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Raynes Gibson & Matthews Accountants Ltd - Financial Statements Questionnaire for Individuals

  • Please ensure that all records as requested throughout this questionnaire, are included.

    If you are unable to provide certain information, please include your notes about this in the field provided below each question.
    We look forward to seeing you in the office when you bring them in.
  • Please indicate which financial year end the data in this questionnaire relates to
    DD slash MM slash YYYY
  • Terms of Engagement

    To Raynes Gibson & Matthews Accountants Ltd
    I/We hereby instruct you to prepare my/our Financial Statements and Taxation Returns for this year from the information and records I/We have supplied to you.
    I/We accept responsibility for the accuracy and completeness of all records and information supplied to you.
    You are hereby authorised to communicate with my/our bankers, solicitors, finance companies, and any other business that I/We deal with to obtain such information as you require in order to complete the above duties.
  • DD slash MM slash YYYY
  • Wages / National Superannuation / Benefits

  • (In most cases we will obtain these records directly from the IRD however, we do need to check all details have been included).
    WagesACC PaymentsNational SuperannuationAny other benefits 
  • Kiwisaver

  • Student Loan

  • Drop files here or
    Max. file size: 128 MB.
    • (please send us a note as to why this information cannot be supplied at this time).
    • Goods & Services Tax (GST) Returns

    • Drop files here or
      Max. file size: 128 MB.
      • (please send us a note as to why this information cannot be supplied at this time).
      • Interest & Dividends

      • - For interest received, you should have an annual advice notice showing the withholding tax deducted. If not please provide a Resident Withholding Certificate for Interest earned from your bank(s)
        - Please provide details of any dividends received and if any dividends are taken as bonus shares, also include these advice slips
        - Or, leave us a note in the field below
        Drop files here or
        Max. file size: 128 MB.
        • (please send us a note as to why this information cannot be supplied at this time).
        • Rental & Leased Property

        • Self Employed Income

        • Partnerships, Trusts, Estates and Companies

        • (please send us a note as to why this information cannot be supplied at this time).
        • Overseas

        • Include overseas interest, dividends, wages received and taxation paid.
          Note: New Zealand tax residents are liable for tax on world-wide income
        • - Please provide details of the value and quantity of the investments held at any time during the financial year.
          - Please provide the date, value and details or any purchase, sales and income (dividends)
          - Please attached all of your investments advisor's reports. This information is required so we can calculate if any income needs to be declared under the FIF (Foreign Investment Fund) rules.
          Drop files here or
          Max. file size: 128 MB.
          • (please send us a note as to why this information cannot be supplied at this time).
          • Any Other Income

          • - Income Replacement Insurance Policy - provide details of premiums and claims as these may be deductible
            - Look Through Company - if you have been allocated a share of a loss other than from a company that we are aware of, please provide details
            - Or leave us a note in the field below
            Drop files here or
            Max. file size: 128 MB.
            • (please send us a note as to why this information cannot be supplied at this time).
            • Donations, (Note from 2013: Housekeeping and Childcare Tax Credits are no longer claimable)

            • Please note: If yes, you will need to bring the ORIGINAL donation receipts in to our offices
            • Working for Families Tax Credits and Parental Tax Credits

              The IRD will calculate this for you.
            • - If you had a child born within the current financial year you may be eligible for the Parental Tax Credit.
              Please include their IRD Number below.
              If you do not have this, you will need to obtain one for them in order to claim any entitlement for them.
              - Where a child has become financially independent during the current financial year, please advise the date they left school or home.
              Child's NameIRD No.Date of BirthDate Left School 
            • - If you have received Working for Families Tax credits during, please supply the certificate issued to you by the IRD, detailing the amounts
              - Also provide details of any child support or maintenance payments made or received.
              - Or send us a note in the field below
              Drop files here or
              Max. file size: 128 MB.
              • (please send us a note as to why this information cannot be supplied at this time).
              • Thank you for completing this questionnaire.

                Your time and effort is appreciated.
                **Please ensure you have provided all the information required to complete your Financials & Tax Returns.
                Lack of complete information may mean an increase in fees as we need to follow up for more information.
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              Raynes Gibson & Matthews
              Accountants Ltd

              110 St Lukes Road
              Sandringham
              Auckland 1025

              Phone (09) 815 7975
              Fax (09) 815 1217
              Click here to email enquiry

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