36
NAT 73004-06.2016 PAGE 1 Sensitive (when completed) H/Company tax return 2016 Notes to help you prepare this tax return are in the Company tax return instructions 2016 and in the H/Company tax return 2016 – extra instructions (the instructions), available on our website ato.gov.au Day Month Year Day Month Year to Or specify period if part year or approved substitute period. Company information Tax file number (TFN) Name of company Australian business number (ABN) Business address of main business Suburb/town State/territory Postcode Postal address on previous tax return Suburb/town State/territory Postcode If the address has changed, print the previous address exactly as shown on the last tax return lodged. Current postal address Suburb/town State/territory Postcode If the address has not changed, print it exactly as shown on the last tax return lodged. Final tax return No Yes Previous name of company If the company name has changed, print the previous name exactly as shown on the last tax return lodged and show Australian company number (ACN) or Australian registered body number (ARBN). or ACN ARBN

H/Company - Home page | Australian Taxation Office · 2018-05-22 · Sensitive (when completed) H/Company tax return 2016 Important notice Information statement PAGE 1a Two accompanying

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NAT 73004-06.2016 PAGE 1Sensitive (when completed)

H/Company tax return 2016

Notes to help you prepare this tax return are in the Company tax return instructions 2016 and in the H/Company tax return 2016 – extra instructions (the instructions), available on our website ato.gov.au

Day Month Year Day Month Year

to

Or specify period if part year or approved substitute period.

Company informationTax file number (TFN)

Name of company

Australian business number (ABN)

Business address of main business

Suburb/town State/territory Postcode

Postal address on previous tax return

Suburb/town State/territory Postcode

If the address has changed, print the previous address exactly as shown on the last tax return lodged.

Current postal address

Suburb/town State/territory Postcode

If the address has not changed, print it exactly as shown on the last tax return lodged.

Final tax return No Yes

Previous name of companyIf the company name has changed, print the previous name exactly as shown on the last tax return lodged and show Australian company number (ACN) or Australian registered body number (ARBN).

orACN

ARBN

H/Company tax return 2016Sensitive (when completed)

Important notice

Information statement

PAGE 1a

Two accompanying schedules form part of this tax return.

Accompanying schedule no. 1 You must complete this schedule in full.

Accompanying schedule no. 2 Details requested must be provided if you have completed any item where S2 appears adjacent to a label in the tax return.

Refer to the H/Company tax return 2016 – extra instructions for information on completing the accompanying schedules

PAGE 2H/Company tax return 2016 Sensitive (when completed)

1 Ultimate holding company name and ABN or country code

ABN OR Country code

Immediate holding company name and ABN

ABN

B

2 Description of main business activity

Industry code Percentage of foreign shareholding %A

3 Status of company – print X in all applicable boxes.

Your selections at this question may determine how the tax law applies to you. See 3 Status of company in the instructions for more information about company status.

BSB number (must be six digits) Account number

Account name

Electronic funds transfer (EFT)We need your financial institution details to pay any refund owing to you, even if you have provided them to us before. Write the BSB number, account number and account name below. (See relevant instructions.)

Public D10

Pooled development fund D5Cooperative D1 Non-profit D3 Strata title D4

Private D9Limited partnership D6 Corporate

unit trust D7 Public trading trust D8

Resident C1 Non-resident no permanent estab. C2 Non-resident with

permanent estab. C3

Multiple business E1 Ceased

business E2 Commenced business E3

4 Interposed entity election statusIf the company has an existing election, write the earliest income year specified. If the company is making one or more elections this year, write the earliest income year being specified and complete an Interposed entity election or revocation 2016 for each election.

L

If revoking an interposed entity election, print R and complete and attach the Interposed entity election or revocation 2016.

Consolidated head company Z1 Consolidated

subsidiary member Z2

Small business entity F1

S2

S2

S2

S2

S2

PAGE 3 H/Company tax return 2016Sensitive (when completed)

Information statement – To be completed by all companies6 Calculation of total profit or loss

Income.00$ , ,

Gross payments subject to foreign resident withholding B ,

.00$ , ,Other sales of goods and services C ,

.00$ , ,Gross payments where ABN not quoted A ,

.00$ , ,Gross distribution from partnerships D ,

.00$ , ,Gross interest F ,

.00$ , ,Forestry managed investment scheme income X ,

CODE

Gross distribution from trusts E .00$ , ,,

.00$ , ,Total dividends H ,

.00$ , ,Gross rent and other leasing and hiring income G ,

.00$ , ,Fringe benefit employee contributions I ,

.00$ , ,Unrealised gains on revaluation

of assets to fair value J ,

.00$ , ,Assessable government industry payments QCODE

,

S $ ,.00, ,Total income

.00$ , ,Other gross income R ,

S2

S2

S2

S2

S2

S2

PAGE 4H/Company tax return 2016 Sensitive (when completed)

Expenses.00$ , ,Foreign resident withholding expenses B ,.00$ , ,Cost of sales A ,.00$ , ,

Contractor, sub-contractor and commission expenses C ,

.00$ , ,Superannuation expenses D ,

.00$ , ,Bad debts E ,

.00$ , ,Lease expenses within Australia F ,

.00$ , ,Lease expenses overseas I ,

.00$ , ,Rent expenses H ,

.00$ , ,Interest expenses within Australia V ,

.00$ , ,Interest expenses

overseas J ,

.00$ , ,Royalty expenses within

Australia W ,

.00$ , ,Royalty expenses

overseas U ,

.00$ , ,Motor vehicle expenses Y ,

.00$ , ,Repairs and maintenance Z ,

.00$ , ,Depreciation expenses X ,

.00$ , ,Unrealised losses on revaluation

of assets to fair value G ,

6 Calculation of total profit or loss – continued

Do you have a non-resident withholding payment or reporting obligation? See instructions.

Complete and attach an International dealings schedule 2016.

Total profit or loss

Q $ ,.00, ,Total expenses

$ ,.00, ,

Subtract Total expenses Q from Total income S T

.00$ , ,All other expenses S ,

S2

S2

PAGE 5 H/Company tax return 2016Sensitive (when completed)

7 Reconciliation to taxable income or loss

Do you need to complete a Capital gains tax (CGT) schedule 2016?

Did you have a CGT event during the year? Yes NoG Answer Yes at G if the company had an amount of a capital gain from a trust.

