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11 What are your income details for the years identiﬁed in
Tax Year 20 – 20
a Gross income (see Notes)
b Allowable deductions (see Notes)
c Net taxable income (a minus b)
d Total net investment losses (see Notes)
e Reportable fringe beneﬁts (see Notes)
f Target foreign income (see Notes)
g Total tax free pensions and beneﬁts
h Reportable superannuation contributions
i Total adjusted taxable income (c + d + e + f + g + h)
IMPORTANT: If you now earn at least 15 per cent less
than the adjusted taxable income provided on this form,
you may be able to supply an estimate of your income.
If your estimate is accepted, we will amend your child
support to reﬂect your new income. Any changes to your
assessment will be effective from the date your estimate
is received. Your assessment will not be backdated.
Privacy and your personal information
Your personal information is protected by law, including the
Privacy Act 1988, and is collected by the Australian
Government Department of Human Services for the
assessment and administration of payments and services.
This information is required to process your application or
Your information may be used by the department or given to
other parties for the purposes of research, investigation or
where you have agreed or it is required or authorised by law.
You can get more information about the way in which the
Department of Human Services will manage your personal
www.humanservices.gov.au/privacy or by requesting a copy
from the department.
I declare that:
• the information provided in this form is complete and
I understand that:
• giving false or misleading information is a serious offence.