Online Tax Assessment Form

Personal Details:

First Name  *
Last Name  *
Tax File Number  *
ABN Number  
Date of Birth(DD/MM/YYYY)  *
Contact Number (H) with area code
Mobile Number  *
Email  *
Occupation (Work)
Private Health:
Provider Name
Membership Number
Address:
Unit Number  *
Streen Number and Name  *
Suburb/City  *
Postcode  *
State
Spouse details(If only applicable):
Spouse name
Tax file number
Date of Birth(DD/MM/YYYY)
Phone number
Bank Details:
Name of Bank  *
BSB max 6 digits  *
Account number max 9 digits  *
Account holder (your) name  *

 

Payers ABN Payers Name Allowances Tax Withholding Gross
Bank Interest:  *
Expenses Details: Provide your work related expenses details
Comments/Notes
  * Required Fields.

I hereby authorize CB Accounting to lodge my Tax Return on behalf of
myself. I further declare that I have not missed out any income to include in the amount
mentioned above.
I declare that:

  • all the information I have provided is true and correct
  • I have the necessary receipts and/or other records to support my claims

Important: The Tax Law imposes heavy penalties for giving false or misleading information.

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