Brisbane Tax Agent

    Client Interview Page 4 - Offsets/Rebates
    A Consultant will contact you upon the completion of the interview

Tax File Number :

Mobile Number :

T1) Do you have a dependent spouse (without dependent child or student), a housekeeper?

Yes
No

Family Tax Benefit (FTB):

Did you have care of a dependent child in 2007?

Yes
No

Did you or your spouse receive FTB through the Family Assistance Office in 2007?

Yes
No

T2. Have you been in prison for the whole year :

Yes
No

T5. Did you have private health insurance in 2007?

Name of the fund	Membership from	To	Membership Number

T6) Did you receive Child Care Benefit and have out of pocket expenses during the 2006

Yes
No

T7) Do you have a child that was born or adopted between 1 July 2001 and 30 June 2004?

Yes
No

Please Call Centrelink

T8)Did you make superannuation contributions on behalf of a spouse?

Yes
No

If yes $......

T9)Did you live in a remote area of Australia or serve overseas with the Australian defence

Yes
No

Place of Residence	Number of Days lived during 2006-2007

T10) Did you have net medical expenses over $1,500?

Yes
No

If yes total exp $

T11) Did you maintain a parent, spouse’s parent or invalid relative?

Name of Dependent	Relationship	Income	Days of Care	% of Contribution