Client Checklist 2021-22

2021-22
SOUTHSIDE TAXATION & FINANCIAL SERVICES PTY LTD

ABN: 62 099 752 888

CLIENT CHECKLIST FOR 2021-2022 INCOME TAX RETURN
A CLIENT DETAILS : (COMPLETE ONLY IF YOUR DETAILS ARE CHANGED OR NEW CLIENT)
Name:…………………………………………………………………………….Tax File Number:………………………………………………………………

Date of Birth:………………………………………………..Email: ………………..……………………………………………………………………….…….

Address:…………………………………………………………………………………………………………………………………………………………….

……….…………………………………………………………………………………………………………………………………………………………..…..

Telephone No: (H)…………………………………(M)………………………………Occupation……………….………………………………..……………
B INCOME DETAILS : (PLEASE PROVIDE SUPPORTING DOCUMENTS)
1 Did you receive any income from:

Salary/wages (Please provide PAYG Summary) ……………………………………………………………………………………..

Centrelink income Payments (like Newstart allowance/Youth allowance/Pension/Maternity leave payment

JOB SEEKER/paid parental leave etc.)…………………………………..

Bank interest & withholding taxes (Please provide bank statement)…………………………………………………………….

Dividends including reinvested dividend from shares (Please provide statement)………………………………………….

Trust (eg: unit, cash management, partnership, deceased estate) ……………………………………………………………..

Did you receive any lumpsum payments (Eg ETP)? …………………………………………………………………………………

FOR CAPITAL GAINS TAX purpose did you sell/ dispose off any assets in Australia and/or overseas

eg: SHARES, BITCOIN, CRYPTO CURRENCY, LAND, INVESTMENT PROPERTY etc) …………….

Did you receive any FOREIGN SOURCE INCOME (eg: foreign employment/Pension/ Interest/Rent) ……………….

Did you receive any other form of income (Royalties, Consulting fees etc)? ………………………………………………..

Did you receive any business income or incur any business expenses with ABN? ……………………………………….

Do you own a rental property?

If yes please summarise the following item in the attached schedule

a) Rent received                                                                 b) Agent’sfee/commission

c) Council rates                                                                   d) Waterrates

e) Repairs & Maintenance (dates and details required)         f) Interest on loan as per bank statement

g) Strata levies                                                                     h) Other

If newly acquired or sold, provide settlement details:

Are you a SOLETRADER: YES/NO. If YES Have you received JOB KEEPER Payment from the ATO :YES/NO

 (Please circle)

YES       NO

YES       NO

YES       NO

YES       NO

YES       NO

YES       NO

YES       NO

YES       NO

YES       NO

YES       NO

YES       NO
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C DEDUCTIONS
a

b c d e f g h

i

 Did you incur any work related expenses which you have documentation for:

Work related motor vehicle expenses (either summarise vehicle expenses including

fuel/rego/repairs & maintenance, lease payment details or log book for business kilometers travelled)…………..            YES      NO

Uniform expenses, laundry and drycleaning……………………………………………………………………………………………              YES      NO

Self- Education expenses more than $250 ……………………………………………………………………………………………….           YES      NO

Purchase of Capital Assets (laptop/Computer/Car) …………………………………………………………………………………..           YES      NO

Union fee/Subscriptions/Magazines ……………………………………………………………………………………………………….          YES      NO

Income Protection Insurance………………………………………………………………………………………………………………….           YES      NO

Anyotherworkrelatedexpenses /Work from home /Home office………………………………………………………………………….Y…E..S………N…O.

Donations to eligible organisations …………………………………………………………………………………………………………             YES      NO

Previous  year Taxagent fee………………………………………………………………………………………………………………….            YES      NO

D Do you have private health insurance cover? (Pl provide policy certificate) ……………………………. YES NO
E Are you eligible for medicare levy exemptions

If yes have you applied for the exemption certificate? ……………………………………………………………………………….

 YES

YES

 NO

NO
F OFFSET/REBATES
1. Dependent (invalid and carer) – Rebate can be claimed for parents only if they are receiving disability
support pension or invalid service pension ………………………………………………………………………………………………. YES NO
2. Did you receive single parenting payment from Centrelink? ……………………………………………………………………….. YES NO
3. Have you made any super contribution for your spouse? …………………………………………………………………………… YES NO
G Are you making any Child Support payments?……………………………………………………………………………………….. YES NO
H Do you have any outstanding commonwealth Liabilities? ……………………………………………………………………….. YES NO
I Do you have a HECS Debt? …………………………………………………………………………………………………………………. YES NO
J Any other information which may be relevant to the completion of this Tax Return? …………………………………….. YES NO
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