Australian 2012 Tax Return: Individual Income, Deductions, and Offsets

This document presents a completed 2012 Australian Individual Tax Return form, filled out with example data. The form covers various aspects of personal income tax, including individual information, income sources (salary, allowances, interest, dividends, and employee share schemes), deductions (work-related expenses, self-education, and others), tax offsets (spouse, senior Australians, and private health insurance), and Medicare levy details. The document demonstrates how to report different types of income, calculate deductions, and claim tax offsets. The return includes sections for electronic funds transfer (EFT) details, tax withheld, and total income calculations. It guides users through the process of completing the form accurately. The form is a comprehensive overview of the requirements for filing an Australian tax return for the 2012 financial year.

IN-CONFIDENCE – when completed Page 1
Tax return for individuals20121 July 2011 to 30 June 2012
Use Individual tax return instructions 2012 to fill in this tax return.
n Print clearly using a black pen only.
n Use BLOCK LETTERS and print one character per box.
S M I T H S T
Your tax file number (TFN) See the Privacy note in the Taxpayer’s declaration
on page 12 of your tax return.
NAT 2541-6.2012
Yes NoAre you an Australian resident? Male FemaleYour sex
Your postal addressPrint the address where you want your mail sent.
Suburb/town/locality
Country if not Australia
State/territory Postcode
No Yes
Has this address changed since
completing your last tax return?
Is your home address different from
your postal address?
Suburb/town/locality
Country if not Australia
State/territory Postcode
No Yes Print your home address below.Read on.
Your date of birth Day Month Year
If you were under 18 years old on 30 June 2012
you must complete item A1 on page 7.
Provide your date of birth to avoid delays in
the processing of your tax return.
Your phone number during business hours
If we need to ask you about your tax return, it is quicker by phone.
Phone number
(include area code)
n Print X in all appropriate boxes.
n Do not use correction fluid or tape.
n Complete your details carefully to avoid delays
in processing your tax return.
Will you need to lodge an Australian
tax return in the future? Yes No FINAL TAX RETURNDon’t know
Individual information
Your name(Print your full name)
Surname or family name
First given name Other given names
Title: Mr Mrs Miss Ms Other
No Yes Print previous surname below.
Has any part of your name changed
since completing your last tax return? Read on.
25410612
X X
X
R O B E R T S
A N D Y

IN-CONFIDENCE – when completedPage 2 TAX RETURN FOR INDIVIDUALS 2012
Income
1 Salary or wages Your main salary and
wage occupation
Payer’s Australian business number Tax withheld – do not show cents Income – do not show cents
.00$ ,TOTAL TAX WITHHELD Add up the$ boxes. ,
.00,C.00,$ $
.00,D.00,$ $
.00,E.00,$ $
.00,F.00,$ $
.00,G.00,$ $
.00,K.00,2 Allowances, earnings, tips, director’s fees etc$ $
.00,R.00,
3 Employer lump sum payments
.00,H.00,
Amount A in lump sum payments box
5% of amount B in lump sum payments b
TYPE
$
$
$
$
.00,A.00,
5 Australian Government allowances and
payments like Newstart, Youth Allowance
and Austudy payment
$ $
.00,B.00,
6 Australian Government pensions and allowances
You must complete item T2 or T3 in Tax offsets. $ $
.00,O.00,9 Attributed personal services income $
.00,J
.00,
7 Australian annuities and superannuation
income streams $
$Taxed element
.00,N $Untaxed element
.00,Y $Taxed element
.00,Z $Untaxed element
Taxable component
Lump sum in arrears – taxable component
.00,Q
8 Australian superannuation lump sum payments .00,$
$
Day Month Year
Payer’s
ABN
Date of
payment
.00,P $
TYPE
Taxed element
Untaxed element
Taxable component
.00,I
4 Employment termination payments (ETP)
.00,$ $
Taxable component TYPEDay Month Year
Payer’s
ABN
Date of
payment
Electronic funds transfer (EFT)
Provide your financial institution details.
Write the BSB number, account number and account name below.
BSB number (must be six digits) Account number
Account name (for example, JQ Citizen. Do not show the account type, such as cheque, savings, mortgage offset)
Do not include
total income here
C L I E N T S E V I C E M A N A G E R
1 6 6 0 0 5 5 8 0 0

