New Zealand Tax Refund Application

Please fill out this simple form with as much information as possible - it will take just 4 minutes! Once you complete this form, our representative will contact you within 8 hours !

CONTACT DETAILS
( * - mandatory fields )

Title

First Name *

Middle Name

Surname *

Postal Address *

Email address *

Phone number *

Line Type *

Country Code *

Area Code *

Phone number *

Please send confirmation via SMS to this number

Date of Birth *

DD/MM/YYYY

Which country are you from? *


State *
City *

How did you hear about our service? *

What is the name of that person/organisation? *

ADDITIONAL INFORMATION

Have you previously filed a tax return to the New Zealand Tax Authorities for this year? *

If yes, do you currently have your Notice of Assessment?

If yes, please (scan and email, fax or post a copy) to taxback.com today.

Approximate first date of arrival in New Zealand *

DD/MM/YYYY

Approximate last date of departure from New Zealand *

DD/MM/YYYY

If student - Field of study. If working - Occupation

IRD Number (if known)

Address while in New Zealand

How many employers did you work for? *

NOTE: Please only select the number of employers that you received wages from.


EMPLOYER 1

Company Name *
Full Business Address


If you worked for a recruitment agency, the name of your consultant (if known)
Telephone Number
Fax Number
E-mail Address / Website
Approximate date you began work *	DD/MM/YYYY
Approximate date you finished work *	DD/MM/YYYY
Do you have your final payslip or Certificate of Earnings? *	If yes, please fax, scan and email or post to taxback.com today
If no, would you like us to source replacements for you?	*document retrieval fee applies


EMPLOYER 2

Company Name *
Full Business Address


If you worked for a recruitment agency, the name of your consultant (if known)
Telephone Number
Fax Number
E-mail Address / Website
Approximate date you began work *	DD/MM/YYYY
Approximate date you finished work *	DD/MM/YYYY
Do you have your final payslip or Certificate of Earnings? *	If yes, please fax, scan and email or post to taxback.com today
If no, would you like us to source replacements for you?	*document retrieval fee applies


EMPLOYER 3

Company Name *
Full Business Address


If you worked for a recruitment agency, the name of your consultant (if known)
Telephone Number
Fax Number
E-mail Address / Website
Approximate date you began work *	DD/MM/YYYY
Approximate date you finished work *	DD/MM/YYYY
Do you have your final payslip or Certificate of Earnings? *	If yes, please fax, scan and email or post to taxback.com today
If no, would you like us to source replacements for you?	*document retrieval fee applies


EMPLOYER 4

Company Name *
Full Business Address


If you worked for a recruitment agency, the name of your consultant (if known)
Telephone Number
Fax Number
E-mail Address / Website
Approximate date you began work *	DD/MM/YYYY
Approximate date you finished work *	DD/MM/YYYY
Do you have your final payslip or Certificate of Earnings? *	If yes, please fax, scan and email or post to taxback.com today
If no, would you like us to source replacements for you?	*document retrieval fee applies


EMPLOYER 5

Company Name *
Full Business Address


If you worked for a recruitment agency, the name of your consultant (if known)
Telephone Number
Fax Number
E-mail Address / Website
Approximate date you began work *	DD/MM/YYYY
Approximate date you finished work *	DD/MM/YYYY
Do you have your final payslip or Certificate of Earnings? *	If yes, please fax, scan and email or post to taxback.com today
If no, would you like us to source replacements for you?	*document retrieval fee applies


Have you also worked in any of the following countries? to select multiple options, hold down the control key while selecting
Did you receive a tax refund?

YOUR FEEDBACK AND ADDITIONAL INFORMATION
Please enter any additional comments and information here:


Please read our terms and conditions and indicate that you accept them in order for your registration to proceed
Yes, I accept the Terms and Conditions *

DON'T FORGET-IMPORTANT!
Once you hit submit you will need to send us your final pay-slip(s) or Certificate of Earnings from each of your employers (if you have them) - see details on the next page.