.00$ , ,Total profit or loss amount shown at T item 6 ,

.00$ , ,Section 40-880 deduction Z ,

.00$ , ,Capital works deductions I ,

.00$ , ,Deduction for project pool H ,

.00$ , ,Immediate deduction for capital expenditure E ,

.00$ , ,Deduction for decline in value of

depreciating assets F ,.00$ , ,

Forestry managed investment scheme deduction U ,

Less: .00$ , ,CSection 46FA deductions for flow-on dividends ,

.00$ , ,Landcare operations and deduction for decline in value of water facility, fencing asset and fodder storage asset N ,

.00$ , ,Deduction for environmental

protection expenses O ,

.00$ , ,Accounting expenditure in item 6

subject to R&D tax incentive D ,

.00$ , ,Non-deductible expenses W ,

.00$ , ,Other assessable income B ,

.00$ , ,Australian franking credits from

a New Zealand company C ,.00$ , ,

TOFA income from financial arrangements not included in item 6 E ,

.00$ , ,Franking credits J ,

.00$ , ,Non-deductible exempt income expenditure U ,

.00$ , ,Net capital gain AAdd: ,

.00$ ,, ,Subtotal

Have you applied an exemption or rollover? Yes NoMCODE

.00$ , ,POffshore banking unit adjustment ,

Do you need to complete the International dealings schedule 2016?

Complete and attach an International dealings schedule 2016.

S2

S2

S2

S2

S2

PAGE 6H/Company tax return 2016 Sensitive (when completed)

Less: – continued

Do you need to complete a Losses schedule 2016?

.00$ ,, ,XOther deductible expenses

.00$ , ,Tax losses transferred in (from or to a foreign bank

branch or a PE of a foreign financial entity) S ,

.00$ , ,Tax losses deducted R ,

.00$ , ,WTOFA deductions from financial arrangements not included in item 6 ,

.00$ ,, ,Subtraction items subtotal

.00$ ,, ,*Taxable/net income or loss T

.00$ , ,VExempt income ,

.00$ , ,QOther income not included in assessable income ,

8 Financial and other information

Functional currency chosen O

.Functional currency translation rate N

$ , ,Opening stock A ,.00

$ , ,Purchases and other costs S ,.00

$ , ,Closing stock BCODE

,.00

Trading stock election Yes No

$ , ,Trade debtors C ,.00

$ , ,All current assets D ,.00

$ , ,Total assets E ,.00

$ , ,Trade creditors F ,.00

$ , ,All current liabilities G ,.00

$ , ,Total liabilities H ,.00

$ , ,Total debt J ,.00

$ , ,Commercial debt forgiveness K ,.00

(an amount must be included even if it is zero)

Franked dividends paid J $ , ,,.00

Unfranked dividends paid K $ , ,,.00

Franking account balance M $ , ,,.00

S2

S2

PAGE 7 H/Company tax return 2016Sensitive (when completed)

9 Capital allowances

$ , ,Other depreciating assets first deducted B ,.00

$ , ,Intangible depreciating assets first deducted A ,.00

Depreciating assets first deducted in this income year

Have you self-assessed the effective life of any of these assets? Yes NoC

$ , ,Assessable balancing adjustments on the disposal of intangible depreciating assets F ,

.00

$ , ,Termination value of intangible depreciating assets H ,.00

$ , ,Termination value of other depreciating assets I ,.00

$ , ,Total adjustable values at end of income year E ,.00

$ , ,Deductible balancing adjustments on the disposal of intangible depreciating assets G ,

.00

Did you recalculate the effective life for any of your assets this income year? Yes NoD

For all depreciating assets

$ , ,Total deduction for decline in value of intangible

depreciating assets used in exploration or prospecting K ,.00

$ , ,Total mining capital expenditure and/or transport

capital that you allocated to a project pool and for which you can claim a deduction this income year

J ,.00

$ , ,Total deduction for decline in value of other

depreciating assets used in exploration or prospecting L ,.00

For entities connected with mining operations, exploration or prospecting

8 Financial and other information – continued

$ , ,Total salary and wage expenses DCODE

,.00

$ , ,Payments to associated persons Q ,.00

$ , ,Net foreign income R ,.00

Do you need to complete a Losses schedule 2016?

Attributed foreign income

$ , ,Listed country B ,.00

$ , ,Transferor trust V ,.00

$ , ,Total TOFA gains T ,.00

$ , ,Total TOFA losses U ,.00

,

CODE

$ , ,Loans to shareholders and their associates N .00

$ , ,Excess franking offsets H ,.00

$ , ,TOFA gains from unrealised movements in

the value of financial arrangements S ,.00

$ , ,Gross foreign income G ,.00

$ , ,Unlisted country U ,.00

S2

PAGE 8H/Company tax return 2016 Sensitive (when completed)

12 National rental affordability scheme

National rental affordability scheme tax offset entitlement J .$ , ,,

10 Small business entity simplified depreciation

Deduction for certain assets A $ , ,.00,

Deduction for general small business pool B $ , ,

.00,

11 Consolidation deductions relating to rights to future income, consumable stores and work in progress

Pre rules deductions D $ , ,.00,

Interim rules deductions E $ , ,.00,

Prospective rules deductions F $ , ,.00,

15 Licensed clubs only Percentage of non-member income A %

14 Personal services income Does your income include an individual’s personal services income? Yes NoN

Did you satisfy the results test in respect of any individual? Yes NoC

Do you hold a personal services business (PSB) determination in respect of any individual? Yes NoD

Total amount of PSI included at item 6 income labels A $ , ,

.00,Total amount of deductions against

PSI included at item 6 expense labels B $ , ,.00,

Unrelated clients test E1 Employment test E2 Business premises test E3

For any individual for whom you did not satisfy the results test or hold a PSB determination, and each source of their PSI income yielded less than 80% of their total PSI, indicate if you satisfied any of the following personal services business tests – print X in the appropriate box(es).

13 Losses information

Complete and attach a Consolidated groups losses schedule 2016 or a Losses schedule 2016, as applicable, if the sum of U and V is greater than $100,000. Refer to the applicable schedule instructions for full details of who must complete the schedule.

Tax losses carried forward to later

income yearsU $ , ,

.00,

Net capital losses carried forward to later income years

V $ , ,.00,

PAGE 9 H/Company tax return 2016Sensitive (when completed)

16 Life insurance companies and friendly societies only

Complying superannuation class B $ , ,

.00,Net capital gain – complying

superannuation class C $ , ,.00,

Net capital gain – ordinary class D $ , ,.00,

Assessable contributions E $ , ,.00,

Fees and charges F $ , ,.00,

22 Internet trading Did you sell any goods or services using the internet? Yes NoQ

23 Reportable tax position Are you required to lodge a reportable tax position schedule? Yes NoB

If you answered Yes at B complete and attach a Reportable tax position schedule 2016.

Foreign income tax offset $ , ,.

