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TAX REFUND SPECIALIST


HOW DO I APPLY?

You can apply on line by completing the following application form.

Alternatively, you can print complete the PDF application form and fax, post or scan & e-mail it to us and this will speed up the processing time so you will get your refund faster.

If you choose to apply on-line, we will post to you a hard copy of the application page and a postage paid return envelope as the IRD require us to gain a hand written signature before we can commence processing your application.

PDF
Download Application Form PDF

email: mytaxbackoffice@xtra.co.nz
fax: 09-5799025


 

* Required Fields

First Name   *
Middle Names   *
Surname   *
Date of Birth   *
What was your last year at high school?   *
e-mail address

IRD Number

  *

Bank Account Number

  *

Postal Address

   *

Suburb

   *
Town   *
Home ph. Number   *
Mobile ph. Number
ID Type  *
Drivers Licence Other (Only check if you do not have a driver's license)
Drivers Licence  
Drivers License Number
(5a on license)		   *
Drivers License Code
(5b on license)		   *
Other ID  
Type
No.
Current Employer   *
Work Phone   *
How did you hear about us?
I have read the below declaration Yes

DECLARATION

  • I certify that I am the above person and the IRD number and Bank Account number given above is my own.
  • All my income is derived exclusively from wages or salary. I have received no rental income, business income, overseas income, trust or Maori Authority income during the past 5 years.
  • I authorise MYTAXBACK to act on my behalf and obtain my information from Inland Revenue for the current and previous 5 tax years. This may include cancelling old bank accounts held by Inland revenue.
  • I instruct MYTAXBACK to request my Personal Tax Summaries or file my IR3 and have supplied all information necessary to carry out such service and I accept full responsibility for the accuracy and completeness of this information.
  • I understand that any refund may be first applied to any outstanding arrears for any tax type that I have with Inland Revenue prior to any remaining balance being refunded.
  • I agree to the fee structure below and agree to pay this processing fee for the service provided by MYTAXBACK in calculating and claiming my refunds due for all tax types and I understand that the fees listed are for each year that a refund is processed on my behalf and calculated prior to the payment of any tax type arrears.
  • I authorise the Inland Revenue to transfer any refunds in the nominated bank account of My Tax Back NZ Limited and agree and accept that MYTAXBACK will forward the balance to my bank account or post a refund cheque to the address given above after deducting the processing fees.
  • I would like to remain a client of MYTAXBACK and have future years automatically checked for tax refunds. I will notify MYTAXBACK if I decide to withdraw authority to access my IRD information or if I receive other income listed above.
MYTAXBACK refund level per Tax year
  
Procesing Cost Including GST
Nil refund or less than $30 
  
Zero fee 
Between $31 and $100 
  
$30
Between $101 and $200 
  
$60
Between $201 and $300 
  
$80
Between $301 and $500 
  
$130
Between $501 and $700 
  
$170
Between $701 and $1000 
  
$220
Between $1001 and $1500 
  
$350
Between $1501 and $3000 
  
$400
Over $3000 
  
$500
A $5 search fee will apply if no IRD number is provided. This fee is waived if there is no refund.

If there are any withholding payments or you were overseas for part of the year there is a minimum charge of $150 for that year.

  • I have supplied all interest dividends, overseas income or Maori authority income details herewith.

  • owe Child Support Arrears.

  •    have a Student Loan.

  •    been overseas for more than 2 months. For Tax purposes, I am a New Zealand Resident.

  •    read and understand all the terms of this agreement.

Comments?



Disclaimer of Liability

We have not performed an audit or review and therefore neither we nor any of our employees or agents accept any responsibility for the accuracy of the information from which this person’s return has been prepared. Further, the Return has been prepared at the request of and for the purposes our client and we accept no responsibility on any grounds whatsoever including liability for negligence, to any person.

Your refund cheque will be made out in the name of the person above and will be sent to the address given above. If you have any enquires, please feel free to contact us at any time.

 
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