the year? NO YES 1

2 INCOME 1. Salary or wages NO YES * PAYG payment summaries - Did any of your PAYG Summaries include Parental Leave Payments? NO YES 2. Allowances, earnings, tips, director s fees, etc. NO YES * PAYG payment summaries 3. Employer lump sum payments NO YES * PAYG payment summaries 4. Employment termination payments (ETPs) NO YES * ETP payment summaries 5. Australian government allowances (eg. Newstart, Youth Allowance, Sickness Allowance, Austudy) NO YES *Annual govt payment summaries 6. Australian government pensions and allowances NO YES *Annual govt payment summaries 7. Australian annuities and superannuation income NO YES *PAYG payment summaries streams 8. Australian superannuation lump sum payments NO YES *Annual super payment summaries 9. Attributed personal services income - Do you have a Partnership, Family Trust, or Company arrangement into which income is paid for your services? NO YES 10. Gross interest (eg. from bank a/c, term deposit) NO YES *Bank statements or annual bank summary. 11. Dividends NO YES *Dividend statements (normally two per year) 12. Employee share schemes NO YES *Employee share scheme statement 13. Income from partnerships and/or trusts NO YES *Trust distribution statements from managed funds 14. Personal services income (PSI) NO YES *If Yes, please complete Sole Trader Checklist 15. Net income or loss from business (sole trader) NO YES *If Yes, please complete Sole Trader Checklist 16. Deferred non-commercial business losses NO YES 17. Net farm management deposits/withdrawals NO YES *Bank statements (applicable for primary producers only) 18. Capital gains or losses (eg. from sale of shares, real estate, etc) NO YES *If Yes, please complete Capital Gains Tax Checklist 19. Income from control of foreign entities NO YES 20. Foreign Source Income (including foreign pensions) NO YES *Provide details of country, amount received, exchange rate and any foreign tax withheld 21. Rent (date first rented: / / ) NO YES *If Yes, please complete Rental Checklist 22. Bonuses from life insurance companies or friendly societies NO YES 23. Forestry managed investment scheme income NO YES 24. Other Income NO YES 2

3 DEDUCTIONS D1. Work related car expense claims Make and Model of Motor Vehicle:.. Engine capacity of vehicle (please tick): 0 1,600cc 1,601 2,600cc 2,601cc and over PLEASE SELECT WHICH OF THE FOLLOWING FOUR METHODS YOU WISH TO CLAIM: Cents per kilometre method (up to a max of 5,000 work related kms). Please provide number of work related kms travelled: Total work related kms travelled:..kms Logbook method. Please provide logbook that was maintained for at least 12 consecutive weeks and provide the following information required. Log book start date: / / Log book end date: / / Total kms travelled: kms Work Related kms travelled:.kms Fuel $... Registration $... Insurance $... Interest or leasing charges $... Repairs and maintenance $... Other $... Original cost of vehicle $... Date of purchase / / 1/3 of actual expenses method (must have travelled > 5,000 work related kms). Logbook not required. Please provide the following information. Fuel $... Registration $... Insurance $... Interest or leasing charges $... Repairs and maintenance $... Other $... Original cost of vehicle $... Date of purchase / / 12% of cost price of car method (must have travelled > 5,000 work related kms). Maximum car value is $59,133 or $75,375 for certain fuel-efficient cars in the 2012/13 income year Original cost of vehicle $... Date of purchase / / 3

