Make a payment
Forms and guides Ngā puka tāke me ngā puka tohutohu

Statement of assets and liabilities (IR110)

(published March 2012)

About this form

This form lists your assets and liabilities at a certain date.

PDF | 83kb | 6 pages

When to use this form

We may ask you to fill in this form to assist us during an audit.

What you will need

You will need to provide:

  • details of your personal New Zealand and overseas assets and liabilities.
After you finish

Please print, sign and post the completed form to your nearest Inland Revenue office. See Contact us >

You may wish keep a copy of this form for your personal records.

List of postal addresses for Inland Revenue >