Rebates

Spouse rebate:
Name of Spouse:   
Maintenance Period:   
Children:
Names & birth dates
Cared for all or part of the year? Dates from:

to

Is the child a student?    
If any child has separate income, please give details of type and amount:      
Did your spouse have any separate income?
If yes, enter the amount received in the table below.
Basic Parenting Allowance:   
Wages (gross amount):   
Bank Interest:   
Other Income:   
Child care expenses:   
Work related expenses:   
Other:   
Superannuation Contributions:
Name of Fund:   
Policy number:   
Contributions Paid: $   
Sole Parent:
Names & birth dates
Cared for all or part of the year?
Dates: from -


to

Is the child a student?  
Has the child had separate income?
How much? 		   
Medical Expenses over $1250
(Net of refunds from Medicare of private fund)

Specify type of expense and net amount paid.


Zone Rebate
Did you live in a remote area?
If yes: which? 		 
Dates of residing in that area:   

Private Health Insurance Rebate
Name of Fund  
Membership Number  
Number of Children  
Amount to claim  

 Other rebates

Specify details below:

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