Appoint an Executive Office Holder
to act on your behalf
IR401
March 2019
•
Complete this form to appoint an executive office holder to act on behalf of your organisation with Inland Revenue. This
includes making enquiries, receiving statements, financial authority and registering for and managing a myIR secure
online services account for your organisation.
Business/Organisation Information
Organisation’s name
Organisation’s IRD number
(8 digit numbers start in the second box.
)
•
Executive Office Holder Please provide details of the person who will be the Executive Office Holder.
The Executive Office Holder is an individual who has an administrative or supervisory authority within the organisation:
• who has been specifically appointed to perform special duties in that regard and
• who has obtained specific written authority from the governing body to become an account owner for that non-individual
organisation. (Note: this is different from a tax agent).
For a company, trust or partnership anyone can be appointed into an executive office holder position i.e. wages clerk.
For a club, society or school the Executive Office Holder must hold an official position which has a governance or leadership
type role in the organisation i.e. chairperson, president, chief executive officer, treasurer, secretary. Documentation supporting
their position must be attached.
Name
First name(s) Surname
IRD number Phone number
( )
Executive office holder's date of birth
Day Month Year
Street address
Street address (not a PO Box or Private Bag)
Suburb or RD Town or city Postcode
Current position occupied
(
eg Chief Financial Ofcer)
•
Owner Please provide details of a valid owner who has the delegated authority to appoint an executive office holder.
Valid owners are:
• For a company – a director
• For a trust – a trustee with the delegated authority from the other trustees to act on all of their behalf. If no such authority
has been given then all trustees must sign this form.
• For an ordinary partnership – a partner
• For a limited partnership – a general partner
• For an estate – the administrator or executor of the trust
• For a school – principal or chairperson of the school board of trustees
• For a Body Corporate – owner of the professional administration company, chairperson or secretary of a body corporate
• For any other non individual – business owner, chairperson/president of the governing board or committee.
If you are not able to provide an IRD number and/or we have no record of the owner, documentation supporting their position
must be attached.
Owner’s Name
First name(s) Surname
Owner’s IRD number
Phone number
( )
Owner’s street address
Street address
Suburb or RD Town or city Postcode
Owner’s position
(eg director, partner, etc)
By signing this form, you are confirming that you have the delegated authority to appoint an executive office holder
on behalf of your organisation.
Owner’s signature
•
Appointing an executive office holder does not change your responsibilities. You are still responsible for you or your
organisation's tax matters; for example you need to make sure that any returns are filed and tax paid by the due date.
