81 Cashmere Road PO Box 28-132 Christchurch 8242 Phone: (03) 337 0076 Mobile: 027 220 6299 Email: cyril@childs.co.nz Website: www.childs.co.nz Name: Balance Date: 31 March 2017 ANNUAL CLIENT QUESTIONNAIRE CHECKLIST 2017 FINANCIAL YEAR Please take the time to complete this checklist as it is IMPORTANT and helps you: Identify and provide the information we need to prepare your financial accounts. Minimise the queries from us during the preparation of your financial accounts (this has a positive effect on fees). Ensure we can complete your financial accounts within our goal of four weeks. It also helps us meet the quality standards that are required of us as a member of Chartered Accountants Australia and New Zealand. This checklist is in several parts as detailed below. Please complete all of the compulsory checklists. The other checklists only need to be completed if they apply to your business. Checklist Update Personal Details Personal Income Checklist Authorisation and Terms of Engagement Business Information Checklist Rental Information Checklist Trust Information Checklist Accounts Receivable / Debtors (Form A) Accounts Payable / Creditors (Form B) Sale or Purchase of Fixed Assets (Form C) Requirement Compulsory Compulsory Compulsory If Applicable If Applicable If Applicable If Applicable If Applicable If Applicable Page 1 of 15
Name: Balance Date: 31 March 2017 Update of Personal Details Postal Address Home Address Email Address Home Phone Work Phone Mobile Phone Fax Full Name Full Name Date of Birth \ \ Date of Birth \ \ Your date of birth is useful, as it can help with tax planning and retirement planning issues. Bank details for REFUNDS from Inland Revenue Department (deposit slip preferred) Bank / Branch - Account # _ - _ Page 2 of 15
Name: Balance Date: 31 March 2017 Personal Income Checklist 1 Income Did you receive any income from salaries / wages / superannuation/ ACC? If yes, the IRD will send us your Summary of Earnings automatically. 2 Rebate Information Did you make any donations to Approved Charities for which a rebate can be claimed? (NB: since 1 April 2012 payments made for childcare from are no longer eligible for a tax credit) Please list donations and provide receipts:....... 3 Other Income Did you receive any other income, for example from, estates or trusts, overseas pensions, income protection insurance? If yes, please list and provide relevant details:............ 4 Interest / Dividend Income Did you receive any income from interest or dividends? If yes, please provide interest certificates, dividend advice notices and Portfolio Statements with a full copy of the investment advisors report Please list all investments held including company/fund name and number of shares/units held:...... Please also list all term deposits, bonds held:...... Please note Computershare and Link Market Services offer Annual Tax Summaries. If you hold a number of shares we recommend you arrange to receive these summaries. 5 Income Did the business receive 80% or more of its income from services personally performed by one shareholder (or relatives) to a single customer or group of related customers? 6 Income Protection Insurance Did you have Income Protection Insurance? If yes, please attach a copy of the invoice and policy. Page 3 of 15
Personal Income Checklist Continued 7 Rental Income Did you receive any rental income? If yes, please attach the following details (separately) for each property: Address Gross Rental Income Expenditure (i.e. rates, insurance, repairs, mortgage interest paid etc.) Number of months the property was let. Number of months the property was available for letting. 8 Your Will Have you updated your wills within the last five years? 9 Overseas Income Did you own company shares, unit funds/trusts, life insurance policies or superannuation/pension plans with any overseas organisations? Did you have any funds invested overseas with Financial Advisers, Portfolio managers or similar? Did you own 10% or more interest (shareholding) in an overseas entity? If yes to any of the above, please provide full details including name of company/fund, number of share/units, amount invested, country held, income earned, any local tax deducted, and market value at 31 March 2017. 10 Family Assistance / Working For Families If you or your partner started or stopped receiving Working for Families Tax Credits (WFFTC), had a change in relationship status, a child leave school or think you may be eligible please advise the following: For children in your care: Child's Name Date of Date they left IRD # Birth school? / / / / # / / / / / / # / / / / / / # / / / / / / # / / Are you registered for WFFTC? Are there any shared custody arrangements in place? Average number of hours worked per week: You Your partner Did you receive any of the following? Distributions from a family trust Fringe Benefits from employment Other payments or regular contributions to your day to day expenses Did the children in your care receive any income from rent, royalties, trusts or PIE income? If yes to any of the above questions, please attach full details. Page 4 of 15