,J20 Foreign income tax offset

If you have completed labels A or U a Research and development tax incentive schedule 2016 is required to be completed and lodged with your Company tax return.

21 Research and development tax incentive

Include amount in calculation statement at label E – Refundable tax offsets

Refundable R&D tax offset

Refundable R&D tax offset U .$ , ,,

Feedstock adjustment

Feedstock adjustment – additional assessable income W .$ , ,,(include this amount at item 7B – Other assessable income)

Non‑refundable R&D tax offset

Include total amounts from labels A and B in calculation statement at label D – Non‑refundable carry forward tax offsets

(A plus B less C)

Non-refundable R&D tax offset A .$ , ,,

Non-refundable R&D tax offset carried forward from previous year B .$ , ,,

Non-refundable R&D tax offset carried forward to next year D .$ , ,,

Non-refundable R&D tax offset to be utilised in current year C .$ , ,,

18 Pooled development funds Small and medium sized enterprises income G $ , ,

.00,

Unregulated investment income H $ , ,.00,

19 Retirement savings accounts (RSAs) providers only

Net taxable income from RSAs V $ , ,.00,

No-TFN contributions income U $ , ,.00,

(an amount must be included even if it is zero)

Income tax payable on no-TFN contributions income X $ , ,.

,(an amount must be included even if it is zero)

PAGE 10H/Company tax return 2016 Sensitive (when completed)

Overseas transactions or interests/thin capitalisation – the following questions must be answered.

International related party dealings/transfer pricing24 Did you have any transactions or dealings with international related parties (irrespective of whether

they were on revenue or capital account)? Such transactions or dealings include the transfer of tangible or intangible property and any new or existing financial arrangements.

Yes NoX

25 Was the aggregate amount of the transactions or dealings with international related parties (including the value of property transferred or the balance outstanding on any loans) greater than $2 million? Yes NoY

26 Overseas interestsDid you have overseas branch operations or a direct or indirect interest in a foreign trust, foreign company, controlled foreign entity or transferor trust? Yes NoZ

27 Thin capitalisationDid the thin capitalisation provisions affect you? Yes NoO

If you answer Yes at item 25, 26 or 27 complete and attach an International dealings schedule 2016.

28 Transactions with specified countriesDid you directly or indirectly send to, or receive from, one of the countries specified in the instructions, any funds or property ORDo you have the ability or expectation to control, whether directly or indirectly, the disposition of any funds, property, assets or investments located in, or located elsewhere but controlled or managed from one of those countries?

Yes NoI

PAGE 11 H/Company tax return 2016Sensitive (when completed)

Calculation statement*Important: Item 7 label T and labels A, T1, T5 and I of the calculation statement are mandatory. If you leave these labels blank, you will have specified a zero amount.

H1

Credit for interest on early payments – amount of interest

$ , , .

H5

Credit for TFN amounts withheld from payments from closely held trusts

$ , , .

, ,H4Tax withheld from interest or investments

$ .

, ,H7Other credits

$ .

Eligible credits

(Add H1, H2, H3, H4, H5 and H7)

H $ , , .,

H2

Credit for tax withheld – foreign resident withholding

$ , , .00

H3

Credit for tax withheld where ABN is not quoted

$ , , .00

Please refer to the Company tax return instructions 2016 on how to complete the calculation statement.

AMOUNT DUE OR REFUNDABLE A positive amount at S is what you owe,

while a negative amount is refundable to you.

S $ , , .,(T5 plus G less H less I less K)

PAYG instalments raised K $ , , .,

*Tax offset refunds (Remainder of refundable tax offsets) I $ , , .,

(unused amount from label E – an amount must be included even if it is zero)

Franking deficit tax offset F $ , , .,

R&D recoupment tax M $ , , .,

Non‑refundable carry forward tax offsets D $ , , .,

Refundable tax offsets E $ , , .,

Section 102AAM interest charge

G $ , , .,

Non‑refundable non‑carry forward tax offsets C $ , , .,

Gross tax B $ , , .,(T1 plus M)

Subtotal 1 T2$ , , .,(B less C – cannot be less than zero)

Subtotal 2 T3$ , , .,(T2 less D – cannot be less than zero)

Subtotal 3 T4$ , , .,(T3 less E – cannot be less than zero)

*TAX PAYABLE T5$ , , .,(T4 less F – cannot be less than zero, an amount must be included even if it is zero)

.00$ , ,*Taxable or net income A ,(an amount must be included even if it is zero)

*Tax on taxable or net income T1 $ , , .,(an amount must be included even if it is zero)

PAGE 12H/Company tax return 2016 Sensitive (when completed)

Declarations

PUBLIC OFFICER’S DECLARATIONImportant Before making this declaration check to ensure that all income has been disclosed and the tax return, all attached schedules and any additional documents are true and correct in every detail. If you leave labels blank, you will have specified a zero amount or the label was not applicable to you. If you are in doubt about any aspect of the tax return, place all the facts before the ATO. The income tax law imposes heavy penalties for false or misleading statements in tax returns. This declaration must be signed by the public officer.

Privacy Taxation law authorises the ATO to collect information including personal information about the person authorised to sign the declaration. For information about your privacy go to ato.gov.au/privacy

DECLARATION:I declare that the information on this tax return, all attached schedules and any additional documents is true and correct.

Date

Day Month Year

Public officer’s signature

Daytime contact number (include area code)Public officer’s name

JHours taken to prepare and complete this tax return

declare that this tax return has been prepared in accordance with information provided by the taxpayer, that the taxpayer has given me a declaration stating that the information provided to me is true and correct and that the taxpayer has authorised me to lodge this tax return.

Date

Day Month Year

Agent’s signature

Tax agent’s declaration:

Client’s reference

Agent’s phone number (include area code) Agent’s reference number

Contact name

I,

PAGE 13 H/Company tax return 2016Sensitive (when completed)

Other informationUnless otherwise stated the following questions relate to the period 1 July 2015 to 30 June 2016.

Please answer each question by placing a cross – X – in the appropriate box and provide all additional information requested.

The questions in this schedule do not apply to any transactions occurring between members of a consolidated group, including the head entity, that occur while these members are part of the consolidated group.

Information statementThis accompanying schedule forms part of the H/Company tax return 2016.

Complete all questions in full.

See Definitions in the H/Company tax return 2016 – extra instructions for the meaning of the following terms: arrangement, associate, entity, limited recourse loan, non-recourse loan and reasonably arguable position.

For the foreign country codes, see Appendix B of the H/Company tax return 2016 – extra instructions.