IN-CONFIDENCE – when completed Page 3TAX RETURN FOR INDIVIDUALS 2012
I If you completed theTax return for individuals (supplementary
section) 2012,write here the amount from TOTAL SUPPLEMENT INCOME
OR LOSS on page 15.
.00,
LOSS
,$
.00,
LOSS
$ ,
TOTAL INCOME
OR LOSS Add up the income amounts and deduct any loss amount in the$ boxes
on pages 2 and 3.
Your tax file number (TFN)
Attach here all documents that the instructions tell you to attach.
Do not send in your tax return until you have attached all requested attachments.
Income –continued Income – do not show cents
$ ,M .Tax file number amounts
withheld from gross interest
10 Gross interest Gross interestIf you are a non-resident make sure you have
printed your country of residence on page 1. $ .00,L ,
11 Dividends
$ ,V .
Unfranked amount
Tax file number amounts
withheld from dividends
Franked amount
Franking credit
If you are a non-resident make sure you have printed your
country of residence on page 1.
$ .00,S ,
$ .00,T ,
$ .00,U ,
12 Employee share schemes
Discount from taxed upfront
schemes – eligible for reduction$ .00,D ,
Discount from taxed upfront schemes –
not eligible for reduction $ .00,E ,
Discount from deferral schemes$ .00,F ,
Discount on ESS Interests acquired
pre 1 July 2009 and ‘cessation time’
occurred during financial year
.00,G $ ,
Total assessable discount amount$ .00,B ,
Foreign source discounts $ .00,A ,
TFN amounts withheld from discountsC $ , .,
25410712
1 6 3 0

IN-CONFIDENCE – when completedPage 4 TAX RETURN FOR INDIVIDUALS 2012
Deductions
D1 Work-related car expenses .00$ ,A TYPE
CLAIM
D2 Work-related travel expenses .00$ ,B
D3 Work-related uniform, occupation specific
or protective clothing, laundry and dry
cleaning expenses
.00$ ,C TYPE
CLAIM
D4 Work-related self-education expenses .00$ ,D TYPE
CLAIM
D5 Other work-related expenses .00$ ,E
D6 Low value pool deduction .00$ ,K
D7 Interest deductions .00$ ,I
D8 Dividend deductions .00$ ,H
D9 Gifts or donations .00$ ,J
D10 Cost of managing tax affairs .00$ ,M
D If you completed theTax return for individuals (supplementary section)
2012, write here the amount from TOTAL SUPPLEMENT DEDUCTIONS on page 15. .00,$ ,
TOTAL DEDUCTIONS Add amounts at itemsD1 to D .00,$ ,
SUBTOTAL TOTAL INCOME OR LOSS less TOTAL DEDUCTIONS .00$ ,
LOSS
,
You must read
the deductions
section in the
instructions if you are
claiming deductions
for expenses that
relate to your work
as an employee at
items D1–D6.
Losses
L1 Tax losses of earlier income years
.00$ ,F
.00$ ,Z
Primary production losses
claimed this income year
Non-primary production losses
claimed this income year
.00$ ,Q
.00$ ,R
Primary production losses carried
forward from earlier income years
Non-primary production losses carried
forward from earlier income years
If you were not required to complete L1,
TAXABLE INCOME write the amount from SUBTOTAL above here.
OR LOSS If you completed L1, add up the amounts you wrote at F and Z and take the total
the amount you wrote at SUBTOTAL. Write the answer at $ TAXABLE INCOME O
.00$ ,
LOSS
,
Make sure that you complete item M2 on page 6.
7 1 0
8 5 1 0
2 5 0