Name: Balance Date: 31 March 2017 AUTHORISATION and TERMS OF ENGAGEMENT I/We hereby instruct Cyril Childs Chartered Accountant Limited to prepare my/our Financial Statements and Taxation Returns for the year/period ending 31 March 2017. I/We accept responsibility for the accuracy and completeness of the information supplied in this questionnaire checklist, which is to be used in the preparation of my/our Financial Statements and Tax Returns. You are not to complete an audit, nor do I/we wish you to undertake a detailed review of my/our affairs in order to substantiate the accuracy of my/our information, and therefore you are unable to provide any assurance on my/our Financial Statements. I/we understand that you accept no liability for the accuracy and completeness of the information supplied by me/us. I/We understand your work cannot be relied on to detect error or fraud. I/We further understand that the Financial Statements will be prepared at my/our request and for my/our purposes only and that you will not be liable for any losses, claims or demands by any third person. I/We also accept responsibility for all other records and information supplied to you in addition to those set out on the pages 1 to 15. I/We accept responsibility for any failure by me/us to supply all relevant records and information to you. This document does not limit our existing signed Engagement Letter for Compilation Engagement. In order to assist with the preparation of your Financial Statements and Tax Returns and pursuant to the Privacy Act 1993 I/we authorise Cyril Childs Chartered Accountant Limited to obtain relevant information as required from my/our banks, solicitors and other third parties to complete the preparation of my/our Financial Statements and Tax Returns. Client Name Client Signature Date \ \ Person to Contact with Queries Phone Number Page 5 of 15
Name: Balance Date: 31 March 2017 Business Information Checklist 1 Accounts Receivable Do you have any accounts receivable as at your balance date? (i.e. Money owing to your business). If yes, complete Form A (attached). 2 Bad Debts Were any bad debts written off in the financial year? If yes, what was the total value (excluding GST)? 3 Accounts Payable Do you have any accounts payable as at your balance date? (i.e. Money your business owes to others). If yes, complete Form B (attached). 4 Sale / Purchase of Fixed Assets Did you sell, purchase or stop using any fixed assets in your business in the past year? If yes, complete Form C (attached). 5 Trading Stock (Businesses) Does your business have any trading stock? If yes, please record the value of stock on hand as at 31 March 2017: GST Included Excluded Stock takes are required unless your stock is less than $10,000 and your turnover is less than $1.3m. How is your stock valued? Select lower of: Cost Selling Price Replacement Value Have you written off a substantial amount of stock that will affect your gross profit? You must have physically dumped any stock that you have not valued. If yes, please provide details of this, including the value. 6 Work In Progress (Businesses) Do you have any work in progress at your balance date? If yes, please state the dollar value: Work in progress (cost price excluding GST) is work you have substantially completed but have not yet invoiced. It should not be included in your stock take or revenue. If purchases and other expenses have been included in work in progress valuations but are not yet paid for, then these should be included in your accounts payable / creditor listing Form B. 7 Cash On Hand Please provide the GST inclusive figure of unbanked takings, petty cash and till float that has not been included in your bank reconciliation at your balance date. Page 6 of 15
Business Information Checklist Continued 8 Holiday Pay Did you pay any holiday pay within the first 63 days (by 2 June) after this balance date? If yes, please provide details. 9 Loans / Hire Purchases Have you taken out a new loan, hire purchase or lease-to-own agreement since your last balance date? If yes, please provide loan balances as at your balance date, statements, summaries and / or documentation of the new agreements or any change in borrowings. 10 Business Deposits Has all business income been deposited into the business bank account? If not, please provide the date, amount including GST and details of the items not deposited. 11 n Business Deposits Were there any deposits made into your business bank account that were not business income? If yes, please provide the date, amount including GST and details of the items 12 Business Expenses Paid Privately Were any of your business expenses paid from your personal funds? If yes, please provide the date, amount including GST and details of the items 13 Bartercard or Swap Schemes used Personally Were any of your Bartercard or Swap Scheme transactions used for personal use? If yes, please provide details of these. 14 Goods for your Own Use Did you use any business goods or products for your own personal use? (For example: commercial clients work products or staff used at home; farming clients milk, meat or produce?) If yes, please provide details. 15 Contingent Liabilities Are you involved in any transactions that may materially affect the profitability or solvency of your business, for example, a pending court case or dispute? If yes, please provide details. 16 Office at Home / Workshop If part of your home is set aside principally for use as an office/workshop/storage area, please provide the following details: Business Area: M2 Total Area: M2 Total Home Expense for the year (including GST): Power Insurance (Building & Contents) Interest (House Mortgage) Rates Repairs & Maintenance Rent Other Total Page 7 of 15
Business Information Checklist - Continued 17 Lease Commitments (Premises/Vehicles) Do you have any Lease commitments? If yes, please provide the value of any Annual Lease Payments and the Lease Expiry Date....... 18 Capital Commitments Did you enter into any agreements or contracts prior to your balance date that commit your business to significant capital expenditure? If yes, please provide details of these. 19 Key Expenses Please provide copies of the following: Legal expenses Repairs and maintenance over $500 Entertainment Overseas business travel (include a diary record of business and private days) ACC levies paid Insurance 20 Motor Vehicles (n companies) Have you updated your log book in the last three years? If yes, please provide the vehicle model and percentage of business usage from your log book for each vehicle you use. Motor Vehicles The proportion of motor vehicle business use as established by your vehicle log book(s) is/are: Vehicle Description: Vehicle Description: Business km Business km Total km Total km Percentage Business % Percentage Business % Please note, a detailed and accurate log book must be completed for a three month period every three years; OR Vehicle expense claims will be limited to a maximum of 25% of expenses incurred. If you are operating as a Company, please indicate which vehicles you are currently paying Fringe Benefit tax for:. 21 Earthquake Matters Have you received a payment from EQC or an Insurance Company relating to your business? Are there any other ongoing insurance matters? If yes, please provide details. Page 8 of 15
Name: : Balance Date: 31 March 2017 Rental Information Checklist 1 Rental Income and Expenditure Please supply bank statements clearly identifying and detailing all transactions that relate to the rental properties; OR Please provide details of the following for each rental property. (Use separate sheets if necessary) Property Address: If the property was not rented for a full 12 months please provide details of why... Income: Total Rent Received Expenses: Rates Insurance House and Contents Repairs and Maintenance (please attach details or invoices) Mortgage Interest (attach copy of loan summary/statements from bank) Details of any other expense relating to rental property: If a property manager has been used please provide all summary statements for the period. Details of visits to inspect property/conduct property business: Date, Details, Kilometers.......... 2 Sale or Purchase of Rental Property If a property was purchased or sold during the 12 months to 31 March 2017 please supply: Sale and Purchase Agreement Details of Chattels purchased or sold with the property Solicitors Settlement Statements Mortgage details 3 Earthquake Matters Have you received a payment from EQC or an Insurance Company relating to the rental properties? Are there any other ongoing insurance matters? If yes, please provide details:.................... Page 9 of 15
Trust Name: Balance Date: 31 March 2017 Trust Information Checklist 1 Changes to Trust: Please provide details of any of the following: New Trust Deeds or changes to existing Trust Deeds Full details of any new beneficiaries Details of any changes to Trustees 2 Interest / Dividend Income Did the Trust receive any income from interest or dividends? If yes, please provide interest certificates, dividend advice notices and Portfolio Statements with a full copy of the investment advisors report Please list all investments held including company/fund name and number of shares/units held:................. Please also list all term deposits, bonds held:......... Please note: Computershare and Link Market Services offer Annual Tax Summaries. If you hold a number of shares we recommend you arrange to receive these summaries. 3 Overseas Income Did the Trust own company shares, unit funds/trusts, life insurance policies or superannuation/pension plans with any overseas organisations? Did the Trust have any funds invested overseas with Financial Advisers, Portfolio managers or the likes? Did the Trust own 10% or more interest (shareholding) in an overseas entity? If yes to any of the above questions, please provide full details including name of company/fund, number of share/units, amount invested, country held, income earned, any local tax deducted, and market value at 31 March 2017....... Page 10 of 15
