INDIVIDUALS TAX INTERVIEW CHECKLIST

2022 Income Tax Return

TAX ACCOUNTANT’S NAME:

NEW CLIENTS COMPULSORY QUESTIONS – POI Yes/No

1. ATO POI REQUIREMENT FOR ALL NEW CLIENTS: Photo ID sighted, copied and retained by agent – e.g.
passport, drivers licence. List here:
Yes
2. ‘Online Services for Agents – Client Authorisation’ form completed and signed by client and retained by agent
as evidence. Yes

CLIENT DETAILS
1. Tax File Number: 969222509
2. Name: Mr/Mrs/Ms/Miss: XIAOLEI CAO
3. Residential Address: 31 Riverina street, calamvale, 4116
Postal Address: 31 Riverina street, calamvale, 4116
4. Tel No: (H) 0422927967 Tel No: (W)
Mob: Fax No:
5. Date of Birth: 14/03/1993 Email: cao.cici0314@gmail.com
6. Occupation: Driver Casual worker
Bank Account:
7.
BSB: 064162 Acct No. 11177307 Name on Acct: Xiaolei Cao

Codes: R/S (Receipt Sighted), C/A (Client Advised Receipt), N/R (No Receipt), P/R (Prefill Report)

INCOME (provide evidence where appropriate)

1. Salary and wages Yes  No 
Allowances whether or not shown on the payment summary
Individuals non business
2.
• allowances, benefits, earnings, tips, jury service Yes  No 
• cents per km reimbursement for car expenses Yes  No 
3. Employer Lump Sum Payments Yes  No 
4. Employment Termination Payments Yes  No 
5. Newstart, Sickness or other Government benefits Yes  No 
6. Aust Government pensions and allowances Yes  No 
7. Australian annuities and superannuation income streams Yes  No 
8. Australian superannuation lump sum payments Yes  No 
9. Attributable Personal Services Income Yes  No 
10. Interest Yes  No  Income Matching System
Check total dividend amount
11. Dividends Yes  No 
and time shares were held
12. Employee Share Schemes Yes  No 
13. Income from partnerships and/or trusts Yes  No 
14. Personal Services income as a sole trader Yes  No 
15. Net income or loss from a business Yes  No 
16. Deferred non commercial business losses Yes  No  If yes, see TR 2001/14
See statement of account
17. Farm Management deposits/withdrawals Yes  No 
from financial institution
18. Capital gains or losses – any assets disposed of? Yes  No 
19. Income from control of foreign entities Yes  No 
20. Foreign source income (including foreign pensions) Yes  No 
If yes, seek information on
21. Rent Yes  No 
rental expenses
22. Bonus from life assurance or friendly society policy Yes  No 
23. Forestry Managed Investment Scheme income Yes  No 
24. Other income (details) Yes  No 
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 DEDUCTIONS
Work related car expense claims If yes, choose appropriate
D1 Yes  No 
(cents per km, log book) method
Work related travel expenses:
Apportion private & business
Employee domestic travel with reasonable allowance Yes  No 
travel
Receipts for expenses if more than reasonable allowance rates Yes  No 
Overseas travel with reasonable allowance
Yes  No 
D2 Accommodation receipts/diary/itinerary
Employee without reasonable travel allowance (domestic and
overseas). If travel is for 6 or more nights is there a travel diary or Yes  No 
itinerary?
Specify other work related travel expenses e.g. borrowed car Yes  No 
Work related uniform and other clothing expenses:
Protective clothing Yes  No 
Occupation specific clothing Yes  No 
D3 Non-compulsory uniform Yes  No 
Conventional clothing Yes  No 
Laundry (up to $150 without receipts) Yes  No 
Dry cleaning Yes  No 
Work related self education (formal courses):
• Student Union Fees Yes  No 
• Course fees (excluding HECS payments) Yes  No 
D4
• Travel Yes  No 
• Text books Yes  No 
• Other (please specify) Yes  No 
Other work related expenses:
Seminars and courses not at an educational institution but related to
your work
• Seminars or course fees Yes  No 
• Travel Yes  No 
• Other Yes  No 
80c per hr if working from
Home office expenses Yes  No  home in the period 1/7/21 -
30/6/22.
D5 Computer and software Yes  No 
Usage diary required if
Telephone/mobile phone/internet (Do you have a diary record?) Yes  No 
claiming more than $50.
Tools and equipment Yes  No 
Subscriptions, union fees or professional body fees Yes  No 
Journals/periodicals Yes  No 
Depreciation Yes  No 
Expenses in relation to allowances Yes  No 
Sun protection Yes  No 
Any other work deductions (specify) Yes  No 
Depreciating assets valued
D6 Low value pool deduction Yes  No 
under $1000
D7 Interest deductions Yes  No 
D8 Dividend deductions Yes  No 
D9 Gifts and donations Yes  No 
D10 Cost of managing tax affairs Yes  No 
D11 Deductible amount of UPP or a foreign pension or annuity Yes  No 
Personal superannuation contributions Yes  No  Written acknowledgement
D12 Full name of fund: letter from super fund
Policy No. required.
D13 Deduction for project pool Yes  No 
D14 Forestry Managed Investment Scheme deduction Yes  No 
D15 Other deductions (specify) e.g. Income Protection Insurance Yes  No 
L1 Tax losses of earlier income years (provide details of exempt income) Yes  No 
TAX OFFSETS
Calculate taxable income
T1 Seniors and Pensioners (including self-funded retirees) Yes  No 
including spouse
T2 Did you receive a superannuation income stream? Yes  No 
T3 Superannuation contributions on behalf of your spouse Yes  No 
T4 Zone or overseas forces Yes  No 
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 T5 Invalid and invalid carer Yes  No 
T6 Landcare and water facility Yes  No 
T7 Early stage venture capital limited partnership Yes  No 
T8 Early stage investor
T9 Other non-refundable tax offsets
Low income tax offset and
low & middle income tax
T10 Other refundable tax offsets Yes  No 
offset (calculated by the
ATO)
OTHER
Health Fund Statement
1. Do you have private health insurance? Yes  No 
(Essential)
Do you have a spouse? Yes  No 
• Spouse’s taxable income
• Spouse’s reportable fringe benefits
2.
• Spouse’s Australian government pensions
• Spouse’s non-taxable pensions
• Spouse’s net investment loss
Low income earner or
3. Are you entitled to the Medicare Exemption/reduction? Yes  No 
exemption category
Did you cease, or become a tax resident of Australia in the 2021/22
4. Yes  No 
year?
5. Has the ATO notified you that you have been selected for an audit? Yes  No 
Do you owe any money to any government department (e.g. Child
6. Yes  No 
Support, HECS, Student Supplement Loans)?
Self assessment and substantiation rules have been explained and
7. Yes  No 
understood?