IN-CONFIDENCE – when completed Page 5TAX RETURN FOR INDIVIDUALS 2012
Your tax file number (TFN)
25410812
Tax offsets
T2 Senior Australians (includes age pensioners,
service pensioners and self-funded retirees) N CODE
TAX OFFSET
If you had a spouse during 2011–12 you must also
complete Spouse details – married or de facto
on pages 9–11.
The Tax Office will work out this tax
offset amount. Print your code letter
in the TAX OFFSET CODE box. Y CODE
VETERAN
T3 Pensioner O CODE
TAX OFFSET
If you had a spouse during 2011–12 you must also
complete Spouse details – married or de facto
on pages 9–11.
The Tax Office will work out this tax
offset amount. Print your code letter
in the TAX OFFSET CODE box. T CODE
VETERAN
If you completed item T2 Senior Australians
above DO NOT complete this item.
T4 Australian superannuation income stream .00$ ,S
T5 Private health insurance .00$ ,G
Amount of refundable tax offset not
previously claimed by way of reduced
private health insurance premiumsYou must also complete Private health insurance
policy details on page 6.
T If you completed theTax return for individuals (supplementary section)
2012,write here the amount from TOTAL SUPPLEMENT TAX OFFSETS on page 16.
.00,$
Add up all the tax offset amounts at items T1, T4, T5 andT . .00$ ,UTOTAL TAX OFFSETS
T6 Education tax refund
T1 Spouse (without dependent child or student),
child-housekeeper or housekeeper .00$ ,P TYPE
CLAIM
To claim the spouse tax offset you must also complete applicable Income
tests on page 8 and Spouse details – married or de facto on pages 9–11.
Tax offsets – do not show cents
Child-housekeeper’s adjusted taxable income $ ,V .00
Only complete the following question if you had more than one dependent spouse between 1 July 2011 and 30 June 20
Did you have a dependent spouse born on or before 30 June 1971? Print Y for yes
or N for no.
You can no longer claim the Education Tax Refund (ETR). The ETR has been
replaced by the Schoolkids Bonus.
For information about the changes to the ETR, read question T6 in the Individual
tax return instructions 2012.
2 5 0 0
2 5 0 0

IN-CONFIDENCE – when completedPage 6 TAX RETURN FOR INDIVIDUALS 2012
Private health insurance policy details
You must provide the details for each policy if item T5 or M2 asked you to complete this section.
B
Type of cover
C
Membership numberHealth insurer ID
B C
B C
Medicare levy related items
M1 Medicare levy reduction or exemption
If you have completed item M1 and had a spouse during 2011–12
you must also complete Spouse details – married or de facto on pages 9–11.
YNumber of dependent children and students
CLAIM
TYPE
VFull 1.5% levy exemption – number of days
WHalf 1.5% levy exemption – number of days
Reduction based on family income
Exemption categories
NOTE
Only certain taxpayers are entitled to a Medicare levy
reduction or exemption. Read the M1 Medicare
levy reduction or exemption in the instructions to
work out if you are eligible to claim.
M2 Medicare levy surcharge (MLS)
If you do not complete this item you may be charged the full Medicare levy surcharge.
To help you determine if you have to pay the surcharge read M2 Medicare levy surcharge in the instructions.
For the whole period 1 July 2011 to 30 June 2012 were you and all of your dependants (including your
spouse) – if you had any – covered by private patient hospital cover?
A
Number of days you do not
have to pay the surcharge
DNumber of dependent children
THIS ITEM IS COMPULSORY FOR ALL TAXPAYERS.
Yes You must complete Private health insurance policy details
above. You have now finished this item. No Read on.E
For the whole of 2011–12 were you:
n a single person – without a dependent child or children – and your income for surcharge
purposes (including your total reportable fringe benefits amounts) was $80,000 or less or
n a member of a family – which may consist of you and your spouse (married or de facto)
with or without a dependent child or children; or a sole parent with a dependent child or
children – and the combined income for surcharge purposes (including the total reportable
fringe benefits amounts) of you and your spouse (if you had one) was $160,000 or less
(plus $1,500 for each dependent child after the first)?
No Yes You do not have to pay the surcharge.
You must write 366 at A.
You may have to pay the surcharge. Read M2
Medicare levy surcharge in the instructions.
You must write the following at A:
n 0 when you have to pay the surcharge for the whole period
1 July 2011 to 30 June 2012
n 366 when you do not have to pay the surcharge for the
whole period 1 July 2011 to 30 June 2012
n the number of days you do not have to pay the surcharge
for part of the period 1 July 2011 to 30 June 2012.
If you had a spouse during 2011–12 complete Spouse details – married or de facto on pages 9–11.
If you were covered by private patient hospital cover at any time during 2011–12 you must complete Private
health insurance policy details above. Read the Private health insurance policy details section in the instructions.

