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!

Use secure connection (SSL)

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?	If yes, please fax, scan and email or post to taxback.com today
Do you have your Certificate of Earnings?	If yes, please fax, scan and email or post to taxback.com today


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?	If yes, please fax, scan and email or post to taxback.com today
Do you have your Certificate of Earnings?	If yes, please fax, scan and email or post to taxback.com today


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?	If yes, please fax, scan and email or post to taxback.com today
Do you have your Certificate of Earnings?	If yes, please fax, scan and email or post to taxback.com today


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?	If yes, please fax, scan and email or post to taxback.com today
Do you have your Certificate of Earnings?	If yes, please fax, scan and email or post to taxback.com today


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?	If yes, please fax, scan and email or post to taxback.com today
Do you have your Certificate of Earnings?	If yes, please fax, scan and email or post to taxback.com today

I want to provide you with my bank details


Currency of the transfer *
Bank name *
Address of the bank branch *
Branch code *
SWIFT /BIC code *
Personal account number /IBAN for all EU countries/ *
Name of account holder *



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.