This schedule forms part of the tax return of:

Name of company

Tax file number (TFN)

Public officer’s signature

H/Company tax returnAccompanying schedule no. 1 2016If there is insufficient space on the form to completely answer any question or if any question requires multiple answers attach extra sheet(s) with the additional information.

If the disposal was to an associated person or entity provide the following additional information:The full name of the

associated person or entity

Provide the foreign country code

The country of residence of the associated person or entity

If an associated entity provide its tax file number (if known)

1 Capital gains1(a) Did the company dispose of an asset by entering into a transaction where

either the acquisition and capital costs of the asset forming part of that transaction or the consideration for the disposal of the asset was greater than $1,000,000 and the disposal of the asset did not constitute a CGT event described in Division 104 of the Income Tax Assessment Act 1997 (ITAA 1997)?

If yes, provide the following information in respect of each such disposal.

No Yes

The description of the asset disposed of

The reason for the profit or gain not being included in the calculation of the

company’s taxable income or loss

The amount of the loss not included in the company’s

taxable income or loss

The amount of the profit or gain not included in the company’s taxable

income or loss$$

The date of acquisition of the asset

The cost of the asset $

Day Month Year

The date of disposal of the asset

Consideration in respect of the disposal $

Day Month Year

If the asset had its tax cost set for consolidation purposes, provide details of the cost base or reduced cost base just before the joining time

$

PAGE 14H/Company tax return 2016 Sensitive (when completed)

1(c) Did the company own or have any beneficial interest in any land and/or buildings situated in Australia which were not acquired or were not used for the purpose of gaining or producing assessable income?

If yes, provide the following information in respect of each such property.

No Yes

The address of the property

The cost of any improvements to the property $

The date the company acquired the property The cost of the property $

Day Month Year

The full name of any person or entity holding the property on the

company’s behalf

Provide the foreign country code

The country of residence of any person or entity holding the property

on the company’s behalf

If the company has a valuation of the property at other than cost, provide details of the most recent valuation

Value $

Date

Day Month Year

1(d) Were any members’ interests subject to the CGT rollover provisions before forming, joining, or leaving the consolidated group (or Multiple Entry Consolidated (MEC) group) during the year of income?

The name of the member entity

The date the choice for the CGT rollover was made

Day Month Year

The CGT rollover provision

If yes, provide the following information in respect of each such interest.

No Yes

If the disposal was to an associated person or entity, provide the following additional information:

The full name of the associated person or entity

Provide the foreign country code

The country of residence of the associated person or entity

If an associated entity provide its tax file number (if known)

No Yes If yes, provide the following information in respect of each such disposal.

1(b) Did the company dispose of an asset by entering into a transaction where either the acquisition and capital costs of the asset forming part of that transaction or the consideration for the disposal of the asset was greater than $1,000,000 and the company had a CGT event described in Division 104 of the ITAA 1997 (including a rollover but not including a profit or gain on the disposal of a personal use asset)?

The description of the asset disposed of

The amount of the loss included in the company’s

taxable income or loss

The amount of the profit or gain included in the company’s taxable

income or loss$$

The date of acquisition of the asset

The cost of the asset $

Day Month Year

The date of disposal of the asset

Consideration in respect of the disposal $

Day Month Year

If the asset had its tax cost set for consolidation purposes, provide details of the cost base or reduced cost base just before the joining time

$

PAGE 15 H/Company tax return 2016Sensitive (when completed)

2 Non assessable receipts and distributions2(a) Did the company receive any distributions of capital, capital advancements

or distributions of corpus from a trust, or gifts of money or property, from any person or entity with an aggregate value of $500,000 or more for the year of income, which was not included in the company’s assessable income?

If yes, provide the following information in respect of each such distribution.

No Yes

The reason for and the source of the distribution (eg from settled funds or

asset revaluation reserve)

The reason for the distribution not being assessable income to the company

Amount $The nature of the distribution

The date of the distributionDay Month Year

The full name of the person or entity making the distribution

Provide the foreign country code

The country of residence of the person or entity making the distribution

If an associated entity provide its tax file number (if known)

2(b) Did the company make any capital advancement, or any other distribution of capital, or make any gift or any other transfer of money or property to any person or entity, or make any provision of an asset for use by an entity?

If yes, provide the following information for each such distribution.

No Yes

The nature of the distribution

The source of the distribution (eg from capital reserves)

Amount $The date of the distributionDay Month Year

The full name of the recipient

Provide the foreign country code

The country of residence of the recipient

If an associated entity provide its tax file number (if known)

The date of those entriesDay Month Year

The name of the reserve account

A description of the entries made in the account

If the distribution was sourced from a reserve account (including an account for capital profits, asset revaluation or general reserve) provide the following additional information:

PAGE 16H/Company tax return 2016 Sensitive (when completed)

3 Overseas transactions3(a) Did the company make or receive payment of any amount greater than

$500,000 (other than receipts listed in answer to question 2(a) on page 15) to or from any person or entity located outside of Australia, which payment was not an allowable deduction or assessable income to the company?

If yes, provide the following information in respect of each such payment made or received.

No Yes

The nature and purpose of the payment

The reason for the payment not being an allowable deduction or

assessable income to the company

Amount of payment received $$Amount of payment made

The date of the paymentDay Month Year

The full name of the other party to the transaction

Provide the foreign country code

The country of residence of the other party to the transaction

3(b) Did the company pay, or incur a liability to contribute to or bear the cost of, any amount by way of loan; capital contribution; fees for accounting, banking, legal, consulting or other services provided or received; or otherwise in respect of the establishment or maintenance of any person or entity located outside Australia?

If yes, provide the following information for each such payment or liability.

No Yes

The reason for it being deductible

Amount $The nature of the payment or liability

Amount $The nature of any assessable income derived by the company in respect of

the payment or liability

Amount $The nature of any deduction claimed

by the company in respect of the payment or liability

The full name of the person or entity for whom the amount of payment or

liability was paid or incurred

Provide the foreign country code

The country of residence of the person or entity

3(c) Did the company claim a deduction for any expenses incurred (other than salary or wages expenses) in respect of management, consulting, financial, administrative or other services provided to the company by a person or entity (other than an associate listed in answer to question 4(b) on page 18) located outside Australia?

If yes, provide the following information in respect of each such expense.

No Yes

A description of the services provided to the company

$The amount of the expense

The full name of the person or entity

Provide the foreign country code

The country of residence of the person or entity

PAGE 17 H/Company tax return 2016Sensitive (when completed)

3(d) Did the company make any contributions on behalf of employees to any offshore employee benefit trust, offshore superannuation, pension, retirement, employee welfare, stichting or anstalt or other like offshore funds?

If yes, provide the following information in respect of each fund.

No Yes

$The amount of contributions

made to the fund

The full name of the fund

Provide the foreign country code The country of residence of the fund

3(e) Did the company have any accounts with any bank or other financial institution outside Australia (other than credit cards or debit cards)?

If yes, provide the following information in respect of each such account.

No Yes

Did the company derive any interest income from the account? No Yes

The name of the institution at which the account was located

The name of the account

Provide the foreign country code

The number of the account

The address of the institution at which the account was located

3(f) Did the company own, have a beneficial interest in, or have the ability or expectation to control directly or indirectly, any funds, property, investment or other assets, tangible or intangible, located outside Australia or managed from a location outside Australia?

If yes, provide the following information in respect of each such asset.

No Yes

The cost of the asset $

The date the company acquired the asset or gained an interest or control

Day Month Year

If the company has a valuation of the asset at other than cost, provide details

of the most recent valuation

Value $

Date

Day Month Year

The full name of any person or entity holding the asset on the company’s behalf

Provide the foreign country code

The country in which the asset is located

Provide the foreign country code

The country of residence of any person or entity holding the asset

on the company’s behalf

The nature and a description of the asset

Did the company use the asset for any income-producing activity? No Yes

PAGE 18H/Company tax return 2016 Sensitive (when completed)

4 Transactions with associates

3(g) Did the company have, or did the company provide any person with, any credit cards or debit cards which were issued from outside Australia?

If yes, provide the following information in respect of each such card.

No Yes

Did the company derive any interest income in respect of the card? No Yes

The name of the institution which issued the card

The name of the account

The reason for it being deductible

Provide the foreign country code

The number of the account

The address of the institution which issued the card

The full name of any person provided with the card

The full name of the person or entity which paid the accounts

The nature of any deduction claimed by the company for expenses

incurred on the accountAmount $

4(a) Did the company derive any assessable income in respect of management, consulting, financial, administrative or other services provided by the company to an associated person or entity?

If yes, provide the following information in respect of each such income amount derived.

No Yes

A description of the services provided by the company

The amount of the assessable income $

The full name of the associated person or entity

Provide the foreign country code

The country of residence of the associated person or entity

Provide the tax file number of the associated entity (if known)

4(b) Did the company claim a deduction for any expenses incurred (other than salary and wages expenses) in respect of management, consulting, financial, administrative or other services provided to the company by an associated person or entity?

If yes, provide the following information in respect of each such expense.

No Yes

A description of the services provided to the company

The amount of the expense $

The full name of the associated person or entity

Provide the foreign country code

The country of residence of the associated person or entity

Provide the tax file number of the associated entity (if known)

PAGE 19 H/Company tax return 2016Sensitive (when completed)

For the purposes of question 4(c) only, the following definitions apply:

Controller of the company has the meaning given by section 727-355 of ITAA 1997

Equity or loan interests has the meaning given by section 727-520 of ITAA 1997

Related entities or persons refers to entities that, together with the company, would meet the ultimate controller test in section 727-105 of ITAA 1997 or the common ownership nexus test in section 727-110 of ITAA 1997.

4( c )(i) Did the company enter into any arrangements (for example, loans and other ongoing service arrangements, the transfer of assets) with related entities or persons where the market value of what was to be provided or received by the company exceeded $5 million?

If YES, advise

No Yes

Details of any losses made on the realisation of direct or indirect equity

or loan interests in the company that have taken place since the arrangement was entered into

The name of the related entities or persons

A brief description of the arrangement

Whether the parties provided market value consideration or dealt at

arm’s length in relation to all of the transactions under the arrangement

(ii) Were any equity or loan interests in the company n held by a controller or their associate, varied or brought to an end (for example,

changing the rights attaching to a share or the terms of a loan, buying back or cancelling a share or other equity interest or forgiving a loan), or

n issued to a controller or their associate? If YES, advise

No Yes

The names of the parties involved

A brief description of the arrangement

(iii) Did the company realise n an asset over which a right was granted to an associate on or after 1 July 2001, or n an asset (including a share or trust interest) that was acquired under a capital gains

tax rollover as a replacement for such an asset where at the time of that realisation the right was still in existence?

If YES, provide

No Yes

Details of the transaction under which the right was created

PAGE 20H/Company tax return 2016 Sensitive (when completed)

$

Opening balance as at 1 July 2015 Total debits for the year Total credits for the year Closing balance

as at 30 June 2016

$ $ $

Dr or Cr

Cr

4(d) Did the company owe, as at 30 June 2016, any amount on account of a loan or advance of funds received by the company at any time (including those received via a loan account as a partner, a member of a joint venture, a shareholder of a company, or a trust beneficiary) from any associated person or entity (including a director or shareholder of the company)?

If yes, provide the following information in respect of each such account.

No Yes

Did the company claim a deduction for any interest expenses incurred by the company in respect of the account?

No Yes

Did the company have a written loan agreement with the associated person or entity?

No Yes

Does any part of the deduction claimed for interest expense relate to interest that has been capitalised and not paid?

No Yes

The name or title of the account

The full name of the associated person or entity

Provide the foreign country code

The country of residence of the associated person or entity

Provide the tax file number of the associated entity (if known)

$

Opening balance as at 1 July 2015 Total debits for the year Total credits for the year Closing balance

as at 30 June 2016

$ $ $

Dr or Cr

Dr

4(e) Was the company owed, as at 30 June 2016, any amount on account of a loan or advance of funds made by the company at any time (including those made via a loan account as a partner, a member of a joint venture, a shareholder of a company or a trust beneficiary) to any associated person or entity (including a director or shareholder of the company)?

If yes, provide the following information in respect of each such account.

No Yes

Did the company derive any interest income in respect of the account? No Yes

Did the company have a written loan agreement with the associated person or entity?

No Yes

The name or title of the account

The full name of the associated person or entity

Provide the foreign country code

The country of residence of the associated person or entity

Provide the tax file number of the associated entity (if known)

PAGE 21 H/Company tax return 2016Sensitive (when completed)

4(f) Did the company acquire any asset or any interest in any asset (other than loan accounts listed in answer to question 4(e) on page 20), tangible or intangible, from any associated person or entity?

If yes, provide the following information in respect of each such acquisition.

No Yes

If the company has a valuation of the asset at other than cost, provide

details of the most recent valuation

Value $

Date

Day Month Year

Details of any loan provided by the associated person or entity to the

company in respect of the acquisition

Amount $

The full name of the associated person or entity

Provide the foreign country code

The country of residence of the associated person or entity

The nature and a description of the asset

Did the company use the asset for any income-producing activity? No Yes

The date of acquisition of the asset The cost of the asset $

Day Month Year

Provide the tax file number of the associated entity (if known)

4(g) Did the company provide to an associated person (other than in respect of employment or services rendered) free or subsidised access to or use of any car, house, boat, artwork, club membership, or any other asset owned, rented or leased by the company?

