29/08/2022

Date: __________________________

Client Reference (please do not fill, for office use only) __________________________

Client Details: Name Title (Mr/Mrs/Ms/Miss)

SWAPNA
First Name________________________
ALEX
Last Name: ____________________________

Middle Name (if any):

26/08/1981
Date of Birth: ____________________

605 995 859

TFN: ___________________________

Unit 15 186-198 Lake Street, Cairns North QLD 4870

Address Permanent: ___________________________________________________________________________

Address Postal (if different):_____________________________________________________________________

0404289115 swapnaalex7@gmail.com
Mobile No:_______________________ Phone No: ______________ E-mail ID: ___________________________
Reg Nurse
Occupation Name: ________________________

No
Bank Interest (if any) __________Dividends
No
(if any) ___________
No
Any other Income (For example From Centrelink): __________________

Swapna Alex
Bank Account Details: Account Holder Name: _____________________

064804
BSB: ____________________
14247682
Acc No: _____________________

Spouse Details:

SANJU SIMON
Spouse First Name: ___________________ Last Name____________________________

Not Working 22/05/1977

Spouse estimated Income: ____________________Date of Birth:____________________

Dependent Children Details:

SERA SANJU 05/11/2011

First Name: _______________________Last Name: _______________________DOB_____________

SANNE
First Name: _______________________Last
SANJU 09/092014
Name: _______________________DOB_____________

First Australian entry on 30/03/2022

Started work 04/04/2022