This form contains 47 fields organized into 17 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name	Type	Description
Australian Residency Status
No	Checkbox	Check this box if the young person is not an Australian resident.
Yes	Checkbox	Check this box if the young person is an Australian resident.
Care Status
No, young person not in care	Checkbox	Check this box if the young person is not wholly or substantially in your care, meaning they are not a dependent child for CSHC income test purposes.
Yes, young person in care	Checkbox	Check this box if the young person is wholly or substantially in your care, then proceed to the next question.
Combined Total Adjusted Taxable Income
Combined Adjusted Taxable Income	Number	Enter the combined total adjusted taxable income for you and your partner, which is the sum of your total income (F) and your partner's total income (F). Fill only if 'Your Total Income', 'Your Total Estimated Income', 'Partner's Total Income', 'Partner's Total Estimated Income' is a calculation of the sum of total incomes. Depends on: Your Total Income, Your Total Estimated Income, Partner's Total Income, Partner's Total Estimated Income
Your Deemed Income Stream 1	Number	Enter your estimated deemed income from the first account-based income stream.
Partner's Deemed Income Stream 1	Number	Enter your partner's estimated deemed income from the first account-based income stream.
Your Deemed Income Stream 2	Number	Enter your estimated deemed income from the second account-based income stream.
Partner's Deemed Income Stream 2	Number	Enter your partner's estimated deemed income from the second account-based income stream.
Current Living Arrangement
No, does not live with me	Checkbox	Check this box if the young person does not currently live with you, indicating this young person is not a dependent child for CSHC income test purposes.
Yes, lives with me	Checkbox	Check this box if the young person currently lives with you, indicating this young person is a dependent child for CSHC income test purposes.
Employer Provided Benefits Estimate
Your Employer Provided Benefits	Number	Provide an estimate of the value of your employer provided benefits for the current financial year less $1,000.
Partner's Employer Provided Benefits	Number	Provide an estimate of the value of your partner's employer provided benefits for the current financial year less $1,000.
Foreign Income Estimate
Your Estimated Foreign Income	Number	Please provide your estimated foreign income in Australian dollars for which you will not pay Australian income tax for the current financial year.
Partner's Estimated Foreign Income	Number	Please provide your partner's estimated foreign income in Australian dollars for which they will not pay Australian income tax for the current financial year.
Full-time Education Status
No	Checkbox	Check this box if the young person is not in full-time education.
Yes	Checkbox	Check this box if the young person is in full-time education.
Next Question Number If Not Full-time Education	Text	Please enter the number of the next question to proceed to if the young person is not in full-time education. Fill only if 'No' is 'No'. Depends on: No
General
Print button	Button
Clear	Button
Q2GoToQ7	Button
Q5GoToQ7	Button
Q6GoToQ8	Button
Print button	Button
Clear	Button
Income Limit Status
No, Income Not Below Limit	Checkbox	Check this box if the young person's income is NOT below their applicable limit, indicating they are not a dependent child for CSHC income test purposes.
Yes, Income Below Limit	Checkbox	Check this box if the young person's income IS below their applicable limit to proceed to the next question.
Legal Dependant Status
No, not a legal dependant	Checkbox	Check this box if the young person is not a legal dependant of another person (other than your partner).
Yes, is a legal dependant of another person	Checkbox	Check this box if the young person is a legal dependant of another person (other than your partner).
Legal Responsibility for Young Person
No	Checkbox	Check this box if you are NOT legally responsible, either alone or jointly, for the young person's day-to-day care, welfare, and development.
Yes	Checkbox	Check this box if you ARE legally responsible, either alone or jointly, for the young person's day-to-day care, welfare, and development.
Next Question if Not Legally Responsible	Text	Provide the number of the next question to proceed to if you are not legally responsible for the young person's day-to-day care, welfare, and development. Fill only if 'No' is 'No'. Depends on: No
Reportable Superannuation Contributions Estimate
Your Reportable Superannuation Contributions	Number	Please provide your estimated value of reportable superannuation contributions for the current financial year.
Partner's Reportable Superannuation Contributions	Number	Please provide your partner's estimated value of reportable superannuation contributions for the current financial year.
Social Security Benefit Status
No	Checkbox	Check this box if the young person is not receiving a social security pension or benefit.
Yes	Checkbox	Check this box if the young person is receiving a social security pension or benefit.
Taxable Income Estimate
Your Taxable Income Estimate	Number	Enter your estimated taxable income for the current financial year.
Partner's Taxable Income Estimate	Number	Enter your partner's estimated taxable income for the current financial year.
Your Total Estimated Income	Number	Enter your total estimated income, calculated as the sum of your entries for A, B, C, D, and E. Fill only if 'Your Taxable Income Estimate', 'Your Estimated Foreign Income', 'Your Estimated Total Net Investment Loss', 'Your Employer Provided Benefits', 'Your Reportable Superannuation Contributions' is a calculation (A+B+C+D+E). Depends on: Your Taxable Income Estimate, Your Estimated Foreign Income, Your Estimated Total Net Investment Loss, Your Employer Provided Benefits, Your Reportable Superannuation Contributions
Partner's Total Estimated Income	Number	Enter your partner's total estimated income, calculated as the sum of their entries for A, B, C, D, and E. Fill only if 'Partner's Taxable Income Estimate', 'Partner's Estimated Foreign Income', 'Partner's Estimated Total Net Investment Loss', 'Partner's Employer Provided Benefits', 'Partner's Reportable Superannuation Contributions' is a calculation (A+B+C+D+E). Depends on: Partner's Taxable Income Estimate, Partner's Estimated Foreign Income, Partner's Estimated Total Net Investment Loss, Partner's Employer Provided Benefits, Partner's Reportable Superannuation Contributions
Total Income
Your Total Income	Number	Provide your total estimated income for the current financial year. Fill only if 'Your Taxable Income Estimate', 'Your Estimated Foreign Income', 'Your Estimated Total Net Investment Loss', 'Your Employer Provided Benefits', 'Your Reportable Superannuation Contributions' is a calculation (A+B+C+D+E). Depends on: Your Taxable Income Estimate, Your Estimated Foreign Income, Your Estimated Total Net Investment Loss, Your Employer Provided Benefits, Your Reportable Superannuation Contributions
Partner's Total Income	Number	Provide your partner's total estimated income for the current financial year. Fill only if 'Partner's Taxable Income Estimate', 'Partner's Estimated Foreign Income', 'Partner's Estimated Total Net Investment Loss', 'Partner's Employer Provided Benefits', 'Partner's Reportable Superannuation Contributions' is a calculation (A+B+C+D+E). Depends on: Partner's Taxable Income Estimate, Partner's Estimated Foreign Income, Partner's Estimated Total Net Investment Loss, Partner's Employer Provided Benefits, Partner's Reportable Superannuation Contributions
Total Net Investment Loss Estimate
Your Estimated Total Net Investment Loss	Number	Provide your estimated total net investment loss for the current financial year.
Partner's Estimated Total Net Investment Loss	Number	Provide your partner's estimated total net investment loss for the current financial year.
Young Person's Age Group
Under 16 years of age	Checkbox	Check this box if the young person is under 16 years of age.
Aged 16 to 21	Checkbox	Check this box if the young person is aged 16 to 21.
Under 16 Next Question	Text	Enter the number of the question to proceed to if the young person is under 16 years of age. Fill only if 'Under 16 years of age' is 'Yes'. Depends on: Under 16 years of age

Commonwealth Seniors Health Card (CSHC) Income Test and Dependent Child Worksheet Instructions