Mytaxhelp

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

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	Gross Income:
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)
I left NZ temporarily on: (dd/mm/yyyy)
I arrived back in NZ on (dd/mm/yyyy)
I left NZ Permanently on (dd/mm/yyyy)

[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:
I have received dividends: *Amount and date required if yes		Amount:
		Date(s) Received:
I have received Maori Authority Distribution: *Amount and date required if yes		Amount:
		Date(s) Received:
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:	Date Care Ended:
Dependent 2	Date of Birth:	Date Care Ended:
Dependent 3	Date of Birth:	Date Care Ended:
Dependent 4	Date of Birth:	Date Care Ended:
Dependent 5	Date of Birth:	Date Care Ended:
Dependent 6	Date of Birth:	Date Care Ended:
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)

Straight into my bank account thanks (fill bank details below)

Account Holder:

Enter your bank account number:

Legal Stuff:
By ticking this box I acknowledge that the above information is true and correct and that I have read and agree to the terms & conditions. *
By ticking this box you agree this constitutes execution by electronic signature. *

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