• Individual Tax Questionnaire & Checklist (IR3)

  •  -
  • Date of Birth*
     - -

  • 1) Tax Residency

  • Were you in NZ for the full year?

  • 2) Working for Families Tax Credits and Parental Tax Credit

  • Did you or your partner receive family tax credits from Work and Income?

  • 3) Wages/Salary/benefits with tax deducted

  • Did you receive any income with tax deducted from wages, salaries, ACC payments, any benefits or prison?
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  • 4) Income from schedular payments

  • Did you receive income from schedular payments?
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  • 5) NZ Interest

  • Have you received any NZ interest income?
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  • 6) NZ Dividends

  • Did you receive an electricity dividend from ENTRUST?
  • Have you received any other NZ dividend income?
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  • 7) Income from Portfolio Investment Fund

  • Do you have income from a Portfolio investment fund?
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  • 8) Overseas Income

  • Have you received any income from overseas?
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  • 9) Shareholder-employee salary with no tax deducted

  • Did you recieve a shareholder-employee salary with no tax deducted?
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  • 10A) Residential Rental Income

  • Did you receive any income or incur any expenses from residential property?

  • In addition to this questionaire you will need to complete our rental questionaire - one for each property.

  • 10B) Other Rental Income

  • Did you receive any income or incur any expenses from other rentals?
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  • 11) Income from self-employment

  • Did you receive any income from self-employment?

  • Please complete the sole trader questionaire, in addition to this questionnaire

  • 12) Other income

  • A) Did you receive any taxable Maori authority distributions?
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  • B) Did you receive any NZ estate or trust income?
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  • C) Did you receive any partnership income?
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  • D) Did you receive any look-through company (LTC) income?
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  • E) Did you receive any other income?
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  • 13) Expenses

  • Can you claim any expenses?
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  • 14) Bank account (for any refund)

  • 15) Signature

  • By signing and dating this checklist and confirmation of engagement you confirm:

    1) You have completed all the questions above;

    2) We are authorised to proceed with the work.

  • Should be Empty: