Individual tax return 2017 1 uly 2016 to 30 une 2017 Please print neatly in BO TTRS with a black or blue ballpoint pen only. Your tax file number (T) See the Privacy note in the Taxpayer s declaration on page 15 of this return. re you an ustralian resident? ave you included any attachments? Your name Title for example, r, rs, s, iss Surname or family name Given names as any part of your name changed since completing your last tax return? To find out how to update your name on our records, go to ato.gov.au/updatedetails or phone 13 28 61. Your postal address as your postal address changed since completing your last tax return? Suburb or town State Postcode ountry if not ustralia Your home address If the same as your current postal address, print S BOV. Suburb or town State Postcode ountry if not ustralia Your mobile phone number Your daytime phone number (if different from your mobile phone number above) Your email address rea code Phone number Your contact details may be used by the TO: to advise you of tax return lodgment options to correspond with you with regards to your taxation and superannuation affairs to issue notices to you, or to conduct research and marketing. Your date of birth If you were under 18 years of age on 30 une 2017 you must complete item 1 on page 5 of this tax return. ay onth Year inal tax return If you know this is your final tax return, print I. lectronic funds transfer (T) We need your financial institution details to pay any refund owing to you, even if you have provided them to us before. Write the BSB number, account number and account name. BSB number (must be six digits) ccount number ccount name (for example, Q itizen. o not show the account type, such as cheque, savings, mortgage offset) T 1371-06.2017 Sensitive (when completed) Page 1
Income 1 Salary or wages Your main salary and wage occupation Payer s ustralian business number Occupation code Tax withheld (do not show cents) X Income (do not show cents) G 2 llowances, earnings, tips, director s fees etc 3 mployer lump sum payments 4 mployment termination payments (TP) ay onth Year ate of payment R mount in lump sum payments box 5% of amount B in lump sum payments box Taxable component I O Payer s B 5 ustralian Government allowances and payments like newstart, youth allowance and austudy payment 6 ustralian Government pensions and allowances You must complete item T1 in Tax offsets on page 4. 7 ustralian annuities and superannuation income streams 8 ustralian superannuation lump sum payments ate of payment Taxable component ump sum in arrears taxable component ay onth Year Taxable component B Taxed element Untaxed element Taxed element Untaxed element Taxed element Y Z Q Payer s B Untaxed element P 9 ttributed personal services income O Total tax withheld dd up the boxes. $ Page 2 Sensitive (when completed) IIVIU TX RTUR 2017
ttach all requested attachments here. 10 Gross interest Tax file number amounts withheld from gross interest Gross interest 11 ividends Unfranked amount S ranked amount T Tax file number amounts withheld from dividends V ranking credit U 12 mployee share schemes iscount from taxed upfront schemes eligible for reduction iscount from taxed upfront schemes not eligible for reduction iscount from deferral schemes iscount on SS Interests acquired pre 1 uly 2009 and cessation time occurred during financial year T amounts withheld from discounts G Total ssessable discount amount. B oreign source discounts I Only used by taxpayers completing the supplementary section Transfer the amount from TOT SUPPT IO OR on page 10 and write it here. TOT IO OR dd up the income amounts and deduct any loss amount in the boxes. eductions 1 Work related car expenses 2 Work related travel expenses B I 3 Work related uniform, occupation specific or protective clothing, laundry and dry cleaning expenses I 4 Work related self-education expenses I 5 Other work related expenses 6 ow value pool deduction 7 Interest deductions I 8 ividend deductions 9 Gifts or donations 10 ost of managing tax affairs Only used by taxpayers completing the supplementary section Transfer the amount from TOT SUPPT UTIOS on page 11 and write it here. TOT UTIOS Items 1 to add up the boxes. SUBTOT osses 1 Tax losses of earlier income years Primary production losses carried forward from earlier income years on-primary production losses carried forward from earlier income years TOT IO OR less TOT UTIOS Primary production losses Q R claimed this income year on-primary production losses claimed this income year Z TXB IO OR IIVIU TX RTUR 2017 Sensitive (when completed) Subtract amounts at and Z item 1 from amount at SUBTOT. $ Page 3
