Tax Return Questionnaire - Year Ended 5th April 2011

Please enter the following details:

Name:: *

Email Address:: *

Daytime Contact Number: *

Personal Circumstances

Would you please let me have details of any changes in your financial affairs including the opening or closing of bank or buildi:

Income
Employment Income

Name of Employer:

Income per P60 (£):

Tax per P60:

P11D Details (£):

Name of Employer:

Income per P60 (£):

Tax per P60:

P11D Details (£):

Name of Employer:

Income per P60 (£):

Tax per P60:

P11D Details (£):

Name of Employer:

Income per P60 (£):

Tax per P60:

P11D Details (£):

Employment Expenses

Details of professional subscriptions and other deductible expenses incurred:

Pensions Received

Details of state pension and other benefits received

Name of Company:

Reference:

Amount (£):

Name of Company:

Reference:

Amount (£):

Income from trade, profession or vocation (including partnerships)

If we do not prepare accounts, please provide copy accounts and computations:

Pension contributions

Details of all premiums paid in the year to 5/4/2010:

Details of Additional Voluntary Contributions made to Employers Pension schemes and a note of amounts contributed by employer to:

Details of pension contributions to be paid in 2010/11:

Property/Land

Rents Receivable:

Premiums Received:

Expenses Incurred: (please provide a list) :

Income from Savings and Investments

National Savings: eg investment account, income bonds etc.:

Net interest from banks and building societies: (Please also give the name of bank or building society):

Other interest received: (Specify payer & whether gross or net):

Dividends from shares in UK companies: (Please supply dividend counterfoils):

Stock Dividends: (Please supply dividend counterfoils):

Income from UK unit trusts: (Please supply dividend counterfoils) :

Foreign Investment Income

Income from savings and investments abroad: (Please supply any tax certificates) :

Income from Trusts and Estates

Form(s) R185/R185E:

Other Income

Describe the source, when it first arose, amount received and tax deducted (if any):

Expenses and Deductions
Qualifying Loans

Certificates of interest paid on loans for business, let property or other qualifying purpose:

Other Outgoings

Gift Aid:

Gift Aid Paid Since 5 April 2010:

Maintenance Payments: (If either spouse is born before 6 April 1935):

Capital Transactions

Purchase/Sales of Securities: All contract notes for transactions in year, and details of subscriptions for any new shares :

Other Transactions

Enterprise Investment Schemes: Venture Capital Trusts: Details of any investments made or sold during the year :

Gifts and Assets: Names, address of donor and donee, details of assets, date of transfer and any documentation: