Client Information Declaration

Fill up the form

Title
First Name
Last Name
Identity Number
Work Number
Fax Number
Phone Number
E-mail Address
Postal Address
Physical Address
Are you a registered tax payer?
Supply Tax Number
Preferred method of notification

Marius Higgs of TaxAssist is a registered tax practitioner. I hereby warrant that the information provided is true and correct. It is a criminal offence to make false declarations or omit relevant information relating to your income tax. TaxAssist will not be held liable in event of any misrepresentation made by yourself.

PLEASE NOTE: You will not be able to submit this form electronically without uploading the digital signature required.

Signature
Date