Electronic Lodgment Declaration

Mr Rahul Beniwal TFN: 999 399 525
Important: The tax law imposes heavy penalties for giving false or misleading information.
· the agent is authorised to lodge this tax return.
· the information provided to my registered tax agent for the preparation of this tax return, including any applicable schedules is true and correct, and
Declaration
the payment of your taxation liability from your nominated account.
Where you have requested an EFT direct debit some of your details will be provided to your financial institution and the Tax Office's sponsor bank to facilitate
Electronic funds transfer - direct debit
Taxation law authorises the ATO to collect information and to disclose it to other government agencies. For information about your privacy go to ato.gov.au/privacy
not an offence not to provide your TFN. However, you cannot lodge your income tax form electronically if you do not quote your TFN.
The ATO is authorised by the Taxation Administration Act 1953 to request your tax file number (TFN). We will use your TFN to identify you in our records. It is
Privacy
This declaration is to be completed where a taxpayer elects to use an approved ATO electronic channel. It is the responsibility of the
taxpayer to retain this declaration for a period of five years after the declaration is made, penalties may apply for failure to do so.
PART A
Date
I declare that:
YearTax file number
Name
Signature
Electronic Lodgment Declaration (Form I)
999 399 525 2019
Mr Rahul Beniwal
Sensitive (when completed)
Agent : 00013-000
Client Ref: BENI0001

Page 1 of 11
Return year
2019
declaration on page 15 of this return.
See the Privacy note in the Taxpayer's
Given names
Surname or family name
Mr, Mrs, Ms, Miss
Title - for example,Your name
Y for yesPrintYour tax file number (TFN)
for no.Nor
for yesYPrintHave you included any attachments?
for no.Nor
Are you an Australian resident?
1 July 2018 to 30 June 2019
Individual tax return
2019
Rahul
Beniwal
Mr
999 399 525
N
Y
or phone 13 28 61
To find out how to update your name on our records, go to ato.gov.au/updatedetails
for no.Nor
for yesYPrint
your last tax return?
changed since completing
Has any part of your name
N
Print
for no.Nor
for yesY
your last tax return?
changed since completing
Has your postal address
Your postal address
4225QLDCOOLANGATTA
Hill Street
70
ABOVE.
postal address, print AS
If the same as your current
Your home address
4225QLDCOOLANGATTA
Hill Street
70
- to conduct research and marketing.
- to issue notices to you, or
- to correspond with you with regards to your taxation and superannuation affairs
- to advise you of tax return lodgment options
Your contact details may be used by the ATO:
Your email address
Your mobile phone number
number above )
(if different from your mobile phone numbercode
Your daytime phone number PhoneArea
123456
1234560401
tax return, print FINAL.
item A1 on page 5 of this tax return.
If you know this is your finalIf you were under 18 years of age on
Final tax returnYour date of birth
30 June 2019 you must complete
N
14/02/1964
and account name below.
Write the BSB number, account number
number
such as cheque, savings, mortgage offset)
you have provided them to us before.
(must be six digits)
Use Agent Trust Account?
Account name (for example, JQ Citizen. Do not show the account type,
AccountBSB number
to pay any refund owing to you, even if
Electronic funds transfer (EFT)
We need your financial institution details
Sensitive (when completed)
[e-mail]