If yes, provide the following information in respect of each such asset provided.

No Yes

The nature of any deduction claimed by the company in respect of

providing the asset

Amount $

The full name of the person to whom the asset was provided

Provide the foreign country code

The country of residence of the associated person

The nature and a description of the asset

The reason for the asset being provided

Refer to the fact sheet Division 7A and Fringe Benefits Tax (FBT) for guidance.

PAGE 22H/Company tax return 2016 Sensitive (when completed)

5 Debt forgiveness

6 Other transactions

5(a) Did the company forgive any debt of $500,000 or more owed to it by any person or entity?

If yes, provide the following information in respect of each such debt forgiven.

No Yes

The full name of the person or entity whose debt was forgiven

Provide the foreign country code

The country of residence of the person or entity whose debt was forgiven

The total amount forgiven by the company $

The amount of any deduction claimed by the company in respect of the debt forgiven

$

The date the debt was forgiven

Day Month Year

If an associated entity provide its tax file number (if known)

If an associated person or entity show A, or show N for a non-associate

5(b) Did the company have any debt of $500,000 or more owed by it forgiven by any person or entity?

If yes, provide the following information in respect of each such debt forgiven.

No Yes

The full name of the person or entity who forgave the debt

Provide the foreign country code

The country of residence of the person or entity who forgave the debt

The total amount forgiven to the company $The date the debt

was forgiven

Day Month Year

If an associated entity provide its tax file number (if known)

If an associated person or entity show A, or show N for a non-associate

6(a) Did the company participate in any arrangement that was financed by a non‑recourse loan or limited recourse loan?

If yes, provide the following information for every such arrangement.

No Yes

The name of the borrower

The name of the lender

The amount of the loan $

6(b) Did the company take a position, in regard to the application of an income tax law to a matter or identical matters in a particular way, which was: a) reasonably arguable for the purposes of section 284-15 of Schedule 1 of Taxation Administration Act 1953 (TAA 1953), or b) not reasonably arguable for the purposes of section 284-15 of Schedule 1 of TAA 1953?

And in relation to that matter: n an amount of income or capital of more than $1,000,000 was not

included in taxable income, or n a deduction, tax offset or credit of more than $1,000,000 was claimed for the year of income?

If yes, provide the following information for each such transaction.

No Yes

The nature of the transaction

Amount $

Brief details of the position taken

PAGE 23 H/Company tax return 2016Sensitive (when completed)

6(c) Did the company have any accounts with any bank or other financial institution within Australia (other than credit cards or debit cards)?

If yes, provide the following information in respect of each such account.

No Yes

The name of the institution at which the account was located

The number of the account

The name of the account

The address of the institution at which the account was located

Did the company derive any interest income from the account? No Yes

6(d) Did the company derive any amount that is either exempt income or non-assessable non-exempt income?

If yes, provide the following information in respect of each such income amount derived.

No Yes

The nature of the income

The reason for the income being either exempt or non-assessable non-exempt

from Australian income tax

The full name of the person or entity from whom the income was derived

Provide the foreign country code

The country of origin of the income

Provide the amount of the company’s exempt income for the year of income within the meaning of section 6-20 of ITAA 1997. Amount $

Provide the amount of the company’s non-assessable non-exempt income for the year of income within the meaning of section 6-23 of ITAA 1997. Amount $

6(e) Was the company a ‘demerging entity’ as defined in section 125-70 of ITAA 1997?

If yes, provide the following information in respect of each demerger.

No Yes

Name of the demerged entity

Amount of capital distributed under the demerger $

Amount of profit/income distributed under the demerger $

Was a capital gain or loss disregarded under Division 125 of ITAA 1997 No Yes

6(f) Does the company have an association with a complying or non-complying superannuation fund?

If yes, provide the following information about each association.

No Yes

The amount of profit/income distributed under the association $

Did you disregard a capital gain or loss under section 118–320 of ITAA 1997? No Yes

PAGE 24H/Company tax return 2016 Sensitive (when completed)

7 Reserve account transactions

Name of the account

Total reserves

Total debits for the year

$

Total credits for the year

$

Opening balance as at 1 July 2015

$

Closing balance as at 30 June 2016

$

(Transfer this amount to the Summary of shareholders funds on page 26 of schedule No. 1) $

7(a) Did the accounts of the company contain any reserve accounts (including accounts for capital profits, asset revaluation or general reserve)?

If yes, provide the following information in respect of each such reserve account.

No Yes

7(b) Has the disposal of any asset by the company resulted in any amount being credited to a reserve account?

If yes, provide the following information in respect of each such credit.

No Yes

The address of any real estate asset sold

The basis on which the consideration was determined

The amount credited $

The cost of the asset $

The date of acquisition of the asset

Day Month Year

Consideration in respect of the disposal $The date of disposal of the asset

Day Month Year

If the disposal was to an associated person or entity provide the following additional information:The full name of the

associated person or entity

The name of the reserve account

A description of the asset sold

Provide the foreign country code

The country of residence of the associated person or entity

Provide the tax file number of the associated entity (if known)

7(c) Has the revaluation of any asset by the company resulted in any amount being credited to a reserve account?

If yes, provide the following information in respect of each such credit.

No Yes

The address of any real estate asset revalued

The reason for the revaluation

The amount credited $

The cost of the asset $

The date of acquisition of the asset

Day Month Year

The basis of the revaluation

The name of the reserve account

A description of the asset revalued

Was the revaluation carried out by an independent third party? No Yes

PAGE 25 H/Company tax return 2016Sensitive (when completed)

Loan accounts8(f) If the answer to question 4(d) and question 4(e) on page 20 is yes, attach only in respect of any entity (whether

natural person, trust or partnership) a copy of the entities’ loan accounts detailing all debits and credits for the year of income.

8 Financial statements and other informationFinancial statements 8(a) Provide the following financial statements for the year of income:

n statement of financial performance (including details of all abnormal items), or full profit and loss statement (including a profit and loss appropriation account and, where appropriate, manufacturing and/or trading accounts)

n statement of financial position or full balance sheet (show all assets and liabilities inside and outside Australia, including all of the company’s interests in any entity)

n statement of cash flows (where available), andn notes to and forming part of the financial statements.

8(b) If the company is a head company of a consolidated group (or MEC group), provide a copy of:n any financial statements prepared by consolidated subsidiary members that are incorporated into the

head company’s financial statements, andn any reconciliation statements prepared by the consolidated subsidiary members for the process of

preparing the head company’s income tax return.

8(d) If an entity exited a consolidated group (or MEC group) in the year of income, provide detailed copies of all:n exit ACA calculations and working papersn tax cost setting amount calculations for membership interests, andn financial statements used in the preparation of the exit ACA just before the leaving time.

8(e) If a transferred tax or capital loss was deducted or applied during the year of income using the available fraction method, provide detailed copies of all available fraction calculations and/or recalculations (including market valuation and market-valuation method used).

Consolidation information8(c) If a consolidated group (or MEC group) was formed or an entity joined an existing consolidated group

(or MEC group) in the year of income, provide detailed copies of all:n entry allocable cost amount (ACA) calculations and allocation process working papers (including market

valuation and market-valuation method used), and n financial statements used to prepare entry ACA and allocation processes just before joining time.

If the company is the head company of a consolidated group, did you claim a deduction at any of the following labels:

n label 7X or any other label field for the tax cost of an asset that is a right to future income

n label 7X, 7Z, or any other label field for the tax cost of an asset that was set under the residual tax cost setting rule in subsection 701-55(6) of ITAA 1997?

If yes, provide the following information for each tax cost deduction amount.

No Yes

Rules used to claim the deduction Pre rules Interim rules Prospective rules

Entity name

Date the entity joined the consolidated group

Joining entity which held the asset

Asset

Type of asset included at 7X or 7Z Right to future income Residual tax cost setting

Asset description

Tax cost deduction amount

PAGE 26H/Company tax return 2016 Sensitive (when completed)

9(c) List of shareholders Provide separate details for each shareholder.

Full name of registered shareholder Class of share

Are the shares fully

paid? (yes/no)

Number of shares held at 30 June 2016

9(d) Are any shares in the company, or was any interest in shares in the company, held by a registered shareholder on behalf of, or in trust for, a third person or entity?

If yes, provide the following information in respect of all such shares.

No Yes

Class of shares Number of shares

Details of shares held on behalf of a third person or entity

The full name of the person or entity on whose behalf the shares are held

Name of the registered shareholder

Provide the foreign country code

The country of residence of the person or entity on whose behalf the shares are held

9(b) Summary of shareholders’ funds

Issued capital for all classes of shares (from above)

Total reserves (from schedule No. 1, question 7(a))

Accumulated profits/losses closing balance

Total Shareholders’ funds

$

$

$

$

9 Shareholder information

9(a) Summary of share capital Provide separate details for each class of share.

Total paid-up amount $

Total amount unpaid$

Total number issued

$Total issued capital for all classes of shares

(Transfer this amount to the Summary of shareholders’ funds calculation block below.)

Description – full title of shareClass

of share

PAGE 27 H/Company tax return 2016Sensitive (when completed)

9(e) Have any changes occurred during the year of income in the beneficial ownership of shares or in voting, dividend or capital rights attaching to shares in the company or in any other company interposed between the company and natural persons?

If yes, provide full details of the changes that have occurred.

No Yes

PAGE 28H/Company tax return 2016 Sensitive (when completed)

Information statement This accompanying schedule forms part of the H/Company tax return 2016.

Complete all questions in full.

See Definitions in the H/Company tax return 2016 – extra instructions for the meaning of the following terms: associate, entity.

For the trust code letter, see Appendix A of the H/Company tax return 2016 – extra instructions.

For the foreign country codes, see Appendix B of the H/Company tax return 2016 – extra instructions.

Calculation of total profit or lossIncomeLabels B to S Income section – Item 6 (H/Company tax return 2016)

These amounts are taken directly from the company’s financial statements.

Label D Gross distribution from partnerships

Provide separate details of income or loss distributions from partnerships.

Total income or loss distributions from partnerships This amount should be shown at label D Income – item 6 (if figure is a loss, show L in column next to the amount).

Full name of partnership making distributionTax file number of

partnership (if known)

Amount of distribution

$

If loss show as L

Resident (show as R)

or non-resident

(show as O)

If non-resident provide foreign country code

$

H/Company tax returnAccompanying schedule no. 2 2016If there is insufficient space on the form to completely answer any question or if any question requires multiple answers attach extra sheet(s) with the additional information.

This schedule forms part of the tax return of:

Name of company

Tax file number (TFN)

Public officer’s signature

Taxation of financial arrangements (TOFA)Labels T and U Taxation of financial arrangements (TOFA) section – Item 8 (H/Company tax return 2016)

Label U Taxation of financial arrangements (TOFA)

Provide separate details of elections made and the amount of the TOFA gain or loss from each election subject to the TOFA rules.

Election Print Y if you made this election

Amount of TOFA gain$

Amount of TOFA loss$

Election to apply the TOFA rules

Foreign exchange retranslation – general election

Foreign exchange retranslation – election in relation to qualifying forex accounts

Fair value election

Reliance on financial reports election

Hedging financial arrangements election

PAGE 29 H/Company tax return 2016Sensitive (when completed)

Label F Gross interest

Provide separate details of gross interest received from or credited by any associated persons or entities and all non-residents.

For all other gross interest received or credited include the total only at ‘All other gross interest’.

Amount of gross interest received

or credited $

Full name of person or entity paying or crediting interest

All other gross interest

Total Gross interest from all sources – this amount should be shown at label F Income – item 6. $

Resident (show as R)

or non-resident

(show as O)

If non- resident provide foreign country code

Associated (show as A)

or non-associated (show as N)

If an associated entity provide tax file number

(if known)

Label H Total dividends

Provide separate details of dividends paid or credited from any unlisted company (including dividends franked and unfranked, foreign source dividends, bonus shares and liquidators distributions). For all other dividends received include the total only at ‘All other dividends’.

Unlisted company means any company, whether inside or outside of Australia, not listed on any stock exchange.

Full name of payer

Resident (show as R)

or non-resident (show as O)

If non- resident provide foreign country code

Payer’s tax file number (if known)

Total amount of dividend

$

Dividends franked

(show as F) or dividends unfranked

(show as U)

Total Dividends – this amount should be shown at label H Income – item 6.

All other dividends

$

Label E Gross distribution from trusts

Provide separate details of income distributions from trusts.

For the trust code letter, see Appendix A of the H/Company tax return 2016 – extra instructions.

Full name of trust making distribution

Total income distributions from trusts This amount should be shown at label E Income – item 6.

Tax file number of trust (if known)

Amount of distribution

$

Resident (show as R)

or non-resident

(show as O)

If non-resident provide foreign country code

Trust code letter

$

PAGE 30H/Company tax return 2016 Sensitive (when completed)

Expenses

Labels B to Q Expenses section – Item 6 (H/Company tax return 2016)

These amounts are taken directly from the company’s financial statements.

Label E Bad debts

Provide separate details of bad debts written off in respect of debts owed by associated persons or entities.

For all other bad debts written off include the total only at ‘All other bad debts’.

Total Bad debts – this amount should be shown at label E Expenses – item 6.

Full name of debtorIf an associated entity provide

tax file number (if known)

Amount of debt written off

$

The reason the debt is regarded as bad

All other bad debts

Resident (show as R)

or non-resident

(show as O)

If non-resident provide foreign country code

$

Label V Interest expenses within Australia

Provide separate details of interest expenses on money borrowed from Australian sources.

Amount of loan outstanding as

at year end $

Full name of recipient of the interest

If the recipient is an associated entity

provide tax file number (if known)

Amount of interest expense

$

Associated (show as A)

or non- associated (show as N)

Total Interest expenses within Australia – this amount should be shown at label V Expenses – item 6. $

Label R Other gross income

Provide separate details of other gross income amounts.

This label excludes amounts included at labels B to K Income section – item 6.

Amount of other gross income

$Description of gross income item

If income is from an associate, provideIf income is from a resident

(show as R) or non-resident

(show as O)

If non-resident provide foreign country code

Total Other gross income – this amount should be shown at label R Income – item 6.

If an associated entity provide tax file number

(if known)

Full name of associated person or entity

$

PAGE 31 H/Company tax return 2016Sensitive (when completed)

Label U Royalty expenses overseasProvide separate details of royalty expenses paid or payable to all non-residents.

Full name of recipient of the royaltyAmount of tax

withheld$

Amount of royalty expense

$

Associated (show as A)

or non- associated (show as N)

Nature of benefits derived

Foreign country code of

country of remittance

Foreign country code of recipient

Total Royalty expenses overseas – this amount should be shown at label U Expenses – item 6. $

Label S All other expenses Provide separate details of all other expenses incurred relating to associated persons or entities and to all non-residents.For all other expenses include the total only at ‘Other expenses’.

Total All other expenses – this amount should be shown at label S Expenses – item 6.

Description of expenseAmount of all other

expenses $

If the expense

relates to a resident

(show as R) non-resident (show as O)

If non- resident provide foreign country code

If an associated entity provide tax file number

(if known)

Full name of associated person or entity

If expense relates to an associate

Other expenses

$

$

Label W Royalty expenses within AustraliaProvide separate details of royalty expenses paid or payable to associated Australian residents.For all other royalty expenses within Australia include the total only at ‘All other royalty expenses within Australia’.

Full name of recipient of the royalty If an associated entity provide

tax file number (if known)

Amount of royalty expense

$

Total Royalty expenses within Australia – this amount should be shown at label W Expenses – item 6.

Nature of benefits derived

All other royalty expenses within Australia

$

$

Label J Interest expenses overseasProvide separate details of interest expenses on money borrowed from overseas sources.

Full name of recipient of the interest

Associated (show as A)

or non- associated (show as N)

Amount of tax withheld

$

Foreign country code of recipient

Amount of interest expense

$

Amount of loan outstanding as at

year end$

Amount of interest remitted

$

Foreign country code of

country of remittance

Total Interest expenses overseas

This amount should be shown at label J Expenses – item 6. $

PAGE 32H/Company tax return 2016 Sensitive (when completed)

Label W Non-deductible expenses

Provide a full statement detailing all non-deductible expenses comprising the amount shown at label W .

Description of item TOFA component (if applicable)$

Total amount$

Total Non-deductible expensesThis amount should be shown at label W – Reconciliation to taxable income or loss – item 7. $

Labels A to D Add section – Item 7 (H/Company tax return 2016)

Label B Other assessable income

Provide a full statement detailing all other assessable income items comprising the amount shown at label B .

Description of item Amount$

Total Other assessable incomeThis amount should be shown at label B – Reconciliation to taxable income or loss – item 7. $

Reconciliation to taxable income or loss

Labels C to S Less section – Item 7 (H/Company tax return 2016)

Label V Exempt income

Provide separate details of income exempt from tax.

Amount of exempt income

$

Total Exempt income – this amount should be shown at label V – Reconciliation to taxable income or loss – item 7.

If an associated entity provide tax file number

(if known)The nature of the exempt income

If income is from a resident

(show as R) or

non-resident (show as O)

If non- resident provide foreign country code

Associated (show as A)

or non- associated (show as N)

Name of person or entity from whom the income was derived

$

PAGE 33 H/Company tax return 2016Sensitive (when completed)

Label Q Other income not included in assessable income

Provide a full statement detailing all other income items comprising the amount shown at label Q .

Description of item TOFA component (if applicable)$

Total amount$

Total Other income not included in assessable incomeThis amount should be shown at label Q – Reconciliation to taxable income or loss – item 7. $

Label X Other deductible expenses

Provide a full statement detailing all other expenses comprising the amount shown at label X .

Description Amount$

Total Other deductible expensesThis amount should be shown at label X – Reconciliation to taxable income or loss – item 7. $

PAGE 34H/Company tax return 2016 Sensitive (when completed)

Label J Franked dividends paid

Provide separate details of franked dividends paid.

Recipients’ full name Date dividend paidIf paid to an associated entity,

provide tax file number (if known)

Amount of franked dividend paid

$

If non- resident foreign country code

Resident (show as R)

or non-resident (show as O)

Associated (show as A)

or non-

associated (show as N)

Total Franked dividends paidThis amount should be shown at label J – Financial and other information – item 8.

$

Label K Unfranked dividends paid

Provide separate details of unfranked dividends paid.

Recipients’ full name Date dividend paidIf paid to an associated entity,

provide tax file number (if known)

Amount of unfranked dividend

paid $

If non- resident foreign country code

Resident (show as R)

or non-resident (show as O)

Associated (show as A)

or non-

associated (show as N)

Total Unfranked dividends paidThis amount should be shown at label K – Financial and other information – item 8.

$

Losses information

Label U Tax losses carried forward to later income years

Provide separate details of primary production and non-primary production losses from the current and previous years available to be carried forward.

Description of principal activity which generated the lossPrimary production losses

carried forward $

Non-primary production losses carried forward

$

Total losses carried forward

$

Year loss originally incurred

Total Losses carried forward This amount should be shown at label U – Losses information – item 13.

$

Labels U and V Losses information section – Item 13 (H/Company tax return 2016)

Financial and other information

Labels N to S Financial and other information section – Item 8 (H/Company tax return 2016)

PAGE 35 H/Company tax return 2016Sensitive (when completed)