A YOUR INCOME INDIVIDUAL INCOME TAX RETURN CHECKLIST YOUR NAME: CONTACT PH (B): (H) (M) Tax File N o OCCUPATION: ADDRESS: Y N Y N Y N

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1 PO Box 629 Malvern VIC Glenferrie Road Malvern VIC 3144 phone (03) fax (03) AB website IDIVIDUAL ICOME TAX RETUR CHECKLIST OUR AME: COTACT PH (B): (H) (M) DOB: Tax File o OCCUPATIO: ADDRESS: A OUR ICOME 1. Have you received all of your: Unemployment or AUSTUD Statements? Payment Summaries? (Formally known as Group Certificates) Eligible Termination Payment Statements? Pension or Annuity Statements? Specify the undeducted purchase price (if known) If so, please send in the appropriate information. (ie Payment Summaries, ETPs etc) 2. Did you receive interest on any Bank Accounts/Other Investments? If so please provide details of all accounts on which interest was received, the amount(s) received & if accounts are jointly held. 3. Did you receive any distributions from Trusts or Partnerships? If so, please send in the appropriate information. (ie. Annual Tax Summaries, Financial Statements and Tax Returns) 4. Do you have a rental property? If so, then we need details of rent received, interest paid and other deductions for each property. We also require details of any assets purchased in relation to the property during the year such as furniture etc. We will require the cost, date of purchase and a description of the item. If the property was purchased during the year we need the following information:- purchase contract contract date and settlement date list of chattels bought and cost of each (eg. stove, hot water service, carpets, curtains, blinds, oven, heater, etc) details of borrowing costs (such as loan application fees & mortgage discharge fees) and term of loan details of stamp duty and legal fees paid details of expenditure relating to major structural renovation date the property was first constructed (year and month are adequate) date the property was rented out if applicable marketing expenses (not including entertainment) search fees relating to a CGT asset (such as fees to check land titles, but not travel costs to find an asset suitable for purchase) the cost of a conveyancing kit (or similar cost) 5. Do you own any shares? If so, we need the dividend statements for the year or a schedule of total dividends received from each company for the year as follows: Unfranked Dividends Franked Dividends Imputation Credits 1

2 IDIVIDUAL ICOME TAX RETUR CHECKLIST B OUR DEDUCTIOS 6. Did you purchase any shares or interests under an Employee Share Scheme (ESS)? If so: Did you receive a discount on ESS interests you acquired under a taxed upfront scheme? Did a deferred taxing point occur in respect of ESS interest acquired at discount under a deferral scheme? Did a cessation time occur during the income year in relation to the ESS interests you acquired before July 2014 under an ESS and you had not elected to be taxed upfront on the discount on those shares If you answered yes to any of the above questions regarding Employee Share Schemes, we will need the purchase details including any discounts received for these ESS interests, and any statements recieved. 7. Did you sell any assets during the year that may give rise to Capital Gains Tax? (eg. Shares, Rental property, or Investments.) If so we need the following information: asset description purchase and sale dates (contract dates preferable, but if not available an estimated date). cost price and sale price (including purchase price, sales commission, stamp duty, legal expenses, brokers fees etc.) Please attach details and documents. If shares were sold, we require the sale and original purchase documents and any dividend reinvestment documents. (These must show the purchase / sale prices and dates.) 8. Did you receive any other income? If so we need full details of the source and amount of income received. MOTOR VEHICLE 9. Are you required by your employer to use your car for work? If so, please provide the following: Owner: Make & Model: Engine Size: Cost of Vehicle: Odometer - 1 July 2014: Odometer - 30 June 2015: Log Book Business % / Business km travelled Date log book kept: If you travelled 5,000 business kilometres or less, we need details of the business kilometres travelled, your car type and its engine size and registration. OR If you travel more than 5,000 business kilometres for work and would like to use the log book method, then we require a copy of the log book and the actual running costs of the car such as: Registration Insurance and Roadside Assistance Repairs & Maintenance Petrol - If you do not have receipts, please provide an estimate (eg $20 per week) Lease or Hire Purchase (HP) payments 10. Did you buy or sell a motor vehicle during this financial year, which was used for work? If so please provide the following details: If a car was sold, we need: Date of Sale: Sale Price: Dealer sale document (incl. trade-in) Finance payout information (if any) If a car was bought, we need: Date of Purchase: Purchase Price: Dealer sale document (incl. trade-in) Finance information (lease/hp, if any) 2

