Home Based Childcare Carers Application
We will first determine if you have tax to  pay on your earnings for your Home Based Childcare Services.
 
We will also check all your details for prior year income and any refunds that may be due.
If you are unsure with any questions regarding your income, you can send the paperwork from your Agency directly to us by
Photo from Phone                              text to  021 634418
Email                                                julia@mytaxhelp.co.nz
Fax                                                   028 255 30130
                                                                                                                                                                                                                                                      
IRD NUMBER:
Title:
First Name:
Middle Names(s)
Surname:
Email: (required)
Date Of Birth: Pick a date
                                                                                                                                                                                                                                                
Street and Number:
Suburb:
Town / City:
Home Phone:
Mobile Phone:
Have you left Secondary School in the last five years?:
How did you hear about us?:
 

Drivers licence:

Do you have a Drivers Licence? (read below if no licence)
NZ Drivers Licence No:
Card Version:
No NZ Drivers Licence? Please print off this form to apply and send it to My Tax Help with a copy of an approved form of ID.   Please email us for our postal details

 

Home Based Childcare Educator Details: (these details are supplied by your agency)

Gross Income Received for Childcare

Hours Worked
Weeks Worked

Accommodation

A  Do you own your own home - if No please proceed to B

Purchase Price of home

yes
no

Do you receive Accommodation Winz Subsidy if so how much (for the year)?

B  Yearly Rent

Do you receive Accommodation Winz Subsidy if so how much (for the year)?

Additional Costs

Examples: ACC Levies

Any expenses incurred to comply with training requirements i.e. First Aid training

YOU MUST keep receipts for these if you have paid these directly

Tax Details:

I have always lived in NZ or I have since 1st April 2010 and will live here at least until March 2016 (if yes go to [A], if no then complete below)
I arrived in NZ on: (dd/mm/yyyy)   Pick a date
 I left NZ temporarily on: (dd/mm/yyyy)   Pick a date
 I arrived back in NZ on (dd/mm/yyyy)   Pick a date
 I left NZ Permanently on (dd/mm/yyyy)   Pick a date

 

[A] In any of the last 5 years and until at least 31 March 2015 my only income has been / will be from salary/wages and/or government benefits Working for Families, Student allowance, pension, ACC etc) (if yes go to [B], if no then complete below)
I have received interest
*Amount and date required if yes
Amount:
    Date(s) Received: Pick a date
I have received dividends:
*Amount and date required if yes
Amount:
    Date(s) Received:   Pick a date
I have received Maori Authority Distribution:
*Amount and date required if yes
Amount:
    Date(s) Received:   Pick a date
I am self employed:
I am in a partnership:
I receive income from a shareholder salary:
I have a rental property:
I have expenses to claim:
Loss of earnings insurance:
Commission on Interest or dividend income:
 
[B] I have had dependent children living with me in the last 6 years ( 1 April 2011 to 31 March 2015 )  If yes, please give details below
Dependent 1 Date of Birth:Pick a date Date Care Ended:Pick a date
Dependent 2 Date of Birth:Pick a date Date Care Ended:Pick a date
Dependent 3 Date of Birth:Pick a date Date Care Ended:Pick a date
Dependent 4 Date of Birth:Pick a date Date Care Ended:Pick a date
Dependent 5 Date of Birth:Pick a date Date Care Ended:Pick a date
Dependent 6 Date of Birth:Pick a date Date Care Ended:Pick a date
Do you receive Working for Families Tax Credits?:
Do you have a partner/Spouse?:
 

Paying You:

How would you like to be paid?: Send me a cheque to my postal address (Note a cheque will longer)
  (fill bank details below) 
  Account Holder:  
  Enter your bank account number:
 
 

Legal Stuff:

  *
*
 

IRD Stuff: I agree to allow My Tax Help (Trading as Adminguru) to...

Talk to Inland Revenue for me
Find out my wages, tax and other things
Update my details
Sort my tax
Manage my refund money
Stop when I tell you to