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Tax Return Engagement Brochure – your confidentiality is our concern. Terms of Use – Please be sure to read through our terms.

Basic Information
Name*
Prefix First Last
Contact Number*
Email*
Enter Email Confirm Email
Date of Birth*
Residential Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Tax File Number*
Without Spaces
Financial Year ending 30 June*
Which Financial Year?

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Family
Did you have a partner/husband/wife during the financial year?*
- Yes
- No
Full name of partner/husband/wife
First Last
Date of Birth
Partner/husband/wife's Tax File Number
without spaces
What was their estimated taxable income?
How many dependent children do you have?*
Name and Date of Birth of Child/Children
This field is optional. We just want to get to know you. Feel free to leave this blank.
Name Date of Birth (DD/MM/YYYY)

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Payment & Refund
Product Name
Coupon
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
How would you like to pay for your tax return?
- Credit Card
- Direct Debit
- Take out of my return*
*Note, this will incur and additonal $20 fee
Direct Debit
You DO NOT have to check the below fields.
*Note these are our details. Please ensure when using this method in the reference section please type your initials and Date of Birth so we may find your payment easier.
- Mercia Taxation & Accounting Pty Ltd
- BSB: 086-217
- Acct Number: 54-3829-587
Refund Account details
This is where your refund will be deposited.
*must be your name or a joint account with your name, this cant be someone else’s account
Account Name* BSB Account Number
Please note, the cost of your tax preparation is determined by your individual tax circumstances and may be higher than the price of the option you selected, we will contact you if this applies to you before we proceed

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Mercia | Taxation, Business & Finance Advisers

Income of shares/managed funds	Cost of shares/managed funds sold	Proceeds recieved from selling shares/managed funds

Name	Date of Birth (DD/MM/YYYY)