Client Information Form


    Head of HouseholdMarried Filling JointMarried Filling SeparateSingle




    YesNo

    Spouse information (if Applicable)



    Dependent No 1


    Dependent No 2


    Dependent No 3


    Dependent No 4


    Employment Info


    YesNo

    YesNo


    We(I)HEREBY THAT ALL INFORMATION PROVIDED IN THIS CLIENT INFORMATION SHEET IS CORRECT. WE(I) FURTHER STATE THAT WE HAVE PROVIDED ALL THE DOCUMENTS THAT ARE REQUIRED TO PREPARE THE 2012 TAX RETURN AND SUBMIT THAT WE(I) HAVE ADEQUATE DOCUMENTATION TO SUPPORT INCOME & DEDUCTIONS LISTED ON THE TAX RETURN.