4 D2. Other work related travel expenses (eg. Airfares, taxi fares, parking, etc) NO YES *Receipts required regardless of length of absence from home. *Travel diary required for overseas travel or where length of stay was for more than five days. D3. Work related uniform, occupation specific or protective clothing, laundry and dry cleaning expenses NO YES *Receipts and type of claim (i.e Protective, compulsory uniform etc) D4. Work related self-education expenses (eg. Student union fees, books, stationery) NO YES *Receipts required with description D5. Other work related expenses (eg. home office, union fees, seminars, tools, assets <$300, NO YES *Receipts required with description sunscreen and sunglasses) D6. Low value pool deduction NO YES **Receipts required with description (Assets <$1,000) D7. Interest deductions (can only be claimed if there s income at question 10 above) NO YES *Bank statements D8. Dividend deductions (can only be claimed if there s income at question 11 above) NO YES *Receipts required with description D9. Gifts and donations NO YES *Receipts required (Must be endorsed by ATO and not have received anything in return from making the donation (eg Lucky numbers, raffle tickets, pens, stickers etc) D10. Cost of managing tax affairs NO YES *Invoice and receipt only required if not issued by baggetta & co D11. Deductible amount of undeducted purchase price of a foreign pension or annuity NO YES D12. Personal super contributions NO YES Super Fund Name:... Super Fund ABN:. Super Fund TFN:. Contribution Amount: $... Have you provided the fund a notice of intention to deduct the contribution? NO YES Has this notice been acknowledged by the fund? NO YES *If Yes, please provide a copy of this notice D13. Deduction for project pool NO YES D14. Forestry managed investment scheme deduction NO YES D15. Other deductions (eg. Accident & Sickness Insurance Premiums) NO YES *Annual statement of deductibility Do you have any of the following covers in place: Life Cover $ Trauma Cover $ Income Protection $ When was the cover last reviewed: Less than 12 months 1-2 years ago More than 2 years ago L1. Tax losses of earlier income years claimed this year NO YES 4

5 TAX OFFSETS T1. Did you have a spouse (without dependent child or student) for the full income year NO YES *If Yes and your adjusted taxable income (ATI) was <$150,000 and your spouse s ATI was < $9,973, please answer the following - Was your dependent spouse born before 1 July 1952 for all or part of the year NO YES *If No, you do not qualify for this offset. Move on to T2 - Were either you or your spouse eligible for family tax benefit Part B NO YES *If Yes, you do not qualify for this offset. Move on to T2 - Did you or your spouse receive parental leave pay NO YES *If Yes, you do not qualify for this offset. Move on to T2 T2. Seniors and pensioners (includes self-funded retirees) - Were you eligible for Australian Government pensions or allowances NO YES *If No, you do not qualify for this offset. Move on to T3 - If you did not have a spouse, was your rebate income <$50,119 NO YES *If No, you do not qualify for this offset. Move on to T3 - If you had a spouse, was the combined rebate income <$83,580 NO YES *If No, you do not qualify for this offset. Move on to T3 - At any time during the year did you and your spouse have to live apart due to illness or because one of you was in a nursing home, and the combined rebate income was <$95,198 NO YES *If No, you do not qualify for this offset. Move on to T3 PLEASE TICK WHICH SITUATION APPLIES TO YOU You were single, separated or widowed You and your spouse were both eligible of the seniors and pensioners tax offset and had to live apart due to Illness or lived apart because one of you was in a nursing home Your spouse was not eligible for the seniors and pensioners tax offset and you and your spouse had to live apart due to illness or lived apart because one of you was in a nursing home You and your spouse lived together and were both eligible of the seniors and pensioners tax offset You and your spouse lived together and your spouse was not eligible for the seniors and pensioners tax offset T3. Australian superannuation income stream NO YES *PAYG payment summaries (only relevant if income shown at question 7 above) T4. Did you make superannuation contributions to a complying fund on behalf of your spouse NO YES *If Yes, please provide the following information required. Name of Superannuation Fund: Amount of contribution: $... NOTE: Only eligible if spouse s assessable income and reportable fringe benefits <$13,800. 5

6 T5. Zone or overseas forces NO YES *If Yes, please provide the following information required (i) Location.. Number of days away (ii) Location.. Number of days away (iii) Location.. Number of days away T6. Net medical out of pocket expenses >$2,120 ($5,000 for taxpayers with ATI >$84,000 for singles or $168,000 for families) NO YES *Annual statement of benefits from private health Insurance company and Medicare, and any other receipts not included in the statements above T7. Dependent (invalid and carer) NO YES *Not eligible if your ATI or if you had a spouse, combined ATI was >$150,000 T8. Did you have an unused landcare and water facility tax offset from a previous year that you can use this year NO YES T9. Were you an Australian resident born before 1 July 1957 and received net income from working of $63,000 or less NO YES T10. Were you entitled to a tax offset for interest from the infrastructure borrowings scheme NO YES T11. Are you entitled to a Conservation tillage refundable tax offset for an eligible no-till seeder (eligible seeder) NO YES OTHER/ADJUSTMENTS M1. Medicare levy reduction or exemption NO YES *Note: ML threshold is $20,542 for singles and $39,638 (Available to low income individuals and families) for families plus $3,640 for each dependent child Number of dependent children and students Full 1.5% levy exemption number of days Half 1.5% levy exemption number of day.... *Medicare levy exemption certificate M2. Medicare levy surcharge (MLS) **THIS ITEM IS COMPULSORY** i. For the whole period of 1 July 2012 to 30 June 2013, were you and all of your dependants (including your spouse) if any, covered by private patient HOSPITAL cover NO YES *If Yes, provide 2012/13 Private Health Insurance Statement. 6

