Discretionary Income Self-Assessment Tool Form

Income
Outgoings - Essential
Outgoings - Discretionary & Other

Income

Income after tax

Your take-home income after tax, superannuation and any other deductions are taken out, the amount you receive into your bank account.

Amount*

Frequency*

Government assistance

Centrelink and other government payments including but not limited to disability support, pension, veteran allowance, Jobseeker payment, parenting payment, family tax benefit and age pension.

Amount*

Frequency*

Any other income

Any other form(s) of income you receive, including rent, dividends and royalties.

Amount*

Frequency*

Outgoings - Essential

Housing

Owner occupier housing expenses, including rent, board, and/or mortgage payments.

Amount*

Frequency*

Loans and credit cards

Repayments for loans, credit cards, rent to buy, investment housing loans and any other type of loan.

Amount*

Frequency*

Insurance

Home and contents insurance, health insurance, car insurance and any other type of insurance. Excludes pet insurance.

Amount*

Frequency*

Utilities

Phone, internet, electricity, gas, water, council rates, Shire rates, etc.

Amount*

Frequency*

Food and other groceries

Fruit, vegetables, meat, dairy, household consumables and any other grocery items.

Amount*

Frequency*

Medical

GP, Specialists, Physio, Chiro, Optical, medicine, pharmaceutical, therapeutic equipment, hospital, nursing home charges.

Amount*

Frequency*

Travel and transport

Running costs for essential vehicles including fuel, servicing, registration costs, parking and tolls, public transport, taxis, ridesharing.

Amount*

Frequency*

Children

Childcare/school fees, uniforms, school shoes, textbooks, excursions, and other school costs.

Amount*

Frequency*

Personal

Clothes, shoes, and other personal items which you consider to be essential.

Amount*

Frequency*

Pets

Pet food, grooming, minding services, care products, health products, pet insurance, vet fees.

Amount*

Frequency*

Other essential

Child maintenance, spousal maintenance/alimony.

Amount*

Frequency*

Outgoings - Discretionary & Other

Savings

Payments into savings account.

Amount*

Frequency*

Entertainment (excluding Gambling)

Streaming services, cinema, takeaway, alcohol, cafes, bars & restaurants, hotel stays, holidays.

Amount*

Frequency*

Gambling

All gambling spend, including casino gambling, online gambling, sports betting, lotto.

Amount*

Frequency*

Other non-essential

Other ongoing or recurring items not included within the other categories including registration and insurance of recreational vehicles, overseas holidays, gym, gifts, counselling, jewellery, home furnishings, household services including cleaning, gardening, etc.

Amount*

Frequency*