Individual Income Tax Return (ITR) Checklist — 2019/2020

Personal Details:

Full Name:
Tax File Number: Date of Birth:
Address:
Main Occupation:
Mobile:
Email:

Electronic Banking Details:

BSB: Account Number:

Account Name:

Spouse Details:

Spouse Full Name: TFN:

Date of Birth: Taxable Income:

Other Details:

Australian Tax Resident: Dependents: If Yes, Please provide details:

Entitle to Medicare Benefits: Personal Super Contribution: Amount Paid:

Private Health Insurance: Income Protection Insurance: Amount Paid:

Any Business Income (ABN): 1st Year Tax Return:

(Date Arrived)

TAXPAYER'S DECLARATION

I declare that the information I have provided in the checklist, including further emails and any attachments, is true and
correct to the best of my knowledge.

I declare that I have the necessary receipts and/or other records or can obtain the necessary written evidence within a
reasonable time, to support my claims.

Signature:

Date: