Balance Date: 31 March 2014 Balance Date: 30 June 2014 CLIENT INFORMATION QUESTIONNAIRE - FARMING



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Balance Date: 31 March 2014 Balance Date: 30 June 2014 CLIENT INFORMATION QUESTIONNAIRE - FARMING We are conscious of the need to provide an efficient and cost effective service and as our fees are charged on a time basis providing us with all of the records and information requested in the attached questionnaire will enable us to complete your financial accounts with the minimum of delay and cost. TERMS OF ENGAGEMENT I/We authorise Kendons Scott Macdonald Limited to prepare financial statements from the information and records I/We have supplied to you and to act as my/our agent at Inland Revenue Department and Accident Compensation Corporation on all tax and ACC related matters. I/We advise you not to complete an audit or review. I/We accept responsibility for the accuracy and completeness of all records and information supplied to you. AUTHORISATION TO COLLECT INFORMATION FOR ALL FINANCIAL YEARS From time to time it is more cost efficient for us to contact other parties to obtain information for and on your behalf, subject to the provisions of the Privacy Act 1993. Examples are copies of bank statements, details of cheques presented, deposits made, copies of term loan agreements and details of hire purchase agreements, settlement statements, interest and dividend advice notices and information held by Inland Revenue Department. Costs may be charged direct to you by the agency concerned. I/We authorise Kendons Scott Macdonald Limited to request information, which is required for a timely and orderly completion of my/our financial statements, direct from the individual agents concerned. I/We acknowledge that we are aware of the purpose for which this information is being collected and disseminated. I/We authorise Kendons Scott Macdonald Limited to continue to obtain all necessary information required from Inland Revenue Department for the ensuing year. Accident Compensation Corporation You authorise our organisation to act as your agent for ACC levy purposes for all associated entities. This authorisation allows our organisation to query and change information on your ACC levy account(s) through ACC staff, and through ACC Online Services. The authority will also allow our organisations main representative discretion to delegate access to your ACC information to other members of our organisation. Other delegated members of our organisation will also be able to query and change information on your ACC levy account. Signature of Client: Date: Name: Address: POSTAL CODE Please Enter Your Postal Code Above (This is a requirement of NZ Post) Email Address Telephone Number /Fax Number Please tick to confirm that you accept our Terms of Engagement (available on our website www.accounting.co.nz). 1

Name: CHECKLIST RECORDS REQUIRED (Tick One) Enclosed Not Applicable 1. All Cheque Books to date. 2. All Deposit Books to date. 3. All Credit Notes, Payment Advices, Rebate Advices etc. 4. Bank Statements - Working Account - Other Business Accounts (including accounts now closed) - Stock Firms 5. Cashbook and/or Computer Printouts (reconciled to your bank statements if possible) 6. Vehicle Log Book(s) (if applicable). 7. Copies of the monthly Employer deduction forms IR345 and the Employer monthly schedules (if available). (see note below) 8. Resident Withholding Tax on interest reconciliation statement (IR15S). 9. G.S.T and F.B.T Returns together with copies of all work papers and calculations (if an importer or exporter of goods or services please provide customs documentation). 10. Hire Purchase and Lease Agreements - New Agreements commencing this year. 11. Other Legal Contracts - Mortgages, Loans, Advances - Solicitors settlement statements - Guarantees, Loan Securities etc 12. Sundry Invoices - Stock Purchases - Vehicle Expenses - Power, Telephone, Insurances - Mortgage/Loan payment slips, statements 13. Monthly Barter Card or CRT Statements(if applicable) 14. Computer Accounting Packages If you are using a computer package, is it one of the following: MYOB Other Please provide the following additional information User Name Password 2