IN-CONFIDENCE – when completed Page 7TAX RETURN FOR INDIVIDUALS 2012
Adjustments
A1 Under 18
.00,
TYPE
$If you were under 18 years old on 30 June 2012 you must
complete this item or you may be taxed at a higher rate.
Read A1 Under 18 in the instructions for more information.
J
A2 Part-year tax-free threshold NDay Month Year
Date
Months eligible for threshold
Read A3 Super co-contribution in the instructions before completing this item.
A3 Super co-contribution
$F .00,Income from investment, partnership and other sources
$G .00,Income from employment and business
$H .00,Deductions from business income
,
,
,
CODE
LOSS
Flood levy exemption
You must complete this item if you:
n have been affected by a natural disaster, and
n wish to claim an exemption from paying the flood levy.
You must read Flood levy exemption in the instructions to work out whether you are exempt.
I am exempt from paying the flood levy. F

IN-CONFIDENCE – when completedPage 8 TAX RETURN FOR INDIVIDUALS 2012
IT2 Reportable employer superannuation contributions .00$ ,T
IT1 Total reportable fringe benefits amounts .00$ ,W
IT3 Tax-free government pensions .00$ ,U
IT4 Target foreign income .00$ ,V
IT7 Child support you paid .00$ ,Z
IT5 Net financial investment loss .00$ ,X
IT6 Net rental property loss .00$ ,Y
Income tests
You must complete this section if any of the following apply to you.
n You have a payment summary showing total reportable fringe benefits amount or reportable employer superannua
n You or your spouse received family payments, childcare benefits or a tax-free pension from Centrelink or the Depar
Veterans’ Affairs during 2011–12.
n You or your spouse are intending to claim family payments or childcare benefits as a lump sum for the 2011–12 yea
n Your child received student payments from Centrelink based on parental income.
n You hold a Commonwealth seniors health card.
n You were 55 years old or older on 30 June 2012 and you are entitled to the mature age worker tax offset
(see Net income from working – supplementary section in the instructions).
n You paid or received child support.
n You have a HELP or SFSS debt.
n You completed any of the following items:
– 12 Employee share schemes; where you wrote an amount at D
– T1 Spouse (without dependent child or student), child-housekeeper or housekeeper tax offset
– T2 Senior Australians tax offset
– T3 Pensioner tax offset
– M2 Medicare levy surcharge; where you printedX in the NO box at E
– T7 Superannuation contributions on behalf of your spouse tax offset; on the Tax return for
individuals (supplementary section) 2012
– T10 Dependent relative on the Tax return for individuals (supplementary section) 2012
– T12 Net income from working – supplementary section; on the Tax return for individuals (supplementary section)
– T13 Entrepreneurs tax offset; on the Tax return for individuals (supplementary section) 2012
– P9 Business loss activity details; on the Business and professional items schedule for individuals 2012.
We need the information requested in this section to accurately assess your tax offset entitlement, Medicare levy sur
HELP or SFSS repayment amount. We may also pass this information to other government agencies such as Centrelin
use the information to ensure you are receiving your full entitlement to government benefits.
If you had a spouse during 2011–12 you must also complete Spouse details – married or de facto on pages9–11.