Trust Information Checklist - Continued 4 Rental Income and Expenditure Please supply bank statements clearly identifying and detailing all transactions that relate to the rental properties; OR Please provide details of the following for each rental property. (Use separate sheets if necessary) Property Address: If the property was not rented for a full 12 months please provide details of why... Income: Total Rent Received Expenses: Rates Insurance House and Contents Repairs and Maintenance (please attach details or invoices) Mortgage Interest (attach copy of loan summary/statements from bank) Details of any other expense relating to rental property: If a property manager has been used please provide all summary statements for the period. Details of visits to inspect property/conduct property business: Date, Details, Kilometers...... 5 Accounts Receivable Does the Trust have any accounts receivable as at balance date? (i.e. Money owed to the Trust). If yes, please complete Form A (attached). 6 Accounts Payable Does the Trust have any accounts payable as at balance date? (i.e. Money the Trust owes to others). If yes, please complete Form B (attached). 7 Sale/Purchase of Fixed Assets Did the Trust sell, purchase or stop using any fixed assets? If yes, please complete Form C (attached). 8 Your Will Have you updated your will within the last five years? (It is important that your will aligns with the terms of your trust deed please call us if you wish to discuss this further) Page 11 of 15
Trust Information Checklist - Continued 9 Gifting Programme Have you completed any gifting this year? Have you assigned debt to the trust via a Deed of Acknowledgement of Debt? Please advise the date of gifts made to your trust during the financial year. If you have copies of the gifting documentation from your solicitor, please attach this also. Please provide any additional information regarding the Trust activities that may be relevant in preparing the Financial Statements. 10 Earthquake Matters Has the Trust received a payment from EQC or an Insurance Company? Are there any other ongoing insurance matters relating to the Trust? If yes, please provide details. Page 12 of 15
Name: : Balance Date: 31 March 2017 FORM A - ACCOUNTS RECEIVABLE / DEBTORS These are sales or services that you have performed and invoiced up to and including the last day of the financial year (31 March 2017) and that you are yet to receive payment for. These are not to be included in Work In Progress. If you have your own Debtors Ledger you do not have to complete this sheet. Instead attach a copy of your Debtors Ledger. Name Details Ledger Total Invoice GST Net Invoice Code (GST Inclusive) Amount (Excluding GST) (if known) TOTAL ACCOUNTS RECEIVABLE $ $ $ Page 13 of 15
Name: Balance Date: 31 March 2017 FORM B - ACCOUNTS PAYABLE / CREDITORS These are invoices for expenses dated up to and including the last day of the financial year (31 March 2017) which you have received but have not yet paid (e.g. you purchase $100 of stock, receive an invoice dated March but don t pay for the invoice until April, yet the goods are included in your stock take). Please ensure that the details column is filled out (e.g. purchases, motor vehicle, power etc.) If you have your own Creditors Ledger you do not have to complete this sheet. Instead attach a copy of your Creditors Ledger. Name Details Ledger Code (if known) Total Invoice (GST Inclusive) GST Amount Inland Revenue PAYE - n/a Department Inland Revenue FBT - n/a Department Inland Revenue RWT - n/a Department Net Invoice (Excluding GST) TOTAL ACCOUNTS PAYABLE $ $ $ Page 14 of 15
Name: Balance Date: 31 March 2017 FORM C SALE OR PURCHASE OF FIXED ASSETS FIXED ASSETS NO LONGER USED Please look at the Fixed Asset Schedule of your previous year s set of financial statements and note any fixed assets below that you are no longer using in the business. Asset Code Asset Description ASSETS PURCHASED Please supply any documentation that was required for the sale or purchase of an asset (e.g. hire purchase agreements, invoices). For transactions involving land and buildings please supply Sale and Purchase Agreements, Solicitor Settlement statements and mortgage details. Date Purchased Asset Cost Price (GST Exclusive) New or Used How Financed ASSETS SOLD Date Sold Asset Sale Price (GST Exclusive) Page 15 of 15