PERSONAL INCOME TAX RETURN CHECKLIST – 2018

1 PERSONAL INCOME TAX RETURN CHECKLIST 2020 NameDate of BirthIRD NumberINCOMETick if includedDid you receive any salary, wages, National Superannuation, Social Welfare,Benefit, Family, Assistance, Accident Compensation etcNote: Details of this are not required as IRD will provide full details directly to usPlease provide the following if applicable:Interest-all RWT certificates / PIE INCOME Annual CertificatesDividends-all dividend warrants (including shares in lies and bonus issues)Rents-Details of gross rents received and expenses to be claimed againstthis INCOME (eg.)

2 Rates interest, repairs, insurance)-If property has been bought or sold during the year we require copiesof settlement statements, sale and purchase agreement and loan documentationEstate or Trust-Details of any INCOME and any tax paid by an estate/trustPartnerships-Details of any share of INCOME or losses in all partnerships and any tax paidOverseas INCOME -Details of any other INCOME overseas sourced INCOME and all investments INCOME -Full details of any other source of INCOME not included above. eg shareholdersalaries from entities we do not act If you have been attributed a share of loss, please provide you have investments outside New Zealand you will need to list these andvalue these as at 1 April 2019.

3 This will form the basis of the FIF tax calculationwhich is levied on 5% of the Investment addition we need all Investment sale and purchase details during the year1/4/2019 to 31/3 :Please provide details of the following expenses if applicable:-fees incurred for RETURN preparation (other thanBarlow McCormack Limited)-expenses against INCOME that has been receivedwith withholding tax deducted-interest incurred in relation to PERSONAL loansfor business related activities or sharepurchases- INCOME protection insurance premiums paid-ACC Levies PaidWorking for Families:- The INCOME to be included in this calculation has changed.

4 Seeseparate questionnaire if you think you are Loan -Please advise details of loan, repayments etcRebates Donations made during the yearPlease forward the receipts to us so we can calculate your rebateSign:Date:For further copies of this questionnaire please contact us or visit our