Page 2 of 11Individual Tax Return 2019 Mr Rahul Beniwal TFN: 999 399 525
Income
Occupation code X
Your main salary and wage occupation
Salary or wages1
111111Director - executive
Payer Allowances Lump A Lump B Tax Withheld Gross
Purple Rain Pty Ltd ABN: 84 111 122 223 RFBA:1128 RESC:5200
48,337.00 156,000
$boxes.Add up theTotal tax withheld 48,337.00
Dividends11
withheld from dividends V UFranking credit
Franked amount
Unfranked amount S
T
Tax file number amounts
Unfranked Franked Franking credit TFN amount Business?27.5%
0.00 24,960
0
58,240
N Y56,000.00 24,000.00Purple Rain Pty Ltd
N N680.00 291.43CBA Shares
N N900.00 385.71COH Shares
N N450.00 192.86FLT Shares
N N210.00 90.00TLS Shares
LOSS
/
Only used by taxpayers completing the supplementary sectionI Transfer the amount from TOTAL SUPPLEMENT INCOME OR LOSS 16,019
LOSS
/Add up the income amounts and deduct any loss amount in the boxes.TOTAL INCOME OR LOSS 255,219
Deductions
D1 A
CLAIM
/Work-related car expenses S3,400
D5 EOther work-related expenses 307
JD9 Gifts or donations 2,400
RSPCA 1,200
Sea Shepherd 1,200
D Transfer the amount from TOTAL SUPPLEMENT DEDUCTIONS
Only used by taxpayers completing the supplementary section 6,390
boxesadd up thetoD1ItemsTOTAL DEDUCTIONS D 12,497
LOSS
/TOTAL DEDUCTIONSlessTOTAL INCOME OR LOSSSUBTOTAL 242,722
from amount at SUBTOTAL
item L1and ZF LOSS
/$
Subtract amounts at
TAXABLE INCOME OR LOSS 242,722
U-add up the boxesItems T2 andTOTAL TAX OFFSETS T 0
Medicare levy surcharge (MLS)
(including your spouse) - if you had any - covered by private patient HOSPITAL cover?
liable for surcharge
Number of days NOT A
for no.Nor
for yesYPrint
E
If you do not complete this item you may be charged the full Medicare levy surcharge.
THIS ITEM IS COMPULSORY
M2
For the whole period 1 July 2018 to 30 June 2019, were you and all your dependants
Sensitive (when completed)

Page 3 of 11Individual Tax Return 2019 Mr Rahul Beniwal TFN: 999 399 525
Private health insurance policy details
You must read Private health insurance policy details in the tax return instructions before completing this item.
Fill all the labels below unless directed in the instructions.
tax return instructions.
Tax claim code. Read the
rebate received
Your Australian Government
Benefit code
Australian Government rebate
Your premiums eligible for
L
J
insurer ID number
K
MembershipHealth
CODE
B C
30
7373
BUP RDA1465
D
(for ATO validation only)
Total reportable fringe benefits amounts
Employers not exempt from FBT under section 57A of the FBTAA 1986
Employers exempt from FBT under section 57A of the FBTAA 1986
W
If the amount is zero, write 0.
TReportable employer superannuation contributionsIT2
If you had a spouse during 2018-19 you must also complete Spouse details – married or de facto on page 7.
You must complete this section.
Income tests
N
Total reportable fringe benefits amountsIT1
1,128
1,128
5,200
0
XNet financial investment lossIT5 0
YNet rental property lossIT6 0
Non-resident foreign income
/
(For ATO validation only)
/
Estimated eligible income
Estimated total income
Adjusted taxable income 247,922
161,200
264,277
Indeterminate
If you had more than one spouse during 2018-19 print the name of your spouse on 30 June 2019 or your last spouse.
Your spouse's name
If you did not have a spouse, go to page 8.
Your spouse's gender
K
FemaleMale
date of birth
Your spouse's YearMonthDay
Other given names
Surname or family name
First given name
We need the information included in this section to assess your tax accurately.
If you had a spouse during 2018-19, you must complete Spouse details - married or de facto.
Use related ref details?Spouse details-married or de facto
X
10/04/1968
Kazmi
Shenaaz
N
Period you had a spouse - married or de facto
30 June 2019.
No YesDid your spouse die during the year?
YesNo- 1 July 2018 to 30 June 2019?
Did you have a spouse for the full year
From
to
N
spouse between 1 July 2018 and
full year, write the dates you had a
MIf you did not have a spouse for the
L
X
X
Sensitive (when completed)