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Gold Coast Accountant

New Client Form

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    Thank you for considering Accounting & Tax Solutions as your Tax Agent and Accountant.
    We would appreciate it if you could please take the time to fill out the following details:

    Business Information
    Business Name:
    GST Registered YESNO
    Trading as:
    Tax File Number:
    ABN:
    ACN:
    Client Personal Information
    Full Name:
    MRMRSMSMISS
    Date of Birth:
    Place of Birth:
    Occupation:
    Tax File Number:
    Medicare No:
    Spouse/Partners Information
    Full Name:
    Date of Birth:
    Place of Birth:
    Occupation:
    Tax File Number:
    Medicare No:
    Children Information
    YES If Yes, names and dates of birth:
    Centrelink/Child Support Obligations: YESNO
    Child Name (1):
    DOB:
    Child Name (2):
    DOB:
    Child Name (3):
    DOB:
    Child Name (4):
    DOB:
    Contact Information
    Full Name:*
    Address:*
    PO Box:
    Mobile#:
    Home Phone#:
    Business Phone#:
    Fax#:
    Email:
    Bank Account Details (for ATO Refund):
    BSB:
    Acc Number:
    Acc Name:
    Other Information
    Income Protection Insurance: - (Interested? YES / NO)
    Medical Insurance:
    Copy of ID: (ie. Drivers License, Medicare Card, Passport)
    YESNO
    Upload your ID
    How did you hear about Accounting & Tax Solutions?
    GoogleWalk InReferral
    Client wishing to use secure 'Client Portal' (e-signing)?
    YESNO