Form to request preparation of individual tax return

Instruction:- Please complete and submit this form to request preparation of your individual tax return.

Fields marked * are compulsary.

Please complete the form in capital letters.

if yes please provide private health insurance statement as on attatchment to this form.
If yes complete below
Details of work-related expenses
D1. Work related Car Expenses (Please note you cannot claim travel for commuting to and from your work place)
Make of Car Registration number (Rego) Purchase Date Purchase Price $ Odometer reading year Start Odometer reading year End
If you want to use cents per km method, please input number of kms travelled in the financial year (Maximum 5,000 kms) (kms)
Please put any other details in the text box below Registration $ Insurance $ Repair & Maintenance $ Fuel $
Service $ Cleaning $ Interest $ Other $
D2. Work related Travel Expenses (Air Travel, Taxis, Parking, interstate/overseas travel/accommodation, etc)
Details Amount $
D3. Work related Uniform/Laundry/Safety shoes
Details Amount$
Protective Clothing
Occupation specific clothing
Compulsory Uniform
Dry cleaning
D4. Work related Self education expenses directly releted to your work
Name of Course and Institution Date Paid Amount$
D5. Other Work related Expense
Nature Of Expense Amount$ Use for work
Home office expenses
Computer and software
Telephone/mobile phone
Tools and equipment
Subscriptions and union fees
Sun protection items
Seminars and courses
Other (please specify)
Please put the details below for any work related asset & depreciable items eg, laptop, desktop, assets costing more than $300
Date of purchase Description of Assets Purchased Amount Work related use
D9. Donations Given to tax deductible recipients
Name Amount $
Name Amount $
Name Amount $
Name Amount $
Name Amount $
Name Amount $
D10. Tax Agent Fees (paid during the financial year for which tax return is being prepared) $
D12. Personal Super Contributions for which tax deductions can be claimed
D15. Income protection, sickness and accident protection insurance. Premium paid
Foreign exchange losses/Derivative losses
Details of any other Income and Expenses not covered above
Detail Amount $
Please specify any other details relevant to your tax return not included above:
If you need to send any more information please email it to [email protected]
Attachment(select multiple files by pressing CTRL key):