Client Details and Authority

The details you provide in this form give us the information we require as a registered Tax Agent to access your ATO records. Submitting the form creates no obligation for you to avail yourself of our services.

After receiving your completed form, we will provide you with an estimate of your tax refund and we will give you a fixed quote for our fees. You can then decide whether to proceed with us for your lodgment or other services as requested.

I just want a free tax checkup at this stage.

First Name *

Last Name *

Date of Birth *

Tax File Number (TFN) *Must be 9 digits

ABN (if applicable)Must be 11 digits

Residential Address *

Postal Address (if different to Residential)

Mobile PhoneInclude at least one phone number

Daytime Phone (if different to Mobile)

Email Address *

Preferred method of contact

Occupation

Are you a Veteran (as recognised by the Department of Veterans Affairs)

YesNo

Number of Dependent ChildrenThis is used for some income tests and may impact on your Medicare or Medicare Levy Surcharge liabilities.

Do you have a spouse for tax purposes? *

YesNo

'Spouse' has a specific meaning in tax law and includes another person of any sex who "lives with [you] on a genuine domestic basis in a relationship as a couple".

Spouse's Name *If you would like us to prepare and lodge your tax return and your spouse's tax return, your spouse will need to complete a separate Client Details and Authority form. Your spouse can access the form through the link in the email we sent you.

Spouse's Date of Birth *

Bank Details

These are the bank details that will be submitted to the ATO. They cannot be used for debiting money from your account either by the ATO or Quintilis. This account will be used to deposit any refund that the ATO owes you.

Check the BSB and Account Number carefully. Errors can delay the payment of your refund.

Name of account holder(s) *

BSB *Must be 6 digits

Account Number *

Authority

In submitting this form, I authorise Quintilis to access my tax records from the ATO and, if I request, provide me with Tax Agent Services (as defined by the Tax Agent Services Act 2009) including preparing my tax documentation and providing me with tax advice. I am aware of and accept Quintilis' Privacy policy and its Statement of Service.
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