Please supply us from your payroll records your gross wages and salaries payments to staff for the year or alternatively record the gross amounts on the monthly IR 345 forms which you provide to us. INFORMATION REQUIRED Enclosed (Tick One) Not Applicable 1. Produce on Hand. (Detail on Schedule, page 3) 2. Stores and Rations. (Detail on Schedule, page 3) 3. Private Use. (Detail on Schedule, page 3) 4. Livestock. (Detail on Schedule, pages 4 and 5) 5. Debtors - Amounts owed to you at Balance Date (Detail on Schedule, page 6) Any bad debts should be written off prior to balance date. 6. Creditors - Amounts owed by you at Balance Date (Detail on Schedule, page 7) 7. Asset Sales and Purchases. (Detail on Schedule, pages 8 and 9) 8. Are all business expenses paid by cheque from your business account? If not, please supply details of these other expenses. 9. Is all business income deposited to your business account? If not, please supply details of these other transactions. 10. Are any deposits not sales? If so, please supply details of those deposits. 11. Entertainment; under the entertainment tax regime 50% of qualifying entertainment expenses are deductible. Receipts for entertainment need to specify who was entertained and why. 12. Income Protection Insurance; did you pay premiums for income protection? These may be claimed either personally or as a business expense. Please provide details including amount paid for year. 13.. If you are registered for G.S.T and any of your suppliers of goods and services are not registered for G.S.T, please supply the name of those unregistered suppliers and note on cheque butt or in cashbook that the payment does not include GST: If you supply computer printouts please ensure that GST has not been deducted from non GST payments. 1. PRODUCE ON HAND (a) Grain and Produce for Sale (harvested but unsold at Balance Date) Description Quantity Estimated Market Value (excluding G.S.T) 3

(b) (c) Wool (shorn but not sold at Balance Date) Quantity kg Estimated Market Value (excluding G.S.T) Other Description Quantity Estimated Market Value (excluding G.S.T) 2. Stores and Rations Estimated cost of food supplied to employees: Permanents ; Casuals ; Shearers 3. Private Use (portion of expenses to be allocated as private) (a) Vehicle Expenses Where Log Book used or (ii) Where no Log Book used Business Portion % Business KM Total KM (maximum 25%) (b) Tolls (Private) 4. Livestock Numbers Reconciliation Stock Type: Opening Stock Purchases Natural Increase Quantity Stock Type: Quantity Opening Stock Purchases Natural Increase Sales Killed for Own Use Deaths and Missing Closing Stock ========= ========= Sales Killed for Own Use Deaths and Missing Closing Stock ========= ========= LIVESTOCK Please complete the following schedules of livestock on hand at Balance Date, and births and deaths for the year. Cross out the sections that do not apply. The categories shown are those required by current taxation legislation. Note - Where possible please identify numbers of NON BREEDING livestock in each category as there may be a taxation advantage to you. i. FLOCK SHEEP NUMBER ii. STUD SHEEP NUMBER Ewe Hoggets Ram Hoggets Ewe Hoggets Ram Hoggets 4

Wether Hoggets Wether Hoggets 2 tooth Ewes 2 tooth Ewes 3 & 4 yr Ewes 3 & 4 yr Ewes 5 yr and older Ewes 5 yr and older Ewes Mixed aged Wethers Mixed aged Wethers Rams Rams ======= ======= Lambs Bred Lambs Bred iii. DAIRY CATTLE NUMBER iv. BEEF CATTLE NUMBER BREED: BREED: Rising 1 yr Heifers Rising 1 yr Heifers Rising 2 yr Heifers Rising 2 yr Heifers Mixed aged Cows (rising Mixed aged Cows (rising 3 yr and older) 3 yr and older) Rising 1 yr Steers & Bulls Rising 1 yr Steers & Bulls Rising 2 yr Steers & Bulls Rising 2 yr Steers & Bulls Rising 3 yr and older Rising 3yr and older Steers & Bulls Steers & Bulls Breeding Bulls Breeding Bulls Calves Bred ======= ======= Calves Bred v. PIGS NUMBER vi. GOATS NUMBER Breeding Sows less than 1 yr of age Breeding Sows over 1 yr of age Breeding Boars Weaners less than 10 wks of age excl.sucklings Growing Pigs 10-17 wks of age (porkers/baconers) Growing Pigs over 17 wks of age (baconers) Piglets Bred BREED: Rising 1 yr Does Mixed aged Does Rising 1 yr Bucks (non-breeding)/wethers Bucks (non-breeding)/ Wethers over 1 yr Breeding Bucks ======= ======= Kids Bred 5

