INSTRUCTIONS

1. This questionnaire is design to collect your personal information to assist in the preparation of your income tax return.

2. Your comments will help promote discussion with your tax advisor to ensure you make the most of your tax position.

3. Please note, not all items and sections will be applicable to your tax affairs, complete as much as you can.

4. You may save and come back to complete the application at any time, just press the "Save & Complete Later" button at the bottom of the questionnaire. A link of the questionnairewill be emailed to you.

5. Once you have submitted the form , your advisor will draft your tax return and come back to you with any further queries or questions.

Security & Privacy

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First Name *

Last Name *

Tax File Number *

ABN (If Applicable)

Date Of Birth *

Mobile Contact No

Email Address

Work Contact No

Address *

Electonic Banking Details (For Refund If Applicable)

Account Name

BSB

Account Number

INCOME

Main Occupation

1. Salary or WagesDid you work for an employer during the year?

2. Allowances, earnings, tips, director's feesDid you receive any other income in relation to your employment?

3. Employment termination payments (ETP)Commonly applicable if you have changed jobs during the year or have been made redundant.

4. Government allowances/paymentsDid you receive payments such as Youth Allowance, Jobseeker & Austudy?

5. Australian government pensions & allowancesDid you receive any government pensions from Centrelink or the Department of Veterans' Affairs?

6. Australian annuities & superannuation income streamsTypically this is a pension drawn from your superannuation if you are of retirement age

7. Gross interestDid you receive interest income from savings or term deposits maintained in a bank account?

8. DividendsDid you receive dividend income from Australian or Foreign Shares held in your name?

Please provide the company name(s) of shares heldWe will cross check the company names you provide with the tax office records

9. Employee share schemesApplicable if you receive an allotment of shares in the company you work in as part of your remuneration package

10. Distributions from Trusts (Managed Investment Funds)Have you received income from units you hold in managed investment funds?

Please upload the annual tax statement for any income received from managed investment funds

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11. Personal services income (PSI)Did you receive PSI income from your employment? Applicable for those who are contractors.

12. Net Income or Loss from businessDid you operate as a sole trader and carry on a business during the year?

Please provide further details regarding the sole trader business you operated during the year.

13. Capital gainsDid you realise a capital gain or loss on the sale of an asset during the year? Eg sale of investment property, shares, bonds etc

Please provide details of capital gain event as per the previous question.

14. Foreign source income & foreign assets or propertyDid you receive any income from assets or property held overseas?

Please provide details of income received from foreign held assets or property

15. Rental income (Investment property)Did you receive any rental income for an investment property held during the year? (Includes properties listed on AirBnB)

Please upload the Annual agent summary including any other expenses to be claimed.

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We'll be in touch to conduct a full rental income and expense review.

16. Other IncomeDid you receive any other income not covered in the previous sections that you would like to discuss?

Please provide further details of any other income received during the year to be discussed.

DEDUCTIONS

D1. Work related car expenses

Lets first determine if you have a valid work related car claim

Did you use your car for work related travel?Refer to the above graphic to determine if you have a car claim

Which method of car claim do you wish to use?

How many kilometres of work related travel did you cover during the year?You can claim a maximum of 5,000km and your claim will be based on 88 cents per KM

Provide cost details of running costs and business use percentageEg. Fuel, insurance, rego, CTP, service, repairs. What percentage relates to business use? eg. 60%

Do you drive an Electric Vehicle (EV)

D2. Work related travel expenses

You may have a claim if you have incurred travel costs as part of your employment. Items that can be claimed include: (must be out of pocket):

short term car hire
Public transport fares
Road tolls
Parking fees
Taxi/Uber fares
Meal & accomodation expenses you incurred while away or overnight for work.

Did you incur any work related travel expenses?

Details of work related travel expensesProvide cost details of work related travel expenses to be claimed including an explanation of the nature of the expense

D3. Work related clothing & laundry expenses

If you are required to wear industry specific clothing or protective wear, you may be able to claim the cost of purchasing those items and/or laundering them. Items you may be able to claim:

Purchase of protective clothing
Purchase of industry specific uniform (items with logo, branding etc)
Purchase of occupation specific clothing (eg chefs checkered pants)
Laundry or dry cleaning of clothing listed above.
Note - General corporate wear is not tax deductible

Did you purchase or launder any items of work related clothing as described above?