Tax offsets T1 Seniors and pensioners (includes self-funded retirees) If you had a spouse during 2016 17 you must also complete Spouse details married or de facto on page 7. TX OST O VTR Y O T2 ustralian superannuation income stream S T Only used by taxpayers completing the supplementary section Transfer the amount from TOT SUPPT TX OSTS on page 11 and write it here. TOT TX OSTS Items T2 and T add up the boxes. U edicare levy related items 1 edicare levy reduction or exemption If you complete this item and you had a spouse during 2016 17 you must also complete Spouse details married or de facto on page 7. Reduction based on family income umber of dependent children and students xemption categories ull 2.0% levy exemption number of days alf 2.0% levy exemption number of days 2 edicare levy surcharge (S) TIS IT IS OPUSORY. If you do not complete this item you may be charged the full edicare levy surcharge. or the whole period 1 uly 2016 to 30 une 2017, were you and all your dependants (including your spouse) if you had any covered by private patient OSPIT cover? Y V W I If you printed Y, you must complete Private health insurance policy details on the next page. If you printed, read below. If you are liable for the surcharge for the whole period 1 uly 2016 to 30 une 2017 you must write 0 at. If you are liable for the surcharge for part of the period 1 uly 2016 to 30 une 2017 you must write the number of days you were OT liable at. If you are OT liable for the surcharge for the whole period 1 uly 2016 to 30 une 2017 you must write 365 at. umber of days OT liable for surcharge If you had a spouse during 2016 17 (and you printed at ), complete Spouse details married or de facto on page 7. If you were covered by private patient hospital cover at any time during 2016 17 you must complete Private health insurance policy details on the next page. Page 4 Sensitive (when completed) IIVIU TX RTUR 2017
Private health insurance policy details You must read Private health insurance policy details in the instructions before completing this item. ill all the labels below unless directed in the instructions. ealth insurer I B embership number Your premiums eligible for ustralian Government rebate Benefit code Your ustralian Government rebate received Tax claim code. Read the instructions. O ealth insurer I B embership number Your premiums eligible for ustralian Government rebate Benefit code Your ustralian Government rebate received Tax claim code. Read the instructions. O ealth insurer I B embership number Your premiums eligible for ustralian Government rebate Benefit code Your ustralian Government rebate received Tax claim code. Read the instructions. O ealth insurer I B embership number Your premiums eligible for ustralian Government rebate Benefit code Your ustralian Government rebate received Tax claim code. Read the instructions. O djustments 1 Under 18 If you were under 18 years of age on 30 une 2017 you must complete this item or you may be taxed at a higher rate. Read the information on 1 in the instructions for more information. 2 Part-year tax-free threshold Read the information on 2 in the instructions before completing this item. ate ay onth Year onths eligible for threshold 3 Government super contributions Read the information on 3 in the instructions before completing this item. Income from investment, partnership and other sources Other income from employment and business G O Other deductions from business income 4 Working holiday maker net income IIVIU TX RTUR 2017 Sensitive (when completed) Page 5
Income tests You must complete this section. If you had a spouse during 2016 17 you must also complete Spouse details married or de facto on page 7. IT1 Total reportable fringe benefits amounts mployers exempt from BT under section 57 of the BT 1986 If the amount is zero, write 0. mployers not exempt from BT under section 57 of the BT 1986 W IT2 Reportable employer superannuation contributions IT3 Tax-free government pensions IT4 Target foreign income IT5 et financial investment loss IT6 et rental property loss IT7 hild support you paid IT8 umber of dependent children T U V X Y Z Page 6 Sensitive (when completed) IIVIU TX RTUR 2017
Spouse details married or de facto If you had a spouse during 2016 17, you must complete Spouse details married or de facto. We need the information included in this section to assess your tax accurately. If you did not have a spouse, go to page 8. Your spouse s name If you had more than one spouse during 2016 17 print the name of your spouse on 30 une 2017 or your last spouse. Surname or family name irst given name Other given names Your spouse s date of birth ay onth Year Your spouse s gender ale emale Indeterminate Period you had a spouse married or de facto id you have a spouse for the full year 1 uly 2016 to 30 une 2017? o Yes If you did not have a spouse for the full year, write the dates you had a spouse between 1 uly 2016 and 30 une 2017. rom ay onth Year to ay onth Year id your spouse die during the year? Yes o This information relates to your spouse s income. You must complete all labels. If the amount is zero, write 0. Your spouse s 2016 17 taxable income Your spouse s share of trust income on which the trustee is assessed under section 98, and which has not been included in your spouse s taxable income istributions to your spouse on which family trust distribution tax has been paid and which your spouse would have had to show as assessable income if the tax had not been paid O T U Your spouse s total reportable fringe benefits amounts mployers exempt from BT under section 57 of the BT 1986 R mployers not exempt from BT under section 57 of the BT 1986 S mount of ustralian Government