IN-CONFIDENCE – when completed Page 9TAX RETURN FOR INDIVIDUALS 2012
Spouse details – married or de facto
If you completed any of the items listed below, and you had a spouse during 2011–12, or if you consent to use part or all
of your 2012 tax refund to repay your spouse’s Family Assistance Office (FAO) debt, you must complete Spouse details –
married or de facto. We need the information included in this section to assess your tax accurately.
Did you complete any of the following items or do you consent to use part or
all of your 2012 tax refund to repay your spouse’s FAO debt?
T1 Spouse (without dependent child or student) tax offset
T2 Senior Australians tax offset
T3 Pensioner tax offset
M1 Medicare levy reduction or exemption
M2 Medicare levy surcharge – and you printedX in the NO box at E
T7 Superannuation contributions on behalf of your spouse (on the supplementary
section of the tax return)
T10 Dependent relative
T13 Entrepreneurs tax offset (on the supplementary section of the tax return)
No Yes You must complete this section. Complete the
information required below then go to page 12.
You do not need to complete this
section. Go to page 12.
Your spouse’s name
If you had more than one spouse during 2011–12 print the name of your spouse on 30 June 2012 or your last spouse.
Surname or family name
First given name Other given names
Your spouse’s date of birth
Day Month Year
K Your spouse’s sexMale Female
Period you had a spouse – married or de facto
L
Day Month Year
M
Day Month Year
N
Yes No
Did you have a spouse for the full year –
1 July 2011 to 30 June 2012?
If you did not have a spouse for the full
year, write the dates you had a spouse
between 1 July 2011 and 30 June 2012.
From
To
R O B E R T S
S U S A N
X
Y

IN-CONFIDENCE – when completedPage 10 TAX RETURN FOR INDIVIDUALS 2012
Spouse details – married or de facto –continued
Make sure you have checked on page 9 that you need to complete Spouse details – married or de facto.
The information on this page relates to your spouse’s income.
The following list shows which details you need to complete.
If you have completed:
n item T1 complete O, S, Q, A, B, C, D and E
n item T2 or T3 complete O, T, S, P, Q, A and D
n item M1 (V or W ) complete O
n item M1 (Y only) completeO and Fif you had a spouse on 30 June 2012
n item M2 and you printedX
in the No box at E
complete O, T, U, S, A, D and F if you had a spouse for
all of 2011–12 or your spouse died during the year
n item T7 complete O, S and A
n item T10 complete O, S, Q, A, B, C, D and E
n item T13 complete O, S, A and D if you had a spouse on
30 June 2012.
Your spouse’s 2011–12 taxable income .00,,$O
If the amount is zero write 0.
Your spouse’s share of trust income on which the trustee is
assessed under section 98, and which has not been included in
your spouse’s taxable income
.00,$T
Distributions to your spouse on which family trust distribution tax
has been paid and which your spouse would have had to show as
assessable income if the tax had not been paid
.00,$U
Your spouse’s total reportable fringe benefits amounts .00,$S
Amount of Australian Government pensions and allowances
(see Q6 Australian Government pensions and allowances in the instructions)
that your spouse received in 2011–12 (exclude exempt pension income)
.00,$P
Amount of exempt pension income (see Amounts that you do not
pay tax on in the instructions) that your spouse received in 2011–12
(show your spouse’s exempt pension income)
.00,$Q
Amount of your spouse’s reportable superannuation contributions
(which is the total of reportable employer superannuation
contributions and deductible personal superannuation contributions)
.00,$A
Your spouse’s amount of any tax-free government pensions paid
under the Military Rehabilitation and Compensation Act 2004 that
have not been included at Q above
.00,$B
Your spouse’s target foreign income .00,$C
Your spouse’s total net investment loss (total of net financial
investment loss and net rental property loss) .00,$D
Child support your spouse paid .00,$E
Your spouse’s taxed element of a superannuation lump sum for which the
tax rate is zero (see M2 Medicare levy surcharge in the instructions) .00,$F
3 5 0 0