vii. DEER NUMBER BREED: 1. Rising 1 yr Hinds Rising 2 yr Hinds Mixed aged Hinds (rising 3 yr and older) Rising 1 yr Stags Rising 2 yr and older Stags Breeding Stags ======= Fawns Bred SCHEDULE OF DEBTORS (G.S.T Inclusive) AMOUNTS OWING TO YOU AT BALANCE DATE This list should not include bad debts written off prior to balance date. / /20 WHAT FOR? NAME OF DEBTOR AMOUNT e.g. sales, G.S.T refund, loan etc. 6

7 SCHEDULE OF CREDITORS (AMOUNTS OWED BY YOU) (G.S.T Inclusive) EXPENSES INCURRED BEFORE BALANCE DATE BUT NOT PAID UNTIL AFTER BALANCE DATE / /20 WHAT FOR? NAME OF SUPPLIER TOTAL e.g purchases, repairs, PAYE etc. (Use extra page if insufficient space)

8 OUTSTANDING CHEQUES (Cheques written out before 31 March (or balance date) but not on bank statement until after balance date). CHEQUE DATE CHEQUE NAME OF AMOUNT WHAT FOR? NUMBER DRAWN SUPPLIER

SCHEDULE OF FIXED ASSET PURCHASES AND SALES N.B: Please attach hire purchase contracts, plus suppliers' invoices and statements where trade-ins are involved. Also solicitor's statements where these have been prepared. BUSINESS ASSETS PURCHASED BY YOU DURING THE YEAR DATE ASSETS ACQUIRED COST (Incl GST) GST CLAIMED YES/NO Indicate 12.5% or 15% 2 ND - HAND YES/NO IMPORTED YES/NO FINANCED BY (ie Cheque, Loan, Hire Purchase) PLANT AND MACHINERY MOTOR VEHICLES OTHER e.g land, buildings furniture etc BUSINESS ASSETS SOLD OR TRADED-IN BY YOU DURING YEAR (Including land and buildings) DATE ASSET SALE PRICE/ WERE SALE G.S.T TRADE PROCEEDS BANKED RETURNED (Incl. G.S.T) INTO BUSINESS YES/NO ACCOUNT YES/NO 9

SCHEDULE OF INTEREST-BEARING INVESTMENTS AND DIVIDENDS RECEIVED Please include all investments held at any time during year. Identify any overseas income. SOURCE OF INTEREST GROSS INTEREST TO 31/3/2014 TAX DEDUCTED RWT CERTIFICATE ATTACHED YES/NO SOURCE OF DIVIDEND Please include all details of shares taken in lieu of dividend. GROSS DIVIDEND TO 31/3/2014 WITHHOLDIN G TAX IMPUTATION CREDITS NUMBER OF DIVIDEND ADVICES ATTACHED 10

New Zealand and overseas investments (e.g. shares, term deposits, superannuation etc) IF YES, please provide the following; for both New Zealand overseas investments: 1. Statement showing term deposits and interest rates at 30 June 2014. 2. Details of shares held at 1 April 2013 to 31 March 2014 and 1 July 2013 to 30 June 2014, including the following details: - company name - number of shares - original cost - market value - portfolio report from broker Including your statement from Link Market and Computer Share for New Zealand shares. 3. Detail of any sale and purchases of shares for the year ended 30 June 2014 4. Details of all other overseas income, including overseas superannuation for the year ended 30 June 2014. HAVE YOU ALSO SIGNED THE DECLARATION ON PAGE 1? 11