Personal Tax Kit 2015/2016

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Personal Tax Kit 2015/2016 Name Saving us time saves you money. Completing this Tax Kit and providing the requested information assists us in efficiently preparing your Tax Returns. If you need a hand we are happy to help you fill in the details. Thank you in advance for taking the time to complete this Tax Kit 141 Baillie Street PO Box 737 P. (03) 5381 1088 Horsham VIC 3400 Horsham VIC 3402 F. (03) 5382 0950 www.bchaccountants.com.au E. info@bchaccountants.com.au... advisers to business

2015/2016 Substantiation Declaration I confirm that you have advised me that I must demonstrate that I have incurred an expense for income producing purposes. In addition you have advised me of the stringent SUBSTANTIATION legislation I must satisfy in relation to work, car and business travel expenses. In addition, you have informed me that I must OBTAIN ORIGINAL RECEIPTS and keep them for a minimum of five years from the date my return is lodged. The receipts must contain the following details: 1. Name of supplier; 2. Amount of expense; 3. Nature of goods and services, (noting the specific type of items purchased or expenditure incurred which I am able to personally record up to the date of lodgment of my return where not adequately noted by the supplier); 4. Date of expense, (which I am able to personally record where not noted by the supplier). Penalties to apply with incorrect returns You have also advised me that additional tax, penalties, interest and possible prosecution action may be taken against me by the ATO if I provide details which lead to an incorrect tax return being lodged. In addition, you have informed me that an important feature of the new tax agent services regime which commenced on 1 March 2010 is the provision of a 'safe harbour' protection from penalties in certain circumstances for taxpayers who engage registered tax agents. You have also advised me that in order to obtain the benefits of 'safe harbour' protection, I must provide you with 'all relevant taxation information' to enable accurate statements to be provided to the Australian Taxation Office. Income from sources in and out of Australia for the year of income You have advised me that as an Australian resident I must declare income from all sources, in and out of Australia, including net capital gains received, for the year of income in my tax return. Apportionment Where items are used for both business and private purposes eg car, mobile telephone, home telephone, computer, etc, I advise I have records to verify my business usage claim. In addition my employer will verify that it was necessary to incur such expenditure in earning my assessable income. Further, I have instructed you to prepare the return based on me being able to produce these records, if required. Audit matters I further confirm that: I. I am aware of the procedures to follow if a document is lost or destroyed; II. I may be required to verify any income or expense item noted in my return in the event of an ATO audit; III. I understand the Substantiation schedules I completed for all work, car and travel expense claims under selfassessment; IV. I understand that, for the purposes of obtaining "safe harbour" protection, it remains my responsibility to properly record matters relating to my tax affairs and to bring all of the relevant facts to your attention in order to show reasonable care; and V. I have read and understood the return prepared for me : I declare that: a) I have disclosed and you have returned all of the income, including net capital gains which I have earned/received for the 2016 income year. b) All income declared, claims for deductions and tax offsets/rebates included in my return are based on my specific instructions and advise that I satisfy the relevant taxation requirements. c) I have the receipts or documentation necessary to substantiate the above claims and I will make them available if required by the Tax Office; and d) That you have clarified what written evidence (including car/travel records) will be required during an audit and penalties, (including prosecution) that may be applied if incorrect claims are identified in an audit situation. Signature of taxpayer Dated the day of 20 Email address for delivery of Notice of Assessment

Update Our Records Please fill in the following information so that our records can be updated with the correct details. Name of Entity BCH Accountants (Vic) Pty Ltd Trading/Business Name BCH Accountants (if applicable) Home Address 141 Baillie Street Horsham 3400 Mailing Address PO BOX 737 Horsham 3402 Phone Number Home Work (03) 5381 1088 Mobile Number Fax Number (03) 5382 0950 E-mail Address info@bchaccountants.com.au Australian Business Number 91 104 634 700 Accounting Software MYOB AE Software Version 5.4.0.726 Children(s) Name & DOB