Provide details as per aboveInclude cost details and a description of items purchased. If claiming laundry costs, just type "Claiming Laundry"

D4. Work related self-education expenses

Eligibility to claim

You can claim self-education and study expenses you incur when the course you take leads to a formal qualification and meets the following conditions.

The course must have a sufficient connection to your current employment activities as an employee and either:

maintains or improves the specific skills or knowledge you require in your current employment activities
results in or is likely to result in, an increase in your income from your current employment activities.

You can claim a tax deduction for the following general course expenses

Course & tuition fees, text books, study material
computer consumables, Office equipment, Stationary
Home office running costs
Parking fees
Travel costs, including car expenses

Do you have a work related self education claim?

Provide details of cost and the name of the course undertaken in relation to the work related self education expenses

D5. Other work related expenses

Did you work from home during the year?If Yes, how many hours in total did you work from home during the year?, Eg 650 hours (The ATO prescribed rate will cover power & gas for heating & cooling)

Do you use your home internet for work use?If yes, what is your monthly bill and what percentage relates to work? eg $90pm, 60%

Do you use your personal mobile for work use?If yes, what is your monthly bill and what percentage relates to work? eg $90pm, 60%

Did you purchase an items of stationary or office equipment for work use?If yes, please include details of purchases Eg, Stationary $50, Desk Lamp $80

Do you pay any Subscription or Union fees related to your work?If Yes, include cost and nature of expense. Eg Software subscription $50, Union Fees $500

Did you undertake any short courses or seminars you paid for?If Yes, include cost details and nature of expense

Did you incur any other work related deductions you wish to discuss?If Yes, include details to discuss further

You may wish to attach copies/photos of large purchases. Eg Computer Equipment, Office Furniture etc

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D6. Gifts or Donations

Did you make any donations to a registered Charity?If Yes, include details. Eg Cancer Council $50, Heart foundation $150

D7. Cost of managing tax affairs

Did you pay for a registered tax agent/accountant to complete last year's tax return?If Yes, include cost details

D8. Personal Superannuation Contributions

Did you make a Personal super contribution during the year?If Yes, provide amount paid, date of payment, and the name of your superfund (This excludes super paid for you by your employer)

D9. Other Deductions

Did you pay for an Income Protection Insurance Policy Premium?If yes, please provide annual premium cost. (Note this is for a policy held outside of your superfund income insurance)

Do you have any other deductions you would like to discuss?List any other expenses you have incurred for the year that you would like to include or discuss. Provide as much detail as you can.

Other Information

Are you entitled to the Medicare levy exemption or reduction this year?If Yes, please provide details or a medicare levy exemption certificate. (Exemptions usually apply to non-residents, war-widows and defence force personnel).

Did you have Private Health Insurance for the year which includes appropriate HOSPITAL cover?

Do you have a HECS/HELP liability or a student financial supplement loan debt?

Were you an Australian Tax Resident for the full year?

Did you have a Spouse for the financial year?

Spouse details requiredRequire Spouse full name, date of birth and taxable income for the year

Did you have care of a dependent child for the year?

How many dependent children were in your care for the year?

ATO Mandatory Questions

Did you have a Capital Gains Tax event during the year?Typically a sale of shares, investment property or other taxable assets. If Yes, provide details

Do you have foreign assets worth more than AU$50,000?

If Yes, please provide details of foreign assets

Do you have either direct or indirect interest in a controlled foreign company (CFC)?

If Yes, provide details

Have you EVER, either directly or indirectly, caused the transfer of property or service to a non-resident trust estate?

If Yes, provide details of transfer

Has any part of your name changed since last completing your tax return?

Please confirm the changes to your name

Other Comments & Questions

Please include any other information you wish to provide or any questions or concerns you may have in relation to your tax return

File/Document Upload

You may attach any documents or receipts you wish to include in your submission here

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Declaration

I, the taxpayer declare the information contained in this document is true to the best of my knowledge. I further instruct and authorise Norwest Tax Solutions to access my ATO records and complete my income tax return for the financial year. I confirm I hold the necessary information & documents to substantiate my claims. *

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