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Self Assessment Form

This form will be submitted to Alexander Bursk.

*indicates compulsory fields

Personal Details
Income Details
All questions are compulsory. If a question is not applicable please write "none" in the box

You should for each employment forward:-

a) Form P60

b) Where applicable: Copy of Form P11D giving details of all expenses and benefits re-imbursed by your employer (or your own company, if you are a Director). Under self assessment rules your employer is obliged to give you a copy of this form by 6 July 2005. If we complete the Forms P11D for your company, we will hold a copy here.

Where possible forward the documentation received from the Benefits Office showing the taxable amount.

a) Jobseekers allowance

b) Invalid Care allowance

c) Incapacity benefit

d) Statutory Sick Pay or Maternity pay paid by the Department of Social Security.

In each case you should state the total amount received during the year ended 5 April 2005. Where applicable forward the form P60.

In each case, forward the dividend vouchers. Also forward documentation of each transaction of each sale or acquisition of shares during that year. You should ensure that you give all details of any free shares received on takeovers and details of any windfall cash received.

You should forward all receipts and documentation to substantiate the expenses.

You should state the net amount of interest credited to each account, confirming whether the account is held in your own name, or jointly with another person.

You should also give details of any accounts you may have opened or closed throughout the year. These should include bank, building society, and National Savings accounts, including interest bearing current accounts. If you receive the interest gross (without deduction of tax), please confirm this.

State the source of the income and where possible supply documents showing the income.

In each case, forward forward the chargeable gain certificate.

a) Gains on policies where no tax is treated as paid.

b) Gains on policies where tax is treated as paid.

If you sell an asset but still have use of that asset please let us have details e.g. if you sell a house to your children but continue to live in it yourself.

Reliefs
All questions are compulsory. If a question is not applicable please write "none" in the box

a) Charitable Covenants

b) Gift Aid

c) Confirm details of any "one off" payments included in (a) and (b) above.

In each case forward the certificate showing the interest paid.

a) The amounts of premiums paid on personal pension and retirement annuity policies during the year ended 5 April 2005.

b) The gross amount of Free Standing Additional Voluntary Contributions paid in 2004/2005.

a) Your date of birth.

b) Your spouse's date of birth.

Partners

Ian S. Epstein, FAIA

Barry Fine, BA FCA

Brian M. Shafar, FCA

Consultant

David Bursk, FCCA

Contact Us

Contact us

By e-mail:
office@alexbursk.co.uk

By phone:
0161 773 7737

By fax:
0161 773 2333

By post:
Alexander Bursk
Parkgates
Bury New Road
Prestwich
Manchester M25 OJW

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