pensions and allowances (see Q6 ustralian Government pensions and allowances in the instructions) that your spouse received in 2016 17 (exclude exempt pension income) mount of exempt pension income (see Spouse details married or de facto in the instructions) that your spouse received in 2016 17. o not include any amount paid under the ilitary Rehabilitation and ompensation ct 2004 mount of your spouse s reportable superannuation contributions (which is the total of reportable employer superannuation contributions and deductible personal superannuation contributions) Other specified exempt payments (see Spouse details married or de facto in the instructions) that your spouse received Your spouse s target foreign income Your spouse s total net investment loss (total of net financial investment loss and net rental property loss) hild support your spouse paid Your spouse s taxed element of a superannuation lump sum for which the tax rate is zero (see 2 edicare levy surcharge in the instructions) P Q B IIVIU TX RTUR 2017 Sensitive (when completed) Page 7
Supplementary section Income Refer to the supplement instructions before you complete item 13. If you are required to complete item 13 include deferred non-commercial business losses from a prior year at either X or Y as appropriate. Refer to the supplement instructions for the relevant code. 13 Partnerships and trusts Primary production istribution from partnerships Share of net income from trusts andcare operations and deduction for decline in value of water facility, fencing asset and fodder storage asset on-primary production Other deductions relating to amounts shown at and istribution from partnerships less foreign income Share of net income from trusts less capital gains, foreign income and franked distributions I X O U et primary production amount ote: If you have a net loss from a partnership business activity, complete items P3 and P9 in the Business and professional items section of this tax return in addition to item 13. Show amounts of: apital gains from trusts at item 18 on page 9 and oreign income at item 19 or 20 on page 9-10. ranked distributions from trusts andcare operations expenses Other deductions relating to amounts shown at O, U and Y et non-primary production amount Partnership share of net small business income less deductions attributable to that share Trust share of net small business income less deductions attributable to that share Share of credits from income and tax offsets Share of credit for tax withheld where ustralian business number not quoted P Share of franking credit from franked dividends Q Share of credit for tax file number amounts withheld from interest, dividends and unit trust distributions R redit for T amounts withheld from payments from closely held trusts Share of credit for tax paid by trustee S Share of credit for foreign resident withholding amounts (excluding capital gains) Share of ational rental affordability scheme tax offset B Show amounts of: redit for foreign resident capital gains withholding from trusts at item 18. 14 Personal services income (PSI) Tax withheld voluntary agreement G Tax withheld where ustralian business number not quoted Tax withheld labour hire or other specified payments et PSI transferred from item P1 on page 12 Page 8 Sensitive (when completed) IIVIU TX RTUR 2017
15 et income or loss from business Primary production transferred from Y item P8 on page 13 on-primary production transferred from Z item P8 on page 13 B If you show a loss at B or you must complete item P9 on page 14. et small business income Tax withheld voluntary agreement Tax withheld where ustralian business number not quoted Tax withheld foreign resident withholding (excluding capital gains) W Tax withheld labour hire or other specified payments 16 eferred non-commercial business losses Item P9 on page 14 must be completed before you complete this item. Your share of deferred losses from partnership activities eferred losses from sole trader activities G Primary production deferred losses I on-primary production deferred losses 17 et farm management deposits or repayments eductible deposits arly repayments natural disaster and drought Other repayments R et farm management deposits or repayments 18 apital gains id you have a capital gains tax G event during the year? ave you applied an exemption or rollover? Total current year capital gains O You must print Y at G if you had an amount of a capital gain from a trust. et capital gain et capital losses carried forward to later income years redit for foreign resident capital gains withholding amounts V X 19 oreign entities id you have either a direct or indirect interest in a controlled foreign company ()? ave you ever, either directly or indirectly, caused the transfer of property including money or services to a non-resident trust estate? I W income Transferor trust income B IIVIU TX RTUR 2017 Sensitive (when completed) Page 9
20 oreign source income and foreign assets or property ssessable foreign source income Other net foreign employment income T et foreign pension or annuity income WITOUT an undeducted purchase price et foreign pension or annuity income WIT an undeducted purchase price et foreign rent R lso include at ustralian franking credits from a ew Zealand franking company that you have received indirectly through a partnership or trust. et foreign employment income payment summary U Other net foreign source income ustralian franking credits from a ew Zealand franking company xempt foreign employment income oreign income tax offset uring the year did you own, or have an interest in, assets located outside ustralia which had a total value of U$50,000 or more? O P 21 Rent Gross rent P Interest deductions Q apital works deductions Other rental deductions U et rent P less ( Q + + U ) 22 Bonuses from life insurance companies and friendly societies 23 orestry managed investment scheme income W 24 Other income Type of income ategory 1 ategory 2 Y V Tax withheld lump sum payments in arrears Taxable professional income Z TOT SUPPT IO OR Items 13 to 24 add up the boxes for income amounts and deduct any loss amounts in the boxes. Transfer this amount to I on page 3. Page 10 Sensitive (when completed) IIVIU TX RTUR 2017
eductions 11 eductible amount of undeducted purchase price of a foreign pension or annuity Y 12 Personal superannuation contributions ull name of fund und ustralian business number ccount number und tax file number 13 eduction for project pool 14 orestry managed investment scheme deduction 15 Other deductions not claimable at items 1 to 14 escription of claim TOT SUPPT UTIOS lection expenses Other deductions Items 11 to 15 add up the boxes and transfer this amount to on page 3. Tax offsets T3 Superannuation contributions on behalf of your spouse ontributions You must also complete Spouse details married or de facto on page 7. paid T4 Zone or overseas forces R T5 Total net medical expenses for disability aids, attendant care or aged care X T6 Invalid and invalid carer B andcare and water facility tax offset T7 andcare and water facility brought forward from earlier income years T T8 T9 arly stage venture capital limited partnership arly stage investor T10 Other non-refundable tax offsets If you are entitled to a low-income tax offset, do not write it anywhere on your tax return. The TO will calculate it for you. I T11 Other refundable tax offsets P O TOT SUPPT TX OSTS Items T3, T4, T6, T7, T8, T9, T10 and T11 add up the boxes. Transfer this amount to T on page 4. djustment 5 mount on which family trust distribution tax has been paid Read the information on 5 in the supplement instructions before completing this item. X redit for interest on tax paid 1 redit for interest on early payments amount of interest IIVIU TX RTUR 2017 Sensitive (when completed) Page 11
Business and professional items section P1 Personal services income (PSI) Print X in the appropriate box. id you receive any personal services income? YS Read on. O Part id you satisfy the results test? P O Q O O If you received less than 80% of your PSI from each source for the whole of the period you earned PSI and you satisfied any of the following personal services business tests, indicate which business test(s) you satisfied. Print X in the appropriate box(es). Refer to the publication Business and professional items 2017 before you complete this item. Unrelated clients test Read on. Read on. Read on. 1 mployment test Part B o not show amounts at part B that were subject to foreign resident withholding. Show these at item P8. YS 1 Go to item P2. Go to item P2. ave you received a personal services business determination(s) that was in force for the whole of the period you earned PSI? YS id you receive 80% or more of your PSI from one source? YS Go to item P2. Go to part B. Business premises test PSI voluntary agreement PSI where ustralian business number not quoted PSI labour hire or other specified payments PSI other eductions for payments to associates for principal work Total amount of other deductions against PSI 1 O If you printed X at 1, 1 or 1, go to item P2 below; otherwise go to part B. et PSI ( + + O + ) less ( + ) Transfer the amount at above to item 14 on page 8. omplete items P2 and P3. o not show at item P8 any amount you have shown at part B of item P1. P2 escription of main business or professional activity Industry code P3 umber of business activities B P4 Status of your business print X in one box only. eased ommenced business 1 business 2 P5 Business name of main business and ustralian business number (B) B P6 Business address of main business Suburb or town State Postcode P7 id you sell any goods or services using the internet? Q Page 12 Sensitive (when completed) IIVIU TX RTUR 2017
