Individual Checklist

Welcome Lowther's Individual Questionnaire.

Complete one checklist per individual.

If there is a required field (marked by *) that does not apply to you, please enter either 0 or N/A.

Your Details

Name *

E-mail *

Contact Number *

IRD Number (if known)

Street

Suburb

Town or City

Post Code

Non-New Zealand Tax Residents Only

Do you have residency or citizenship with any other country other than New Zealand?

No

Yes

If yes, what country?

Please provide your TIN number (Taxpayer Identification Number) for that country.

Income

1. Did you receive Salary, Wages, or Accident Compensation Payments (if yes, we will obtain details from Inland Revenue).

No

Yes

2. Did you receive a benefit eg. Superannuation or Family Support (if yes, we will obtain details from Inland Revenue).

No

Yes

2. Did you receive a benefit eg. Superannuation or Family Support (if yes, we will obtain details from Inland Revenue).

No

Yes

3. Did you receive Withholding Payments (if you work as a Contractor or other payments where no tax has been deducted for your personal services).

No (go to question 4)

Yes

Do you have any expenses to claim against withholding payments of self-employed income?

No

Yes

If Yes, please select from the following and send copies to Lowthers: *

4. Did you receive proceeds from the sale of residential property (apart from your personal residence)?

No

Yes (please provide income details below)

Description of income (payer, amount)

5. Did you receive income from any pension, annuity or superannuation scheme?

No

Yes (please provide income details below)

Description of income (payer, amount)

6. Did you receive any other taxable income (such as royalties)?

No

Yes (please provide income details below)

Description of income (payer, amount)

7. Did you receive income from a rental property?

No

Yes (please provide income details below and also complete a Rental Property Questionnaire)

Description of income (payer, amount)

8. Have you applied for the Covid 19 Wage Subsidy during the year?

No

Yes (please provide details below)

Please provide details of the total amount received from Ministry of Social Development.

Interest & Dividends

1. Did you receive any interest or dividends from the banks or public companies?

No

Yes

Which of the following documents will you send to Lowthers? *

Interest Certificates with RWT paid

Dividend Statements received

Crypto Assets

1. Did you hold or dispose of any Crypto Assets during the year?

No

Yes

If Yes, please provide the details listed below:

A copy of any workings supporting the purchase or sale of your Crypto Assets during the year

2. Have you previously supplied details of your Crypto Asset transactions to Lowthers?

No

Yes

If Yes, please provide the details listed below:

A copy of the workings supporting the purchase and sale of Crypto Assets

Shareholdings, LTC Losses & Directorships

1. Are you a shareholder or director of a company that Lowthers does not act for (excluding shareholdings in publicly listed companies)?

No

Yes

If Yes, please provide Company name (non PAYE remuneration, share of LTC losses, Directors' fees)

Student Loan

1. Do you have a student loan?

No

Yes

If Yes, please provide the voluntary payment amount

Estate, Trust, Partnership or Sole Trader Business Income

1. Did you receive any income from an Estate, Trust, Partnership or Business that Lowthers does not act for?

No

Yes

If Yes, please provide name, type of entity, IRD number, amount, tax credits

Overseas Income

1. Did you receive any income from overseas (excluding interest or dividends included above)?

No

Yes

If Yes, please provide name of entity, currency, amount, tax credits

I agree to send any interest or dividend certificates to Lowthers by:

Expenses that are Tax Deductible against Personal Income

1. Did you incur any expenses relating to earning your non PAYE income such as:
- interest on money borrowed for personal investment, or
- premiums on income protection insurance; or
- funds borrowed to invest in an income producing asset such as shares

No

Yes

If Yes, please provide description of expenses, amount, comments

Donations

You can no longer claim child care payments.

1. Did you make any donations during the year (individual only, not Companies or Trusts)?

No (go to next section)

Yes

2. Do you require Lowthers to complete your rebate claim form?

No (go to next section)

Yes

I agree to send copies of my donation receipts to Lowthers by:

Family Assistance

1. Do you want us to assess your eligibility for Family Assistance? (Not applicable for Companies, Trusts or Partnerships).

No

Yes (please complete details below)

Name of spouse/partner

Date of birth of spouse/partner +

IRD number of spouse/partner

Taxable income of spouse/partner

Complete details of all dependants

Name of dependant 1

Date of birth +

IRD number

Still at school?

No

Yes

Name of dependant 2

Date of birth +

IRD number

Still at school?

No

Yes

Name of dependant 3

Date of birth +

IRD number

Still at school?

No

Yes

Name of dependant 4

Date of birth +

IRD number

Still at school?

No

Yes

Use this box to add any more dependants, separated by a hyphen:

Name of child - Date of birth (DD/MM/YY) - IRD number - Still at school (Y/N)

Travel

Please select the options below which are applicable to you

Did you leave New Zealand during the financial year ended 31 March 2023?

Did you arrive in New Zealand during the financial year ended 31 March 2023?

Were you out of New Zealand for more than a total of 183 days (6 months) within the financial year ended 31 March 2023?

None of the above

If any of the options 1 to 3 above are applicable to you,
please provide more information below.

General

1. Have you declared all your income?

No (provide further details below)

Yes

If No, provide further details here

2. Do you have entitlement to benefits from any foreign company, unit trust, superannuation scheme or life insurance policy?

No

Yes (provide further details below)

If Yes, provide further details here

3. Are there any other matters not included above which you feel might be relevant in determining your tax position?

No

Yes (provide further details below)

If Yes, provide further details here

4. How will you be sending your documents to Lowthers?

Disclaimer

I accept responsibility for the completeness of all records and information supplied to Lowthers for the purpose of them preparing my Income Tax Return.

Where information cannot be located by me I hereby authorise Lowthers to obtain from third parties any records or information that they require to prepare my Income Tax Return and accordingly these third parties are authorised to provide to Lowthers this information.

I acknowledge that additional accounting costs may be incurred for collecting such missing information where this ordinarily should have been included in my documents submitted to Lowthers.

If complete information is not supplied I acknowledge that this may delay the completion of the financial statements and income tax return.

Our Terms of Trade are

You will receive our fees invoice on completion of your assignment. On larger assignments progress invoices may be issued. Our fees invoice will be addressed to your Company, Trust or Partnership as the main entity and could include all work for all your tax payer entities including yourselves as individuals.

All invoices are due for payment 14 days after date of invoice.

So that we can continue to provide our high quality of service, we ask that you pay your accounts on time. If at any time you have any queries or concerns regarding payment, we ask that you contact us as soon as possible to work out a resolution. We have a range of payment options to accommodate multiple situations.

We reserve the right to charge interest at 2% per month on outstanding balances.

In the event of default, if the accounting work is undertaken on behalf of a company or trust, the shareholder/s or trustee/s will be held personally liable for any unpaid invoices.

In the event of default, debt collection costs and other costs incurred relating to the collection of outstanding balances are to be charged on the debt and passed on to you until paid in full.

I Accept

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Date signed * +

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