PROACTIVE SERVICING
Describe:
1. Other services with relevant benefits have been discussed. Yes  No 

Copy of Tax Return & other information (returned receipts) presented

2. Yes  No 
in Corporate Tax Organiser envelope or Folder.

NOTES/OTHER INFORMATION
Ethical letter required? How did the client find out about the practice’s services?

TAXPAYER’S DECLARATION
I declare that all the information I have given is true and correct.

24/1/2023
Taxpayer’s Signature:………………………………………………………………………………….. Date:……………………………………..

TAX PREPARER’S DECLARATION

I declare that the tax return prepared is true and correct.

Tax Preparer’s Signature:…………………………………………………………………………….. Date:……………………………………..

24/1/2023
TAX AGENT’S DECLARATION
I declare that the tax return has been reviewed and is true and correct.

Tax Agent’s Signature:………………………………………………………………………………….. Date:……………………………………..

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 2022 Client Substantiation Declaration

I confirm that you have advised me that I must demonstrate that I have incurred an expense for income producing purposes. In
addition, you have advised me of the stringent SUBSTANTIATION legislation I must satisfy in relation to work, car and business travel
expenses.

In addition, you have informed me that I must obtain original receipts and keep them for a minimum of five years from the date my return
is lodged. The receipts must contain the following details:

• name of supplier;
• amount of expense;
• nature of goods and services (noting the specific type of items purchased or expenditure incurred which I am able to personally
record up to the date of lodgment of my return where not adequately noted by the supplier);
• date of expense (which I am able to personally record where not noted by the supplier); and
• the date of the documents.
Penalties to apply with incorrect returns

You have also advised me that additional tax, penalties, interest and possible prosecution action may be taken against me by the ATO if
I provide details which lead to an incorrect tax return being lodged.

Income from sources in and out of Australia for the year of income

You have advised me that as an Australian resident I must declare income from all sources, in and out of Australia, including net capital
gains received, for the year of income in my tax return.

Apportionment

Where items are used for both business and private purposes, e.g., car, mobile telephone, home telephone, internet, computer etc, I
have records to verify my business usage claim. In addition, my employer will verify that it was necessary to incur such expenditure in
earning my assessable income. Further, I have instructed you to prepare the return based on me being able to produce these records, if
required.

Audit matters

I further confirm that:

I. I am aware of the procedures to follow if a document is lost or destroyed;

II. I may be required to verify any income or expense item noted in my return in the event of an ATO audit;

III. I understand the Substantiation schedules I completed for all work, car and travel expense claims under self-assessment; and

IV. I have read and understood the return prepared for me.

I declare that:

a. I have disclosed and you have returned all of the income, including net capital gains which I have earned/received, for the income
year.

b. All income declared, claims for deductions and tax offsets/rebates included in my return are based on my specific instructions and
advice that I satisfy the relevant taxation requirements.

c. I have all receipts or documentation necessary to substantiate the above claims and I will make them available if required by the
Tax Office; and

d. You have clarified what written evidence (including car/travel records) will be required during an audit and penalties, (including
prosecution) that may be applied if incorrect claims are identified in an audit situation.

Dated the ................

January
24 day of ...........................................(Month) …………….
2023 (Year)

.........................................................................................

Signature of taxpayer
Xiaolei Cao
.........................................................................................

Name (print)