Your Given Name(s) * Your Family Name * E-mail Address: * Your Birth Date dd/mm/yyyy * Your Street Address * Your Suburb * Your State * Choose NSW VIC QLD WA SA TAS ACT NT Other Your Post or Zip Code * Are You an Australian Citizen ? * Yes NoYour preferred contact phone number * Mobile Phone Number Your Gender Male FemaleYour Marital Status Choose Married De-Facto Not married Has Any Part of Your Name Changed? Yes NoIf Yes, What Was Your Former Name? If Married or De-Facto, Details of Your Partner ? Partners Full Name Partners date of Birth (dd/mm/yyyy) Partners Taxable Income Partners Reportable Fringe Benefits $ Partners Personal Superannuation Contribution $ Is Your Partner an Australian Citizen ? Yes NoDid You Receive a PAYG Salary & Wages Payment Summary - if Yes, Please Answer the Following Questions (From the Payment Summary(s)) Yes NoName of Payer Payers ABN or Withholding Number Start of Payment Period (dd/mm/yyyy)
End of Payment Period (dd/mm/yyyy)
Your Occupation During This Period ? Gross Amount $ Tax Withheld $ Reportable Fringe Benefits $ Allowances $ Lump Sum Amounts $ (specify type A,B,D or ,E) Reportable Employer Super Contributions $ Amounts Paid to Unions or Professional Associations $ Details of Any Other PAYG Salary/Wages Payment Summaries? Any Other Reportable Fringe Benefits ? Yes NoDid You Receive Any Other Allowances, Earnings or Fees ? Yes NoAny Other Lump Sum Payments Received ? Yes NoDetails of Any Interest Received ? Details of Any Dividends Received ? How Many Share Sale Transactions Have You Made Choose None One Two Three Four Five Six More than 6 Are You a Member of an Employee Share Scheme ? Yes NoAny Investment property / Rental Income ? Choose None From one property From two properties From three properties From more than three properties How Many Investment Properties Have You Sold ? Do You Have Any Business Income? Yes NoDo You Have Any Partnership or Trust Distributions?: Yes NoAny Newstart / Abstudy / Youth Allowance ? Yes NoAny Australian Pensions ? Yes NoAny Foreign Income, Including Pensions ? Yes NoDetails of Any Work Related Deductions ? note, receipts are required to be held by you if >$300 Details of Any Work Related Motor Vehicle Expense ? note, $300 expense limit does not apply Any Donations to Approved Charities ? Details of Your Cost of Tax Preparation Last Year Do You Have Out of Pocket Medical Bills Over $2000 ($1500 in 2010)? Yes NoDo You Have Private Health Cover? Yes NoIf Yes, Please Provide Health Insurance Details Do You Have HECS Debt or Student Loans? Yes NoNumber of Dependent Children? Choose None One Two Three Four Five Six More than six Any Child Support or Maintenance Arrears? Yes NoAre You Personally Receiving Family Assistance? Yes NoAny Superannuation Contributions if Self Employed or Unsupported? Yes NoDid You Live in a Remote Area During The Year? Yes No Would You Like to Send Us a File Attachment (eg Payment summary, Rental property expenses etc - if more than one file enclose in a zipped folder.)? How Many Years Tax Returns Do You Wish to Prepare? Choose One year Two years Three Years Four Years Five Years Six Years Seven years Eight Years Nine years More than nine years Is There Anything Else You Would Like to Tell Us - or Ask Us? How Did You Find Out About Our Assisted Online Service?: A Google search Using another search engine Through the ITP national website Newspaper Television Radio From a friend, family member or colleague Social networking OtherYour Tax File Number (TFN) * How Would You Like to Pay For Your Tax Returns? * Choose Take the fee from my refund Credit Card (Amex, Visa, Mcard) PAYPAL Bank transfer Definition Of an Average Taxpayer - This Is Needed For the Next Question. Guidance as to What Your Fee Will Be * Choose I am an average taxpayer - you will pay $95 per return for each year I am an average taxpayer with one rental property - you will pay $167 per return for each year I am an average taxpayer with up to 3 rental properties - you will pay $215 per return for each year I am a sole trader - you will pay $250 for each return per year I am in a partnership or have a company - we will provide a quotation None of the above - my situation is special - we will provide a quotation In submitting this form I confirm that the information I will provide is / will be a true representation of my tax situation and I appoint ITP as my Tax Agents to confirm the validity of the information provided. * I Agree I Dont AgreeWould You Like Us to Go Ahead and Prepare Your Tax Return(s) for Lodgment ? * Choose The guidance price applicable to me is acceptable, please go ahead Dont go ahead yet, I would like to receive a quotation by email
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