New Client Information Form

Please complete this form as best you can. We'll be in touch to clarify anything if necessary. You can also draw attention to any problem areas in the box at the end of the form. Use the Submit button at the end of the form to send it to us electronically.

Alternatively you can telephone us on 01332 202660 and we can take the information over the phone.

Another option is to print it out, fill it in by hand and send it to us in the post at: Adrian Mooy & Co Ltd, 61 Friar Gate, Derby, DE1 1DJ.

Name

PrefixFirst NameMiddle NameSurname or family name

Previous surname (if applicable)

PrefixFirst NameMiddle NameSurname or family name

Date surname changed

Reason name changed

Personal address 1

Street Address

Street Address Line 2

Town / City

Post Code

Date you moved to this address

Do you rent your house / owner with mortgage / owner no mortgage / other?

Previous address if at the above address less than 3 years

Date you moved to this address

Date of birth

National Insurance number

Phone number

Email address

Country of domicile if other than the UK

Marital status

Number of children, if any

Student Loan - Do you currently have an outstanding student loan where, subject to meeting earnings test, repayments should be collected directly from your salary?

Do you have a Postgraduate Loan which is not fully repaid?

Please provide a photo ID (copy of photo page of passport or copy of driving license) and proof of address (eg. utility bill). Please send in the post or hand deliver to us at Adrian Mooy & Co Ltd, Chartered Certified Accountants, 61 Friar Gate, Derby, DE1 1DJ. Please enter in the text box on the right which documents you are sending.

Are you a Buy to Let Landlord?

If so, how many properties do you have?

Are they owned by you or jointly by more than one person

Are you are currently employed?

If you are currently employed name of employer and approximate annual salary.

Do you / Did you receive any employee benefits?

If yes, please give details. eg. Company car & fuel, Medical care plans etc.

Brief history of last 5 years covering being a student, unemployed, employed, self employed, living abroad. Please include dates.

Have you recently received a P45 on leaving employment eg. because you went self employed?

Please send us a copy of your P45 if you have it. If you have not yet received it please send a copy to us when you get it.

Browse Files

Have you received any taxable State Benefits (eg. Job Seekers Allowance) this year or last year?

Your Benefits Office will issue you a P45 if you were previously claiming Job Seekers Allowance but have now found a job or started self employment. Please send us a copy. If you have not received your P45 contact your Benefits Office to request it.

Browse Files

Do you receive a Pension?

If so, please give name of pension payer.

Do you currently make payments into a Pension Scheme?

If so, please give pension scheme name and number and annual amount paid.

Have you sold a Property in the last 2 years?

If so, please give brief details of the property sold.

Do you have any investments - eg. share portfolios, ISA's etc?

If so, please give brief details of your investments.

Which of the following apply:

You are a Sole TraderYou are a Partner in a PartnershipYou are a Director or Shareholder in a Limited CompanyYou are a High Earner (+£60,000)You, or someone in your household, receives Child BenefitYou have Rental IncomeYou need to pay Capital Gains TaxMarriage Allowance - You have applied to HMRC to give your partner extra Personal allowance or vice versaNot Applicable

Do you have any other income or expenses not covered above?

If so, please give details.

Have you been self-employed before?

Do you already have a 10 digit UTR (unique taxpayer reference) number?

If you already have a 10 digit UTR (unique taxpayer reference) number please enter it here.

Have you told HM Revenue & Customs that you need to complete a Self Assessment Tax Return?

If not would you like us to do this for you?

If you've started trading when did you start?

What is the name of your business? If your business does not have a name you can leave this blank.

Business address

Street Address

Street Address Line 2

Town / City

Post Code

Please give a brief description of your business.

Will you be doing all your work for one person or firm? If you are going to do all the work for one person or firm, you may be an employee and will need to check your employment status.

If you've started trading how do you currently keep your business records?

What are your estimated annual sales?

Please list personal assets you’ve introduced into the business with an estimate of their current value (for writing down allowance). These could include items such as office furniture, computers, printers and any other equipment, tools etc. for your business.

Does your business have its own bank account?

How many workers are there in the business including yourself?

VAT status:

Does your business employ anyone through PAYE?

Have you had an accountant in the past?

Finally, anything you would like to add or clarify or draw to our attention.

Signature*

Thank you. You've finished. Just press the submit button below.

You'll hear back from us shortly.

New Client Information Form

About you

About your business