New Customer Authorisation Form
Customer Details:
Full Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State
Postal Code
Phone Number
*
-
Area Code
Phone Number
Day of Birth
*
-
Day
-
Month
Year
E-mail
*
Tax File Number
*
Do you have an ABN?
*
YES
NO
ABN Number
*
Employer name
What is your occupation?
*
Do you have a spouse or partner?
*
YES, living together
YES, living separate
NO
Other
Spouse/partner's full name
*
What is an estimated spouse/partner's income?
*
Do you have any dependents?
*
YES
NO
How many dependents do you have?
*
What is the age of your dependents?
*
Do you have a private health insurance?
*
YES
NO
Who is your insurance provider?
What is your policy number?
Do you have any investments? Please specify
*
NO
SHARES
CRYPTO
INVESTMENT PROPERTY
Other
Are you an Australian resident for tax purposes?
*
YES
NO
NOT SURE
I NEED HELP WITH THIS QUESTION
Do you have any foreign income?
*
YES
NO
NOT SURE
Did you received any goverment payments?
*
YES
NO
Is there anything else we should know about you or your situation?
Identity Verification
*
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please upload a clear photo of your valid government issued ID card, driver's license, or passport
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BANK NAME - USED ONLY FOR A TAX REFUND PURPOSE
BANK NAME
ACCOUNT NAME
BSB
ACCOUNT NUMBER
How did you hear about us?
*
Please Select
Friend
Facebook
Website
Booklet
Other
Please Specify
New registered agent appointment
I, hereby appoint Ksenia Nasonova, trading as TAXBAY to be my tax agent and accountant and attend to all my taxation affairs. Accordingly, I authorise them to access my details via the ATO - Tax Agent’s portal.
I accept the terms and conditions of TAXBAY
*
I AGREE
Signature
*
Please verify that you are human
*
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