For your tax credit application form to be processed immediately, you will need to fill out all the relevant details in the form especially the PAYE number and your passport number. This form can be e-mailed or posted to the revenue office.
Please complete the following details in block letters
Title: Mr/Mrs./Dr./ Miss/ Other ____________________________
First Name: ______________________________________________
Last Name: ______________________________________________
Date of birth: Date_________ Month: ____________ Year: _______________
Nationality: _____________________________________________________
Passport No: ____________________________________________________
Address: _______________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
EMPLOYMENT DETAILS:
Name of employer: ______________________________________________________
Address: _______________________________________________________________
Telephone: _____________________________________________________________
Employers PAYE No: ______________________________________________________
Staff personnel No: ________________________________________________________
Date of employment: ______________________________________________________
Frequency of pay: ________________________________________________________
Pay frequency: Weekly Fortnightly Monthly Daily Other
Underline one
Details of any other income:
Income description Annual Amount
_______________________________ ____________________
_______________________________ ____________________
EMPLOYMENT HISTORY
Name of previous employer: _____________________________________________
Address: _____________________________________________________________
_____________________________________________________________________
Telephone: ____________________________________________________________
Date this employment ended: _____________________________________________
Amount of money earned: ________________________________________________
TAX CREDITS
Tick the tax credits that you would like to apply for:
? Single Person Tax Credit ? Married persons tax credit
? Dependent relative tax credit ? Widowed Parent Tax credit
? Rent Relief ? Tuition Tax
? One parent family tax credit ? Home carer’s tax credit
I declare that the information given here is correct to the best of my knowledge
Signature: ___________________________ Telephone no: _________________
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