IN-CONFIDENCE – when completed Page 11TAX RETURN FOR INDIVIDUALS 2012
Z
Family Assistance Office consent– Complete this section only if you consent to use part or all of your 2012
tax refund to repay your spouse’s Family Assistance Office (FAO) debt.
Complete the details below only if:
n you were the spouse of a family tax benefit (FTB) claimant, or the spouse of a child care benefit claimant on 30 June 2012
n your spouse has given you authority to quote their customer reference number (CRN) on your tax return – if your spouse
not know their CRN, they can contact the FAO and
n your spouse has a debt due to the FAO or expects to have a FAO debt for 2012 and
n you expect to receive a refund for 2012 and
n you consent to use part or all of your refund to repay your spouse’s FAO debt.
No Yes
You do not need to complete
this section. Go to page 12. Your spouse’s CRN
Do you consent to use
part or all of your 2012
tax refund to repay your
spouse’s FAO debt?
I consent to the Tax Office using part or all of my 2012 tax refund to repay any FAO debt of my spouse,
whose details I have provided above. I have obtained my spouse’s permission to quote their CRN.
Your signature for FAO consent purposes only
Day Month Year
Date
Spouse details – married or de facto –continued

IN-CONFIDENCE – when completedPage 12 TAX RETURN FOR INDIVIDUALS 2012
Taxpayer’s declarationAll taxpayers must sign and date the declaration below.
If you are completing the supplementary section (pages 13–16) of your tax return, attach it here.
Read and answer the questions below before you sign the Taxpayer’s declaration.
1 Are you required to complete any of the items on the Tax return for individuals (supplementary section
To find out, read Will you need Individual tax return instructions supplement 2012? in the instructions.
No Yes
No YesGo to question 2. Attach pages 13–16 to this page.
2 Have the instructions asked you to attach the following?
a. Any attachments relating to specific questions – to page 3 of your tax return
b. Business and professional items schedule for individuals 2012 – to page 3
of your tax return No Yes
Make sure you have also attached all other documents that the instructions tell you to.
Privacy
The Tax Office is authorised by the Taxation Administration Act 1953 to request you to quote your tax file number (TFN
It is not an offence not to quote your TFN. However, your assessment may be delayed if you do not quote your TFN.
The Tax Office is also authorised by the Income Tax Assessment Act 1936, the Income Tax Assessment Act 1997 and
the A New Tax System (Family Assistance) (Administration) Act 1999 to ask for the other information on this tax return
We need this information to help us to administer the taxation laws.
We may give this information to other government agencies as authorised in taxation law – for example, benefit paym
agencies such as Centrelink, the Department of Education, Employment and Workplace Relations, and the Departmen
of Families, Housing, Community Services and Indigenous Affairs; law enforcement agencies such as state and federal
police; and other agencies such as the Child Support Agency, the Australian Bureau of Statistics and the Reserve Bank
of Australia.The Commissioner of Taxation, as Registrar of the Australian Business Register, may use the ABN and business
details which you provide on this tax return to maintain the integrity of the register.
I declare that:
n all the information I have given on this tax return, including any attachments, is true and correct
n I have shown all my income – including net capital gains – for tax purposes for 2011–12
n I have completed and attached the supplementary section, schedules and other attachments – as appropriate – that
the instructions told me to provide
n I have completed item M2 – Medicare levy surcharge
n I have the necessary receipts and/or other records – or expect to obtain the necessary written evidence within a
reasonable time of lodging this tax return – to support my claims for deductions and tax offsets.
IMPORTANT
The tax law imposes heavy penalties for giving false or misleading information.
The Tax Office will issue your assessment based on your tax return. However, the Tax Office has some time to review y
and issue an amended assessment if a review shows inaccuracies that change the assessment. The standard review p
years, but for some taxpayers it is four years. For more information go to www.ato.gov.au/notices
FOR YOUR TAX RETURN TO BE VALID YOU MUST SIGN BELOW.
Day Month Year
Date
Use the pre-addressed envelope provided with the instructions to lodge your tax ret
For more information, read the Important information section in the instructions.