Your Personal Tax Information Please consider the following 21 items and circle the answers where applicable. Yes answers require further information such as lists, dates, amounts and supporting documents. Your Name Spouse 1 Interest Income Please complete Schedule 1. YES / NO YES / NO (Include Trust Accounts for your children, if you control the money). 2 Dividends From Companies Please complete Schedule 2. YES / NO YES / NO 3 Distributions From managed or unlisted investments. YES / NO YES / NO Please supply the "Annual Tax Statement" from each Fund Manager (not the Quarterly Distribution Statements). 4 Foreign Source Income YES / NO YES / NO Including foreign pensions, wages income from foreign shares or property 5 Rental Property Please complete Schedule 3. YES / NO YES / NO 6 Capital Gains Have you sold any investments (shares, managed funds, YES / NO YES / NO rental properties, land, etc). If so, please provide purchase and sale details. Please complete Schedule 4 for Shares purchased and/or sold. 7 Pension / Centrelink Income Centrelink will no longer be sending YES / NO YES / NO out a paper copy of your annual "Pension Statement. For Pensions, Newstart or Youth Allowance you may access a paper copy if you visit humanservices.gov.au/selfservice 8 Wages Please supply all PAYG Payment Summaries (Group Certificates) YES / NO YES / NO (Also details of any Lump Sum Payments, Eligible Termination Payments and Rollovers) 9 Other Income Have you earnt any income not shown elsewhere? YES / NO YES / NO Amount $: What for? 10 Spouse Income Do we prepare your spouse's tax return? YES / NO If not - Advise: Spouse's Adjusted Taxable Income$... Spouse's TFN... Date of Birth... 11 Work Related Claims Please list below, or supply an itemised summary YES / NO YES / NO and attach all receipts/tax invoices for all work related claims: protective clothing, sun protection, uniforms, self educations, etc. Item:... $..... 12 Self Education Claims If you are undertaking study in relation to your YES / NO YES / NO current employment you may be entitled to claim expenses. Please provide all your receipts 13 Donations Please list below all tax deductible donations as per official YES / NO YES / NO receipt(s) and specify in whose name the donation was made. (Donations to School or Church Building Funds may also be tax deductible)......

Your Name Spouse 14 Motor Vehicle If you intend claiming vehicle expenses (other than a YES / NO YES / NO vehicle claimed in your business return) complete Schedule 6. 15 Life Policies/Insurance Or Friendly Society Bonds YES / NO YES / NO Have you surrendered any life policies or redeemed any Bonds? 16 Superannuation If you made a deductible contribution please provide your YES / NO YES / NO Superannuation Fund S290-170 acknowledgement Company.. Amount paid - 2015/16 $.. 17 Income Protection/Accident/Sickness Insurance YES / NO YES / NO Included here are sickness and accident insurance premiums incurred to protect against the loss of assessable income. Your insurance provider will give you a statement for the allowable deduction. Note: A taxpayer generally cannot deduct for any part (or all) of the premium that relates to compensation for loss of life or trauma. 18 Private Health Insurance YES / NO YES / NO Please supply both "Private Health Insurance Statements" summarising your tax position. 19 Health Expenses Have you spent more than $2,265 (after refunds)? YES / NO YES / NO Please note that only Disability aids, Attendant Care & Aged Care expenditure are eligible. 20 Farm Management Deposits (Primary Producers only): YES / NO YES / NO (Show interest on Schedule 1 and supply FMD statements). Name: Deposited $ Withdrawn $ Balance 30/06/16 $ Name: Deposited $ Withdrawn $ Balance 30/06/16 $ 21 Refund Direct To Your Bank Account YES / NO YES / NO The ATO will only deposit refunds directly into your bank account. Please provide your bank details... BSB A/c No Account Name

Schedule 1 Interest Received From All Sources Please do not include Credit Card Details Bank Branch A/c Number Amount of Interest A/c Fees Whose Name? Schedule 2 Dividends Received Most listed companies pay two dividends per year. Please ensure you provide details of all dividends paid for this year. Company Name Shares Held on 30/06/16* DRP No. of Shares Unfranked Amount Franked Amount Franking Credit Whose name? *Also include bonus issues and dividend reinvestment plan (DRP). Please provide statements.

Schedule 3 Rental Property Property Address Date Acquired (Please provide contract and settlement statement if purchased in 2015/2016) Property/Allotment Number (See Rate Notice) Number of Weeks Property Rented 2015/2016 Gross 2015/2016 Rent Received (Before Agents Commission) $ Owner(s) Name(s) Advertising Agents Commission Letting Fees Bank Fees and Charges Body Corporate Charges Cleaning Council Rates Gardening/ Lawn Mowing Insurance Premiums Interest On Loan(s) Land Tax Legal Fees Pest Control Repairs and Maintenance Stationary, Telephone & Postage Travelling to inspect property Number of trips Kms Per Trip Water Charges Expenses $ Signed Date

Schedule 4 Shares Purchased and Sold Purchases * Company Date Cost Number Sales * Company Date Price Number *Please provide buy and sell contracts, together with DRP/Bonus Issue details. Schedule 5 For Tax Planning Child s Name Date of Birth Income, If any

Schedule 6 Car Expenses Complete this section if you are claiming under the following methods 1. Set rate per kilometre method (To a maximum of 5000 business kms per driver) 2. Log Book Method Car Details Car 1 Car 2 Car 3 Speedo 01 July 2015 Speedo 30 June 2016 Make Model Registration Number Name registered under Engine Capacity cc cc cc Option 1 Set Rate per Km Method Car 1 Car 2 Car 3 No. of Trips to Trips to Other Business Travelling Eg. Visiting Accountant = Total Business Km Option 2 Log Book Business Use Percentage Log Book Date Log Book Date Was the car sold during the year? Started Finished Y/N Log Book Method Car 1 Car 2 Car 3 Please detail below any other information you consider relevant or other particular concerns/queries