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Apply Online for a Tax Refund

This application should only take you 2-3 minutes - then sit back and let us do all the hard work after that.


Please read the following before beginning:


For your security we require everything on this form marked with an asterix (*) to be completed.  Please have the following ready;

- Your IRD Number (if not handy, call 0800 227 774 and they will give it to you).

- Details of any income besides salary and wages you have received within the last five years.

- If you attended school in the last 5 years, the month and year you left school. 

- If you are still at school select the current month and year
 

If you have questions please see our Frequently Asked Questions page or contact us at info@kiwitaxrefund.co.nz


Thank You.

 

 

                   TAX REFUND APPLICATIONPPLICATION


Full Name        

*

Postal Address  

*

 

*

 

Phone Number  

*

E-Mail Address

  *

Cell Phone

 

Date Of Birth (Day / Month / Year)

*
 

IRD Number

*
 

Identification *

  

Drivers Licence Number

or

Other Identification

  

Type

No.

   

Referral Name/Promotion Code

 

Did you receive any New Zealand interest?

Yes

No

If Yes, How Much

Did you receive any other income?

Yes

No

If Yes, How Much

Did you receive any New Zealand dividends?

Yes

No

If Yes, How Much

Have you received trust income?

Yes

No

If Yes, How Much

   

Do you own a rental property?

Yes

No

Have you been self employed in the past 5 years?

Yes

No

Have you lived overseas in the last 5 years?

Yes

No

Have you worked overseas in the last 5 years?

Yes

No

Have you attended high school in the last 5 years?

Yes

No

If Yes, Date Last Attended

Do you have dependant children, aged under 18 years, living with you?

Yes

No

If Yes, How Many?

 
 

I agree with the declaration below

      Yes *
 

Comments

 
 

 

                                           

 

DECLARATION

I certify that the information given above is correct.

I have supplied all interest, dividend, overseas income or Maori authority income details.

I am a New Zealand resident for tax purposes.

I do not owe any arrears in child support

I authorise Kiwi Financial Services Limited to act as my tax agent and to obtain any tax information from Inland Revenue on my behalf

I authorise and instruct Kiwi Financial Services Limited to request my Personal Tax Summary(s). I have supplied all information necessary to carry out such service and I am responsible for the accuracy and completeness of such information.  I certify that any Personal Tax Summary requested, on my behalf, from the Inland Revenue Department by Kiwi Financial Services Limited is true and correct.

I agree to the published fee structure and agree to pay this fee as the cost involved in processing my tax refund.

I authorise the Inland Revenue Department to direct credit all tax refunds and processing fees, as detailed below, to the bank account of Kiwi Financial Services Limited.

I understand that Kiwi Financial Services Limited will deduct the agreed processing fee from my refund(s) before paying the remaining funds to me either by cheque or directly to my nominated bank account.

 

If your total refund turns out to be

Processing cost will be

Less than $80

$10 (refunds of less than $30 not processed)

More than $80 and up to $2500

12% of Refund (for a limited time)

More than $2500

$300

 


DISCLAIMER

We have not audited or reviewed the information you have provided, therefore neither we nor any of our employees, associates or agents accept any responsibility for the accuracy of the information from which any Personal Tax Summaries or Tax Returns have been prepared. All Personal Tax Summaries and Tax Returns have been prepared at the request of, and for the sole benefit of our customer only. Kiwi Refund, Kiwi Financial Services Ltd, it's employees  and agents do not accept any responsibility on any ground whatsoever, including liability in negligence, to any other person.

Please note: any refund, less processing fees, will be deposited into your nominated bank account or paid by cheque which will be sent to you at the address provided above.  All fees are inclusive of G.S.T
 

 

Please print and send it to us at PO Box 13-406 Johnsonville, Wellington

 
 
 


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