P8 Business income and expenses Income Primary production on-primary production Totals Gross payments where ustralian business number not quoted Gross payments subject to foreign resident withholding (excluding capital gains) Gross payments voluntary agreement Gross payments labour hire or other specified payments ssessable government industry payments O G Total business income B I Other business income xpenses Opening stock Purchases and other costs losing stock ost of sales ( + ) oreign resident withholding expenses (excluding capital gains) ontractor, subcontractor and commission expenses Superannuation expenses Bad debts ease expenses Rent expenses Interest expenses within ustralia Interest expenses overseas epreciation expenses otor vehicle expenses Repairs and maintenance ll other expenses Total expenses dd up the boxes for each column. Q S T G I R O P U Reconciliation items Section 40-880 deduction Business deduction for project pool andcare operations and business deduction for decline in value of water facility, fencing asset and fodder storage asset Income reconciliation adjustments xpense reconciliation adjustments et income or loss from business this year eferred non-commercial business losses from a prior year B W X et income or loss from business Y Z Transfer the amounts at Y and Z to item 15 on page 9. IIVIU TX RTUR 2017 Sensitive (when completed) Page 13
P9 Business loss activity details Show details of up to three business activities in which you made a net loss this year. ist them in order of size of loss greatest first. If you print loss code 8 at G, or S you must also complete item 16 on page 9. ctivity 1 escription of activity Industry code Partnership (P) or sole trader (S) Type of loss G ode Year Reference for code 5 Y umber eferred non-commercial business loss from a prior year I et loss ctivity 2 escription of activity Industry code Partnership (P) or sole trader (S) Type of loss ode Year Reference for code 5 Y umber eferred non-commercial business loss from a prior year et loss O ctivity 3 escription of activity P Industry code Q Partnership (P) or sole trader (S) R Type of loss S ode Year Reference for code 5 Y umber eferred non-commercial business loss from a prior year T et loss U P10 Small business entity simplified depreciation eduction for certain assets eduction for general small business pool B Other business and professional items P11 Trade debtors P12 Trade creditors P13 Total salary and wage expenses G P14 Payments to associated persons P15 Intangible depreciating assets first deducted P16 Other depreciating assets first deducted P17 Termination value of intangible depreciating assets P18 Termination value of other depreciating assets P19 Trading stock election or leave blank. I P ours taken to prepare and complete the Business and professional items section S Page 14 Sensitive (when completed) IIVIU TX RTUR 2017
amily ssistance consent omplete this section only if you consent to use part or all of your 2017 tax refund to repay your spouse s amily ssistance debt. omplete the details below only if: you were the spouse of a family tax benefit (TB) claimant, or the spouse of a child care benefit claimant on 30 une 2017 and your spouse has given you authority to quote their customer reference number (R) on your tax return if your spouse does not know their R they can contact the epartment of uman Services and your spouse has a amily ssistance debt or expects to have a amily ssistance debt for 2017 and you expect to receive a tax refund for 2017 and you consent to use part or all of your tax refund to repay your spouse s amily ssistance debt. Spouse s R Z Important: You also need to provide your spouse s name, date of birth and their gender on page 7. I consent to the TO using part or all of my 2017 tax refund to repay any amily ssistance debt of my spouse, whose details I have provided on page 7. I have obtained my spouse s permission to quote their R. Your signature ate ay onth Year Taxpayer s declaration Read and sign the declaration after completing your tax return, including the Supplementary section, Business and professional items section and other schedules if applicable. I declare that: the information provided to my registered tax agent for the preparation of this tax return is true and correct, and I authorise my registered tax agent to lodge this tax return. Taxpayer s signature ate ay onth Year Privacy Important: The tax law imposes heavy penalties for giving false or misleading information. The TO will issue your assessment based on your tax return. owever, the TO has some time to review your tax return, and issue an amended assessment if a review shows inaccuracies that change the assessment. The standard review period is two years but for some taxpayers it is four years. The TO is authorised by the Taxation dministration ct 1953 to request your tax file number (T). We will use your T to identify you in our records. It is not an offence not to provide your T. owever if you do not provide your T, your assessment may be delayed. Taxation law authorises the TO to collect information and to disclose it to other government agencies. or information about your privacy go to ato.gov.au/privacy Tax agent s declaration I, declare that this tax return has been prepared in accordance with information supplied by the taxpayer, that the taxpayer has given me a declaration stating that the information provided to me is true and correct and that the taxpayer has authorised me to lodge the tax return. gent s signature ate ay onth Year lient s reference ontact name gent s telephone number gent s reference number rea code Telephone number IIVIU TX RTUR 2017 Sensitive (when completed) Page 15
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