My E-Tax Application Form  
Cash Now Perth 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:
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:
Address :
Suburb:
State:
Post Code:

Employers ABN:
 [ xx-xxx-xxx-xxx ]
PAYG Gross Salary:
$ .00
PAYG Total Tax Withheld:
$ .00
Other Information
Allowances, earnings or fees:
$ .00
Lump sum payments
$ .00
Eligible termination payments:
$ .00
Gross interest received:
$ .00
Total dividends:
$ .00
Total reportable fringe benefits:
$ .00
Commonwealth allowances - Newstart, Youth allowance or Abstudy:
$ .00
Other Aust pensions:
$ .00  
Total work related deductions:
$ .00
Do you have private health?:
Do you have HECS debt or student loans?:
Do you have any child support or maintenance support arrears?:
Are you receiving family assistance?:
Do you have medical bills over $1,500?:
Do you have investment property?:
Are you a primary producer?:
How did you hear about us?:
Do you want our fees taken from your refund?:
Are you interested in the 48hr refund?:
Do you claiming the Baby Bonus?:
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.