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Registration Form
Personal Details
*
Indicates required field
Title
*
Name
*
First
Last
Tax File Number
*
Date of Birth
*
Phone Number
*
Email
*
ABN (if any)
*
Residential Address
*
Line 1
Line 2
City
State
Zip Code
Country
Postal address (if different)
*
Bank Account
Bank Name
*
Account Name
*
BSB
*
Account Number
*
Visa & Medicare & Spouse Details
Please choose one of the following
*
I am a student with a valid student visa
I have a valid working visa or temporary resident visa.
I am a permanent resident or Australian citizen
Others
Do you have a Medicare card or entitled to Medicare?
*
Yes - for full year
Yes - for only part year
No
Do you have any dependent children?
*
Yes
No
Comment (if any)
*
I hereby certify that the above information is correct to the best of my knowledge and I acknowledge the
substantiation declaration
.
I hereby authorise RJ & Co Tax Accounting to prepare and lodge tax return on my behalf.
Tick and submit
*
Agree
I agree to receiving marketing and promotional materials
*
Submit