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INSTRUCTIONS FOR FORM (click to download)


PERSONAL DETAILS

Enter your personal details.

Tax file number (TFN) *
Your sex	Male Female
Title	Mr Mrs Ms Miss
Family name
Given name
Other names
Date of birth	(dd/mm/yyyy)
Are you an Australian resident for tax purposes?	YesNo
Address line 1
Address line 2
Suburb/Town
State	Australian Capital Territory New South Wales Victoria Queensland South Australia Western Australia Tasmania Northern Territory
Postcode
Country	Leave blank if Australia
Does this address changed since completing your last tax return?	YesNo
Your contact details during business hours - if we need to ask you about your lodgment
Phone number	Area code Number
Email address
BANK ACCOUNT DETAILS
BSB number
Account Number
Account Name

Please Note: For any questions you answers “YES” to below you will be required to attach support documentation at the bottom of the form to assist in the lodgement of your taxation return.

INCOME
1.	Did you receive Wage and/or Salary Income (including PAYG Payment Summaries)?	YesNo
2.	Did you receive any Centrelink payments?	YesNo
3.	Did you receive any Dividends?	YesNo
4.	Did you receive any Trust & Partnership Distribution (including Managed Funds)?	YesNo
5.	Did you receive any Interest Income?	YesNo
6.	Did you sell any capital assets during the year (Capital Gains on sale of assets)?	YesNo
7.	Did you receive any Rental Income?	YesNo
8.	Did you receive any Overseas income/transactions?	YesNo
9.	Did you receive any Superannuation/annuity pension payments?	YesNo
DEDUCTIONS
10.	Did you pay for any self education to maintain your skills?	YesNo
11.	Did you have any home office expenses where home is used as "business premises"?	YesNo
12.	Did you have any Uniform / protective / compulsory clothing, (purchase and laundering)?	YesNo
13.	Did you purchase any tools of trade (including replacing and repairing)?	YesNo
14.	Did you have any Car Expenses (Make, model, engine capacity)? If logbook kept, details of running expenses including fuel, repairs, rego, insurance, maintenance, log book business percentage. If no log book kept, estimate of work related kilometres travelled kms.	YesNo
15.	Did you incur other expenditure as an employee related to your employer?	YesNo
16.	Did you have any personal deductible superannuation contributions – excluding any employer?	YesNo
BUSINESS INCOME
17.	Did you have any net business income/losses?	YesNo
PRIVATE HEALTH COVER
18.	Did you have any Private health insurance?	YesNo
DEPENDENTS
19.	Did you have a spouse (provide name, TFN, DOB and income)?	YesNo
20.	Did you have net Medical expenses in excess of $1,500?	YesNo
21.	Did you have dependent children under 18 – provide name & DOB of each dependent?	YesNo
HECS
22.	Do you have an existing HECS/HELP Debt?	YesNo

Attachment 1
Attachment 2
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Attachment 4
Attachment 5

TERMS AND CONDITIONS (click to download)

   BY CLICKING SUBMIT I AGREE I HAVE READ AND AGREE TO THE TERMS AND CONDITIONS OF MY APPOINTMENT OF MOORE STEPHENS MELBOURNE PTY LIMITED TO PREPARE AND LODGE MY INDIVIDUAL TAXATION RETURN.

Liability limited by a scheme approved under Professional Standards Legislation. Moore Stephens is a network of independent firms which are independent members of Moore Stephens International Limited
- member firms in principal cities throughout the world.