Authority To Act

Asset Ownership

Are you signing up as a Business, Property or Personal Client?*

How do you operate?*

Your Details

Personal IRD Number*

Example: 123-456-789 or 012-345-678 - 8 digit numbers start with a zero.

First Name*

Middle Name

Last Name*

Date of Birth*

Email Address*

Mobile Phone Number*

Are you an overseas tax resident?

Yes
No

Your current country of residence

Please provide your overseas tax identification number

Address

Home Address

Street Address Address Line 2 City Post Code

Joint Details

Personal IRD Number*

Example: 123-456-789 or 012-345-678 - 8 digit numbers start with a zero.

First Name*

Middle Name

Last Name*

Date of Birth*

Email Address*

Mobile Phone Number*

Are you an overseas tax resident?

Yes
No

Your current country of residence

Please provide your overseas tax identification number

Home Address

Street Address Address Line 2 City ZIP / Postal Code

Do you currently have an accountant?*

Yes
No

Accounting Firm Name*

Accounting Firm Email Address*

Hidden

Please provide their details*

Business Entity Details

Entity Name*

(As listed in New Zealand Companies Office)

Entity IRD Number*

Example: 123-456-789 or 012-345-678

Do you use Xero for this entity?*

Yes
No

Does this entity have any additional shareholders/settlors other than yourself?*

Yes
No

Additional Shareholder/Settlor - Full Name*

Additional Shareholder/Settlor - IRD Number*

Example: 123-456-789 or 012-345-678 - 8 digit numbers start with a zero.

Do you want us to act as tax agent for this individual?*

Yes
No

Is there another shareholder/settlor?

Yes
No

Additional Shareholder/Settlor - Full Name*

Additional Shareholder/Settlor - IRD Number*

Example: 123-456-789 or 012-345-678 - 8 digit numbers start with a zero.

Do you want us to act as tax agent for this individual?*

Yes
No

Is there another shareholder/settlor?

Yes
No

Additional Shareholder/Settlor - Full Name*

Additional Shareholder/Settlor - IRD Number*

Example: 123-456-789 or 012-345-678 - 8 digit numbers start with a zero.

Do you want us to act as tax agent for this individual?*

Yes
No

Hidden

Please add a Full Name and IRD Number for each additional shareholder

If you have more than four additional shareholders, please email
info@lighthousefinancial.co.nz and provide their full names and IRD Numbers.

Property Entity Details

Entity Name*

(As listed in New Zealand Companies Office)

Entity IRD Number*

Example: 123-456-789 or 012-345-678

Do you use Xero for this entity?*

Yes
No

Does this entity have any additional shareholders/settlors other than yourself?*

Yes
No

Additional Shareholder/Settlor - Full Name*

Additional Shareholder/Settlor - IRD Number*

Example: 123-456-789 or 012-345-678 - 8 digit numbers start with a zero.

Do you want us to act as tax agent for this individual?*

Yes
No

Is there another shareholder/settlor?

Yes
No

Additional Shareholder/Settlor - Full Name*

Additional Shareholder/Settlor - IRD Number*

Example: 123-456-789 or 012-345-678 - 8 digit numbers start with a zero.

Do you want us to act as tax agent for this individual?*

Yes
No

Is there another shareholder/settlor?

Yes
No

Additional Shareholder/Settlor - Full Name*

Additional Shareholder/Settlor - IRD Number*

Example: 123-456-789 or 012-345-678 - 8 digit numbers start with a zero.

Do you want us to act as tax agent for this individual?*

Yes
No

If you have more than four additional shareholders, please email
info@lighthousefinancial.co.nz and provide their full names and IRD Numbers.

Hidden

Please add a Full Name and IRD Number for each additional shareholder

Is the entity GST registered?*

Yes
No
Don't Know

Payment Period*

One Monthly
Two Monthly
Six Monthly

Reporting Basis*

Payments Basis
Invoice Basis
Hybrid Basis
Don't Know

Would you like us to file your GST returns?*

Yes
No

Please provide as much information as possible below

Asset Ownership

Your Details

Address

Joint Details

Business Entity Details

Property Entity Details

- AML/CFT Identification Requirements

- AML/CFT Identification Requirements

Bank Account Details

Inland Revenue Requirements