About this form

This Quarterly Report monitors the progress of your business and your continuing eligibility for Small Business Coaching. Giving false or misleading information is a serious offence.

When to complete this form

You will need to complete a Quarterly Review after each Financial Quarter for the duration of your period of Small Business Coaching. This form must be lodged with your Self-Employment Assistance Provider within 10 business days after the end of each Financial Quarter. Failure to do so may result in the suspension of your Small Business Coaching.

A Financial Quarter is a period from:  

• 1 July to 30 September; 

• 1 October to 31 December; 

• 1 January to 31 March; and 

• 1 April to 30 June.

If you commenced Small Business Coaching less than four weeks before the end of a Financial Quarter, you are not required to submit a Quarterly Report to your provider for that quarter.

You must only include your personal details on this form. Any of your business partners who also receive Small Business Coaching must lodge a separate Quarterly Report.

Your information and privacy

The collection, use and disclose of personal information is protected by law, including the Privacy Act 1988 (Privacy Act). In the Workforce Australia Privacy Notification and Consent Form, we have provided you with important privacy information about the collection, use and disclosure of your personal information. You should ensure that you have read and understood this information.

More information is available from www.dewr.gov.au/privacy or your provider. Further information about the Privacy Act is available from the Office of the Australian Information Commissioner at www.oaic.gov.au.

How to complete

Questions 1 to 3 - Your details

If you do not know your Job Seeker ID  you can leave those fields blank.

Questions 4 - Financial quarter

The Financial quarters are:

• 1st of July to 30th September

• 1st of October to 31st of December

• 1st of January to 31st of March

• 1st of April to 30th of June

Question 5 - Insurance

Please submit insurance proof here

Question 6 – Your external income

How much did you earn before tax (gross income) from External Sources?

External Income: Casual / Part time Wages, Interest from Bank Accounts, Dividends, Shares and rental income

External Income does not include: Family Tax Benefit Part A or B, Business Income, Self-Employment Allowance / Parenting payments or Partners Income

Question 7 - Hours worked

Enter the average hours you worked in your business each week. Please note you must work 35 hours per week in your business unless you have part-time Mutual Obligation requirements due to caring responsibilities or partial capacity to work. You may also lower the minimum hours to 25 per week if you are undertaking employment or accredited training of up to 25 hours per week. 

Questions 8 - Business Income Summary

Cashflow Summary (Business income only)

Budget 

A. Income – Comes from 1st year cashflow sheet in financials completed in training

B. Expenses - Comes from 1st year cashflow sheet in financials completed in training

C. Net Profit – The difference between Income (A) and Expenses (B)

Actual

A. Income – Any business income received during the quarter

B. Expenses – Any business-related expenses incurred during the quarter

C. Net Profit – The difference between Income (A) and Expenses (B)

Please sign and submit

5. As part of the obligations of the program we are required to check each quarter that your business insurance is still current and has not been cancelled. You can upload a copy of one of the following forms of evidence here if available. If you do not have this available you can submit later in the quarter. 

1.  An updated certificate of currency dated this financials quarter, you can request this from your insurer or broker. 

2. A screenshot from a bank statement showing a monthly insurance deduction 

3. An email from your broker confirming the policy is still current

8.

Budget
(Projected income from financials completed in training)

Actual 
(What you actually earned in your business)

A. Income:

B. Expenses:

C. Net Profit:

I certify that the information supplied on this form is complete and correct to the best of my knowledge. I acknowledge that false information will lead to termination of my Small Business Coaching and where applicable, Self-Employment Allowance and action to recover any payment falsely obtained will be instigated.

If you are completing this form electronically, please print the completed form, sign in the provided signature block and send to your provider. If you are unable to sign due to a disability, please complete all required fields, mark the signature block with the words “unable to sign” and email it to your provider. They will contact you to confirm alternative signature arrangements based on your circumstances.