My E-Tax Application Form  
Cash Now Regular Secure Online Form

Fees - Prepaid - $85.00 via direct debit - from Tax Return - $115.00

48 hr advance on your refund available.

Additional Charges for rental properties, depreciation schedules and

business or primary production income and expenses.

 

Please provide as much information from the following list as possible.

  1. Group certificates.

  2. Last years tax return.

  3. Last pay slip.

  4. Social security, pensions, allowance documents/statements.

  5. Sole parent/spouse/house keeper/low income/aged persons rebate.

  6. Family assistance statement.

  7. Private health statement.

  8. Medical receipts over $1,500.

  9. Schedule of work related expenses.

  10. Bank statements/Loan statements.

  11. Loan and or credit card statements.

  12. Imputation credits from dividend statements.

  13. Superannuation if self employed.

  14. Prior year tax losses.

  15. Previous years accounting/lodgement fee.

  16. Investment property expenses schedule.
  17. Interest/fees on borrowing for investment purposes.
Customer Information
Your First Name:
Your Last Name:
 
Your Birth Date:
Your Tax File No:
 [ xxx-xxx-xxx ]
Your E-mail:
Marital Status:
Your Sex :
Has any part of your name changed since your last return?
Your BSB No:
Your Bank Account No:
Your Postal Address:
Suburb:
State:
Post Code:
Has your address changed in the last 12 months?
Your Home Ph No:
 [ xx-xxxx-xxxx ]
Your Fax No:
 [ xx-xxxx-xxxx ]
Your Work Ph No:
 [ xx-xxxx-xxxx ]
Your Mobile No:
 [ xxxx-xxx-xxx ]
Your Occupation
Preferred method of daytime contact:
Employer Information
Employer's Name 1:

Employers ABN 1:
 [ xx-xxx-xxx-xxx ]
PAYG Gross Salary 1:
$ .00
PAYG Total Tax Withheld 1:
$ .00
Employer's Name 2:

Employers ABN 2:
 [ xx-xxx-xxx-xxx ]
PAYG Gross Salary 2:
$ .00
PAYG Total Tax Withheld 2:
$ .00
Other Information
Interest earnings: ie bank interest
$ .00
Interest & Bank Fees paid: ie bank interest
$ .00
Eligible termination payments:
$ .00
Total dividends from investments: ie shares
$ .00
Do you have private health?:
Do you have HECS debt?:
Do you have medical bills over $1,250?: If yes list amount
$ .00
Do you have investment property?:
Are you claiming the Baby Bonus?:
Did you operate your own business or trade as a sole trader?:
Did you have any dependant children for any part of the year?:
Did you use your vehicle for work related purposes?:
$ .00
Did you incur any work related travel expenses (besides vehicle)?:
$ .00
Were you required to purchase or launder any work uniforms?:
$ .00
Did you pay for and attend any work related seminars or training?:
$ .00
Any self education expenses?: If yes list amount:
$ .00
Did you donate to charity?: If yes list amount:
$ .00
Did you pay someone to prepare last years tax return?:
$ .00
Any other deductions?: If yes list amount:
$ .00
Did you receive any government allowances?:
$ .00
Did you receive a non government pension?:
$ .00
Any foreign income?: If yes list amount:
$ .00
Receive income from a managed trust or partnership?
$ .00
Did you sell any assets?: If yes list amount:
$ .00
Any other income not previously mentioned?
$ .00
Are you interested in the 48hr advance on your refund?:
How did you hear about us?:
From which Cash Now store?:
In submitting this form you confirm that the information is a true representation of your taxation summary and further permit the Cash Now nominated accountant to confirm as a registered tax agent the validity of such information.