Commonwealth Seniors Health Card (CSHC) Income Test and Dependent Child Worksheet Completed Form Examples and Samples
Explore practical examples and samples of the Commonwealth Seniors Health Card (CSHC) Income Test and Dependent Child Worksheet. Learn how to accurately calculate your adjusted taxable income and manage dependent details with our easy-to-follow guides.
Commonwealth Seniors Health Card (CSHC) Income Test and Dependent Child Worksheet Example
How this form was filled:
This example demonstrates how an AI can parse an unstructured email from a financial planner to automatically populate the Commonwealth Seniors Health Card (CSHC) Income Test and Dependent Child Worksheet. By extracting values like taxable income, superannuation contributions, and dependent child status, the system eliminates manual entry errors.
Source document used: Financial Planner Email Summary
Hi John, regarding your application for the Commonwealth Seniors Health Card, I have compiled the figures for the 2026-2027 financial year as we discussed. For your taxable income, we are estimating $32,000, and for your partner, Sarah, we are looking at $18,500. We don't expect any foreign income for either of you. For the net investment loss, you have $2,500 and Sarah has $1,200. Regarding employer benefits, after subtracting the standard $1,000 threshold, your value is $4,500 and Sarah's is $3,000. Your reportable superannuation contributions are $5,000 each. I have also noted that you have two account-based income streams; the first is deemed at $1,200 and the second at $800, while Sarah's are $900 and $500 respectively. Regarding your grandson, Leo, he is 14 years old and currently living with you full-time. He is not receiving any government pensions or benefits, and you are his primary legal guardian. Since he is under 16 and in your full-time care, he qualifies as a dependent child for your application. Let me know if you need any other documents verified for Centrelink before we submit these numbers.
Information used to fill out the document:
- Personal Financials: Your Taxable: 32000, Partner Taxable: 18500
- Employer Benefits: Your: 4500, Partner: 3000
- Superannuation: Your: 5000, Partner: 5000
- Deemed Income: Your Streams: 1200/800, Partner: 900/500
- Dependent Details: Leo, 14 years old, lives at home, no benefits
What this filled form sample shows:
- Automatic calculation of total adjusted taxable income
- Natural language extraction from unstructured professional advice
- Intelligent mapping of age-based logic for dependent children
- Deduction handling for employer-provided benefit thresholds
Form specifications and details:
| FormName: | Commonwealth Seniors Health Card (CSHC) Income Test and Dependent Child Worksheet |
| Agency: | Services Australia |
| UseCase: | Automated CSHC Application Processing |
| FinancialYear: | 2026-2027 |
| Categories: | CAR forms, health forms, income forms, Work and Income forms |
| Created: | May 19, 2026 06:38 PM |