Dauters Accounting Services

CLIENT REGISTRATION FORM

To help us with your details for a new client or to ensure that your details are correct in our records, please complete your details below:

TITLE

TAX FILE NUMBER

DATE OF BIRTH

LAST NAME

FIRST NAME

MIDDLE NAME

RESIDENTIAL ADDRESS

SUBURB

STATE

POSTCODE

Is your postal address the same as your residential address?

POSTAL ADDRESS (if different)

SUBURB

STATE

POSTCODE

SPOUSE LAST NAME

FIRST NAME

EMAIL ADDRESS

IF YOU WOULD LIKE TO RECEIVE ANY REFUND DIRECTLY INTO YOUR BANK ACCOUNT PLEASE COMPLETE YOUR BANK DETAILS BELOW

BSB

ACCOUNT NUMBER

ACCOUNT NAME

PHONE CONTACT DETAILS (please indicate best times and preferred phone to ring)

HOME

Time

AM/PM

MOBILE

Time

AM/PM

WORK

Time

AM/PM

IF YOU ARE A NEW CLIENT, HOW DID YOU HEAR ABOUT US?

ARE YOU HAPPY TO BE CONTACTED BY SMS?

YES

I AUTHORISE DAUTERS ACCOUNTING SERVICES TO REGISTER ME AS A CLIENT AND ACCESS MY INFORMATION FROM THE AUSTRALIAN TAXATION OFFICE WEBSITE / ATO PORTAL.

Signature:

Clear Signature

DATE