7 A1. Were you under 18 on 30 June 2013 NO YES *If Yes, please answer the following question On 30 June 2013, you were (please tick) Working full time or had worked full time for three months or more in 2012/13 (ignoring full time work followed by full time study) and intending to work full time for most or all of 2013/14 and not study full time in 2013/14 Entitled to a disability support pension or someone was entitled to a carer allowance to care for you Permanently blind Disabled and were likely to suffer from that disability permanently or for an extended period Entitled to a double orphan pension and you received little or no financial support from your relatives Unable to work full time because of a permanent mental or physical disability and you received little or no financial support from relatives You were the main beneficiary of a special disability trust A2. In 2012/13, did you become an Australian resident for tax purposes or stop being an Australian resident for tax purposes NO YES *Date became an Aust resident: / / OR Date ceased being an Aust resident: / / A3. Government super contribution Did you make an eligible personal super contribution (for which you are not claiming a deduction) to a complying super fund and you were under 71 years old on 30 June 2013 and your taxable income was less than $46,920 NO YES *If Yes, please provide the following information required Name of Superannuation Fund:.. Amount of contribution: $... A4. Amount on which family trust distribution NO YES *Only relevant where a trust, company or partnership tax has been paid within a family group has distributed to an entity outside the family group C1. During 2012/13, did you make any payments to the ATO more than 14 days before the due date NO YES *Does not include PAYG instalments INCOME TEST INFORMATION (THIS SECTION MUST BE COMPLETED!!!) IT1. Total reportable fringe benefits NO YES *PAYG payment summaries IT2. Reportable employer superannuation NO YES *PAYG Payment summaries contributions IT3. Tax-free government pensions NO YES *Annual govt payment summaries IT4. Target foreign income NO YES *Amounts in AUD$... Details. (Disclose if you have received income from sources outside *Amounts in AUD$... Details. Australia that is neither part of your taxable income nor a fringe benefit) 7

8 IT5. Net financial investment loss Did you receive income from, or claim deductions for: - Shares in a company NO YES - An investment in a managed investment scheme, including a forestry managed investment scheme NO YES - Rights or options for shares or managed investment schemes NO YES - Distributions from a partnership that included income or losses from an investment listed above NO YES - Any investment that is of a similar nature to those listed above NO YES IT6. Did you earn rental income and claimed rental deductions that exceeded the rental income NO YES *If Yes, please complete Rental Checklist IT7. Child support you paid NO YES *If Yes, how much in 2012/13 $ IT8. Number of dependent children (if applicable) Spouse details married or de facto (including same sex) 1. Taxable Income for the 2013 income year 2. Share of trust income on which the trustee is assessed under S.98 of the ITAA36 not included in your spouse s taxable income for Trust/company distribution income paid in respect of which family trust distribution tax was paid by the trust/company 4. Total Reportable fringe benefits amounts 5. Australian Government pensions and allowances excluding exempt pension 6. Exempt pension income 7. Reportable superannuation contributions 8. Tax-free government pensions paid under the Military Rehabilitation And Compensation Act Target foreign income 10. Total net investment loss (total of net financial investment loss and net rental property loss) 11. Child support paid during 2012/ If spouse is 55 to 59 years old, amount of superannuation lump sum (other than a death benefit) during the 2012/13 income year which included a taxed element that does not exceed their low rate cap 8

9 NEW CLIENTS ONLY 1. Please provide a copy of your most recently lodged Tax Return 2. If you are a sole trader, please provide a copy of your most recently prepared Financial Statements I confirm that the above information is correct to the best of my knowledge and that where necessary I hold documentary evidence in support of my claims. Dated the.. day of. 20 Signature of Taxpayer Name (print) OFFICE USE ONLY If Yes at D12, does the client pass the 10% test (circle one) NO YES 9

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