Personal Taxation Form

Personal Information

Name

Address

I accept responsibility for all records and information supplied to you for the purpose of preparing my Income Tax Return. I accept responsibility for any failure by me to supply all relevant records and information to you.

Email Address

Home Phone

Business Phone

Fax No

IRD No

Date of Birth

DD-MM-YYYY

Spouse’s name

Spouse’s IRD number

Spouse’s date of birth

Spouse’s income $

Names of children & years of birth

Convenient time to contact

To assist us in the completion of your personal return please answer the following questions in ALL cases:
If your answer is ‘Yes’ please supply details.

Income information

1. Did you receive any of the following? Salary or wages, Accident Compensation Earnings, Unemployment or other Income-tested benefits. Family Assistance Payments from Income Support, Withholding Payments. *

Yes

No

2. New Zealand Superannuation (enclose personal tax summary). *

Yes

No

3. Other NZ pensions, annuities and superannuation. *

Yes

No

4. Interest (include details of interest, enclose RWT form from payer showing interest PAYE paid to IRD). *

Yes

No

5. Dividends (Dividend Statements must be attached), this includes dividends paid, for example, by the power companies Mercury Energy, Power New Zealand etc. *

Yes

No

6. Shareholder-employee salary of director fees from a company where we do not prepare the accounts. *

Yes

No

7. Non-cash benefits from a company in which you are a shareholder and on which FBT has not been paid. - For example: A low interest loan. *

Yes

No

8. Income from Rents (If yes, complete rental section). *

Yes

No

9. Do you have a mixed use holiday home (that is rented and used privately)? If yes, please enclose details of days used privately and days rented. *

Yes

No

10. Income from Estate / Trust / Partnership / Business where we do not prepare accounts (include details of any tax credits). *

Yes

No

11. Income from the sale of Land / Business. *

Yes

No

12. Income from the sale of Shares or other property (not your residence). *

Yes

No

13. Income from the sale or redemption of securities. *

Yes

No

14. Any other Income, eg: royalties. *

Yes

No

15. Income from any Government Bonds? (Attach details of accrued interest on purchase of bond). *

Yes

No

16. Overseas Earnings and Investments / Foreign Rights Disclosure: (Attach details of any Overseas Earnings and Investments and taxation paid on these earnings.) *

Yes

No

Expenses information

1. If you received income from withholding payments did you have work related expenses? *

Yes

No

2. Have you incurred any expenses related to earning your income? Yes / No e.g. A fee for the completion of a Tax Return, commission on interest or dividend income, interest on funds borrowed to invest an income earning asset. *

Yes

No

3. Premiums on loss of earnings insurance, provided the benefit from the insurance policy is taxable (income protection). Yes / No If yes, please attach details.

Yes

No

Rebate Information

1. For Family Assistance Credits. -Please telephone us for further information if you believe you may be eligible.

2. If you have a Special Home / Farm / Fishing Vessel Ownership Account.- Please attach your “Increase in Savings Certificate” IR30 from your savings institution.

Other Information

1. If you received income from rent please complete the following

Address of property

Rent received $

The number of months the property was available for renting

Expenses

Advertising $

Insurance $

Rates $

Repairs and Maintenance $

Tip Fees $

Mortgage Interest $

Postage and Stationery $

Agent’s Collection Fees $

Car use for rent collection and maintenance km / miles

Please enter in km or miles

If property purchased or sold during year attach solicitor’s statements.

2. Are you a shareholder in a Look-through Company for which we do not prepare accounts? *

Yes

No

Has owners’ basis calculation been checked? *

Yes

No

Please supply the following details:

Name of Company

IRD number

Amount of loss to be claimed $

Add Remove

3. Rebates: Do you have a Student Loan? Yes / No If yes, have you made any extra payments? If so, please give details *

Yes

No

4. If you have any other matters which might be important in determining your tax position that you feel you should discuss with us please note them here.

5. If you are due for a terminal tax refund please indicate how you wish it to be paid:

Refunded in full

Offset against Next Provisional Tax

Offset against ACC Levies

Transferred to Student Loan

Transferred to taxpayer named below

Name

IRD number

Note: If you have any outstanding tax or are in arrears with child support payments, your refund will be transferred by the Inland Revenue Department automatically to cover your debt.

Attach Documents

Please attach any supporting documents to accompany this form. Please attach only Microsoft Word documents, PDF's or Microsoft Excel spreadsheets. Its best to drop the files into a folder as you fill out the form and then drag and drop all the files in one go at the end.

If you have any issues give iFigure a call and we can assist.

File Upload

Maximum file size: 25MB

Declaration

I accept responsibility for all records and information supplied to you for the purpose of preparing my Income Tax Return. I accept responsibility for any failure by me to supply all relevant records and information to you.

I hereby authorise iFigure Accounting Ltd to obtain from any third party any records or information you require for the purpose of preparing my Income Tax Return and accordingly any such third party is authorised to provide you with information required.

Full Name

Todays Date

Signature

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Personal Taxation Form

Let us help you work out your Tax requirements

Personal Information

Income information

Expenses information

Rebate Information

Other Information

Attach Documents

Declaration

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Personal Taxation Form

Let us help you work out your Tax requirements

Download the PDF version of the Personal Taxation form

Personal Information

Income information

Expenses information

Rebate Information

Other Information

Attach Documents

Declaration

Contact us

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