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New Client Form
Client Details
Title
*
Please choose
Mr
Mrs
Ms
Miss
Dr
Other
First Name
*
Last Name
*
Date of Birth
*
Date Format: DD slash MM slash YYYY
Occupation
*
Tax File Number
*
Type of Entity
Please choose
Individual
Company
Trust
Super Fund
Partnership
Estate
Registered for GST
Yes
No
ABN Number (if applicable)
Business Activity Statement (BAS) Required
*
Yes
No
Instalment Activity Statement (IAS) Required
*
Yes
No
Address Details
Residential Address
Street Address (Not a PO box)
*
Suburb
*
City
*
State
*
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Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
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Victoria
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Postcode
*
Postal Address (for correspondence)
Street Address
*
City
*
Suburb
*
State
*
Please choose
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
Postcode
*
Business Address (if applicable)
Street Address (Not a PO box)
Suburb
City
State
Please choose
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
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Western Australia
Postcode
Contact Details
Telephone
Mobile Phone
*
Work Phone
Business Hours (work)
After Hours (home)
Email
Email Address
*
EFT Details (for refunds)
Bank Account Details
Name of Account
*
BSB
*
Account Number
*
Associates
Spouse Details
Do you have a spouse?
*
Yes
No
Spouse's Title
Mr
Mrs
Ms
Miss
Dr
Other
Spouse's First Name
Spouse's Last Name
Spouse's Date of Birth
Date Format: DD slash MM slash YYYY
Spouse's Taxable Income
Period that you had a spouse during the year:
Full Year
Period
Children Details (if applicable)
Children Details (Repeater)
First Name
Last Name
Date of Birth
Date Format: MM slash DD slash YYYY
Add Child
Remove Child
Company(ies)
Companies (Repeater)
ABN
ACN
TFN
Add Company
Remove Company
Trust(s)
Trusts (Repeater)
ABN
ACN
TFN
Add Trust
Remove Trust
Partnership(s)
Partnerships (Repeater)
ABN
ACN
TFN
Add Partnership
Remove Partnership
Super Fund(s)
Super Funds (Repeater)
ABN
ACN
TFN
Add Super Fund
Remove Super Fund
Are you fully vaccinated for COVID-19?
Yes
No
N/A - I am not attending a face-to-face appointment
To ensure we provide a safe workplace for our clients and team, Modoras have adopted a mandatory full COVID-19 vaccination policy for anyone wishing to attend a Modoras office. If you are not fully vaccinated, have been exposed to a confirmed case of COVID-19, have attended a COVID-19 hotspot in the 14 days prior to your appointment or are experiencing flu-like symptoms, please let us know. We will be happy to either reschedule your appointment or conduct it via zoom.
Consent
*
I authorise Modoras Accounting (QLD) Pty Ltd to record the above details to notify the Australian Taxation Office (ATO) that Modoras is appointed as my Tax Agent for my income tax purposes. I also confirm that I have read, understood and agree to the terms of engagement letter. I also confirm that I have read, understood and agree to the terms of engagement letter.
Children Details (Repeater)
First Name
Last Name
Date of Birth
Date Format: MM slash DD slash YYYY
Add Child
Remove Child
Companies (Repeater)
ABN
ACN
TFN
Add Company
Remove Company
Trusts (Repeater)
ABN
ACN
TFN
Add Trust
Remove Trust
Partnerships (Repeater)
ABN
ACN
TFN
Add Partnership
Remove Partnership
Super Funds (Repeater)
ABN
ACN
TFN
Add Super Fund
Remove Super Fund