3 IDIVIDUAL ICOME TAX RETUR CHECKLIST TRAVEL 11. Did you incur any work-related travel expenses? If so, we need a list of expenses incurred. Please note that a diary should be kept if away from home for 6 nights or more and receipts should be supplied where possible. CLOTHIG 12. Did you incur any expenses in relation to uniforms or protective clothing including the laundry / dry cleaning of these uniforms? If yes please provide a list of these expenses, and supply receipts where possible. SELF EDUCATIO 13. Did you complete any courses that were related to your work? If yes, we need to know what type of course and what expenses were incurred. Please supply receipts where possible. ITEREST DEDUCTIOS 15. Did you incur any expenses in the course of earning any interest? This may include account keeping fees for accounts held for investment purposes or management fees for investment advice. Please provide documentation and receipts for these expenses. DIVIDED DEDUCTIOS 16. Did you incur any expenses in the course of earning dividend or similar investment income? This may include any fees for investment advice relating to your investments, interest charged on money borrowed to purchase these shares or similar investments or costs relating to managing your investments such as travel and buying specialist investment journals or subscriptions. Please provide documentation and receipts for these expenses. OTHER 17. Did you have any other work related expenses such as: Union dues Mobile Phone Bills Tools Sickness & Accident Insurance Depreciation (professional library, tools, equipment) Car parking Seminars & Conferences Stationery Briefcase or Calculator Subscriptions Sun protection Any other expenses If so, we require details of these expenses in summary form, or the actual receipts. HOME OFFICE 14. Did you perform any work at home? If yes, could you please estimate how many hours a week you work at home and provide a list of expenses related to this; eg. stationery, books, furniture. If you are claiming home office expenses, we require a list of the house expenditure such as light & power etc and an approximate % relating to home office use. Please supply receipts where possible. 3

4 IDIVIDUAL ICOME TAX RETUR CHECKLIST SUPERAUATIO 18. Do you personally contribute to a Superannuation Fund (not including amounts contributed by your employer)? If yes, specify details Superanuation Fund: COST OF MAAGIG TAX AFFAIRS 23. Did you incur Tax Agent Fees for preparing last years Tax Return? If yes, we need to know the amount and who it was paid to. Policy umber: Amount: Other details: LIFE ISURACE 19. Do you have life insurance cover? Is it paid by you through your superannuation fund? Provide details of your fund: ame of Fund: Policy umber: Amount Paid: ICOME PROTECTIO ISURACE 20. Do you have Income Protection Insurance? Provide details of your fund: ame of Fund: Policy umber: Amount Paid: LOAS 21. Did you take out any new loans / borrow for business or investment purposes? If yes, we need details of the purpose of the loan, the loan statement(s), the term of the loan, application costs and other expenses paid to the bank in relation to the loan. DOATIOS 22. Did you make any donations of $2.00 or more to deductible gift recipients? If yes, please provide a list of these donations, and receipts if possible. ote that we will need specific details if any donations are to political parties or independent members or candidates for Parliament. 4

5 IDIVIDUAL ICOME TAX RETUR CHECKLIST C A OTHER IFORMATIO D REBATES 24. Do you have a H.E.L.P. or FEE-HELP debt or a financial supplement loan? If yes, please provide us with a copy of the statement(s) or amount of debt outstanding. 25. Did you cease full time education during the year? If yes, we need to know the net income earned while a full time student and the date of ceasing full time education. 27. Did you have a spouse (married/defacto) at 30 June 2014? If yes, please include the following information: Full ame: Date of Birth: Tax File umber: Income Received: Wages, benefits from DSS, interest etc.: Expenses Incurred: 26. Did you become a resident of Australia or cease being a resident of Australia during this financial year? If yes, we need to know the date residency status changed and details of any income earned overseas, during the period that you were a resident. Please provide documentation where possible. Bank charges, child-care expense, travel expenses etc. (or spouse s taxable income if unknown): 28. Do you have any children? If yes, please include details such as; full name, date of birth, number of nights under your care and any income received by these children. 5

6 IDIVIDUAL ICOME TAX RETUR CHECKLIST 29. Do you have any dependents other than your children eg. Parents? If yes, please include details such as; full name, date of birth and relationship of dependent. SUPERAUATIO 33. Did you make any contributions to your spouse s superannuation fund? If yes, please include details of the amount of contributions and the taxable income of your spouse. OTHER 34. Do you have a Family Assistance Office debt? If yes, do you consent to use some or all of your tax refund to repay this debt? 30. Are you a sole parent? MEDICAL EXPESES REBATE 31. Were your family s out of pocket Medical Expenses over $2,120 (this amount is income tested) i.e. after Medicare and private health insurance reimbursements? If so you may be able to obtain a rebate. Please provide the following expense details: Payments to doctors, hospitals, chemists, & payments for dental, optical or therapeutic treatment. We also require copies of any Medicare rebate statements and any private insurance rebates received in relation to the above expenses. This rebate can only be claimed if there was a claim in the 2014 financial year. HEALTH ISURACE 32. Did you contribute to any Private Health Insurance during the year? If yes, you should receive a statement from your health fund in regards to the rebate you maybe entitled to. Please include this with your information. 6

7 IDIVIDUAL ICOME TAX RETUR CHECKLIST E REFUD If you are eligible for a refund we will require your bank account details so your refund can be deposited directly into your bank account. Without this information we will be unable to complete your return. Please provide your account details below: Financial Institution: Account ame: BSB: Account umber: Please provide any additional information and sign & date the bottom of the page. A ADDITIOAL IFORMATIO Completed By: Signature: Date: THAK OU FOR OUR TIME AD EFFORT I COMPLETIG THIS CHECKLIST 7