Financial year *01/07/2022 to 30/06/202301/07/2021 to 30/06/202201/07/2020 to 30/06/202101/07/2019 to 30/06/202001/07/2018 to 30/06/201901/07/2017 to 30/06/201801/07/2016 to 30/06/201701/07/2015 to 30/06/201601/07/2014 to 30/06/201501/07/2013 to 30/06/201401/07/2012 to 30/06/201301/07/2011 to 30/06/201201/07/2010 to 30/06/201101/07/2009 to 30/06/201001/07/2008 to 30/06/200901/07/2007 to 30/06/200801/07/2006 to 30/06/200701/07/2005 to 30/06/200601/07/2004 to 30/06/2005
TitleMrMrsMsMiss
Name *
Mobile Number
Business Number
Home Address
Post Code
Contact Email *
Date of Birth *
TFN
Occupation
Please tick relevant box:
I would like to have my return prepared then sent to me for signingI would like to have my return prepared then contacted for an appointment to sign.
1a. Are you a resident for tax purposes?
NoYes
1b. Have you been in Australia for the full financial year?
YesNo
Date Entered
Date Left
2. Are you in Australia on a Visa?
Type of Visa
Date Obtained
3. Are you entitled to use the Medicare system?
Please attach your Medicare Levy exemption certificate, 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.
4. Please provide your bank account details below (for refund if applicable).
BSB
ACCT NO.
NAME THE ACCOUNT IS IN
BANK
5. Did you have a spouse during the period?
NoAs per last yearYes
NAME
D.O.B
2023 TAXABLE INCOME
Number of days with spouse (eg 365)
6. Do you have dependent children?
NB: This only applies to residents of Aus for social security purposes.
Child/Children Information
Name
DAYS CARED FOR (EG: 365)
-+
7. Are you receiving fortnightly Family payments from Centerlink?
8. Do you have Australian approved Private Health Insurance cover?
Please attach "Private Health Insurance Statement for the period"
9. And if so have you claimed the 30% reduction in your premiums?
N/AYesNo
IF NO TOTAL REBATE AS PER HEALTH FUND STATEMENT
10. Do you have a HECS-HELP debt? (higher education contributions scheme
NB: If you have a PELS liability it will be included on your HECS-HELP statement
BALANCE AS AT 28/11/2023
11. Do you have a SSL? (Student supplement loan)
12. Have you completed quarterly or Annual PAYG instalment activity statements (IAS)?
Date
Amount
13. Have you made personal superannuation contributions on top of Employer support?
Total
14. For your Spouse?
15. Have you received a payment summary from your Employer?
16. Have you received any Paid Parental Leave for the period?
17. Have you received a payment summary from Centerlink or any other Government Body?
Please attach "Tax Return Copy" only
18. Have you earned any Bank interest?
Bank
TFN Tax
Bank Fees
19. Have you received any dividends?
Company
Unfranked
Franked
Imputation Credit
20. Have you received any income from managed funds or cash management trusts?
Please attach copy of annual tax and capital gains statements
21a. Have you sold any shares or units in managed funds?
Please attach copy of statement/buy & sell contacts
21b. Have you sold any real estate property, including your principal place of residence
Please attach copy of contract of sale & statement of adjustments relating to when you bought the property and when you sold the property and all the associated expenses and bank statements
22. Do you have an investment property?
Please attach all relevant documents or a summary of all income & expenses
23. Do you have income from small business?
24. Have you received any Foreign Source income?
Please attach all relevant documentation
25. Have you received any other assessable income?
NB - Do not provide any expenses already reimbursed. This is for non-reimbursed expenses only.
26a. Did you do any Motor Vehicle travel?
26b. Have you maintained a log book?
26c. Will your employer be able to validate this work-related expense, in the case of an ATO audit?
A - Please give a brief explanation on how travel relates to business
ESTIMATED BUS. KLM's
REGISTRATION
MAKE & MODEL OF CAR
LITERS IN ENGINE
B - Please give a brief explanation on how travel relates to business
LOG BOOK %
FUEL
REGISTRATION & INS
INTEREST ON LOAN
MV. LEASE PAYMENTS
REPAIRS & SERVICES
DATE CAR PURCHASED
PURCHASE COST
27a. Did you have any other work related travel?
AIRFARES
ACCOMMODATION
MEALS
INCIDENTALS
27b. Did you maintain a travel diary
DAYS TRAVELED
TAXI
PARKING
TRAM
TRAIN
27c. Will your employer be able to validate this work-related expense, in the case of an ATO audit?
28a. Did you have to wear a uniform or protective clothing?
UNIFORM PURCHASE
PROTECTIVE CLOTHING PURCHASE
NON SLIP SHOES
PROTECTIVE SHOES
SUNSCREEN
DRY CLEANING
28b. Will your employer be able to validate this work-related expense, in the case of an ATO audit?
28c. Did you have to launder your uniform?
29a. Did you incur cost for self education relating to your work?
COURSE FEES
UNION FEES
TRAVEL
STATIONARY, PHOTOCOPYING
BOOKS
INSTITUTION
COURSE NAME
Please give a brief explanation on how self education relates to your current employment
29b. Will your employer be able to validate this work-related expense, in the case of an ATO audit?
30a. Did you have other work related expenses?
Seminars
@ Business %
Claimable Deduction
Date Purchased
Stationary
Laptop
Computer
Computer Software
Home Telephone
Mobile Telephone
Internet Charges
Tools & Equipment
Subscriptions & Union
Journals & Periodicals
30b. Will your employer be able to validate this work-related expense, in the case of an ATO audit?
31. If it is your first year with RDV are you depreciating items on your last years return?
N/ANoYes
PLEASE ATTACH COPY OF DEPRECIATION SCHEDULE
32a. Do you ever work from home and have you maintained a logbook?
Hours worked during period
32b. Will your employer be able to validate this work-related expense, in the case of an ATO audit?
33. Have you taken out an investment loan to purchase shares or managed funds?
Interest
Bank Charges
34. Have you made any gifts, charity purchases or donations of $2 or more to an eligible organization?
35. Do you have income protection insurance?
TOTAL
36. Did you incur Tax Agent fees last year?
37. Did you incur fees for investment/business advice?
38. Do you have further deductions?
DETAILS
AMOUNT
Comments
I declare that the information I have given in this questionnaire including any attachments are true and correct. 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 SIGNITURE:
Date:
Once you have completed questionnaire please attach payment summary and any relevant documentation and forward to:
ATTN: TAX SPECIALIST TEAM RDV BUSINESS SOLUTIONS 41 CUMBERLAND ROAD PASCOE VALE VIC 3044 Ph - 03-8640-3700 Fax - (03) 9350 1063 info@rdvbs.com.au
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