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Irish Tax Return Application Form

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    Tax Year*

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    Marital Status*

Personal Information

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Please include a copy of your Photo ID (such as Passport, Driving Licence or National ID Card) and information regarding your permission to work in Ireland (please supply copy of visa or work permit, if relevant).

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    Please upload a copy of your Photo ID (such as Passport or Driving Licence)

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    xAllowed file formats are: .doc, docx, .jpg, .pdf, .gif, .ief, .jpe, .jpeg, .pbm, .pgm, .png, .pnm, .ppm, .ras, .rgb, .rtf, .tif, .tiff, .xpm, .xwd
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    Do you pay or receive any legally enforceable maintenance to your former Spouse?

    Please upload your Courd Order or Deed of Separation.

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    xAllowed file formats are: .doc, docx, .jpg, .pdf, .gif, .ief, .jpe, .jpeg, .pbm, .pgm, .png, .pnm, .ppm, .ras, .rgb, .rtf, .tif, .tiff, .xpm, .xwd
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    Please indicate your basis of assessment*

Residency questionnaire

    Have you been outside Ireland for the last 4 years?*

    Have you or your spouse been outside Ireland for the last 4 years?*

Income Section

    What was your pay frequency during the year 2015?*

    What was your spouse's pay frequency during 2015?*

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    Did you or your spouse receive any Social Welfare payments?*

    Did you receive any Social Welfare payments?*

    Additional Irish or Foreign Income*

Tax Credits And Expenses

IMPORTANT!! Tax credits and expenses may significantly increase your refund or reduce your liability.

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xRental Credit: You are only entitled to this credit if you were renting a property on 07/12/2010. If you only started renting after 07/12/2010 you will not be eligible for Rent Tax Credit.
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    Have you rented a private accommodation during this year?*

    Have you rented a private accommodation on 7 December 2010?*

Rental Credit:

Please provide details for each tenancy since 7 December 2010

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Rental Credit:

Please provide details for each tenancy since 7 December 2010

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Rental Credit:

Please provide details for each tenancy since 7 December 2010

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Rental Credit:

Please provide details for each tenancy since 7 December 2010

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Rental Credit:

Please provide details for each tenancy since 7 December 2010

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    Were you or your spouse a full medical card holder?*

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    xFull Medical Card is a card issued by the Health Service Executive (HSE) which gives you certain health services free of charge.
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    Were you a full medical card holder during the year?*

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    xFull Medical Card is a card issued by the Health Service Executive (HSE) which gives you certain health services free of charge.
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    Did you or your spouse pay Tuition fees to any educational institute during the year? (paid for yourself or dependant relative)*

    Did you pay Tuition fees to any educational institute during the year? (paid for yourself or dependant relative)*

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    Was it a full time or part time course?

    Did you or your spouse incur any medical expenses during the year?*

    Did you incur any medical/dental expenses?*

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    Did your employer pay your Medical insurance?

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    xBenefit-in-kind is a benefit provided in addition to your salary and it is subject to income tax.
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    Did your or your spouse employer pay Medical insurance on your behalf as a benefit-in-kind?

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    xBenefit-in-kind is a benefit provided in addition to your salary and it is subject to income tax.
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    Were you a single parent during the year?

    Did you or your spouse/civil partner stay at home to care for one or more dependent?

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    Did you take care of a dependent relative?

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    xClaimant must have a relative who:
    • Is incapacitated by old age/infirmity from maintaining him/herself
    • Is a widowed father or mother of yourself, your spouse or civil partner or a parent of your civil partner who is himself or herself a surviving civil partner, regardless of age and state of health and
    • Whose income does not exceed a specified amount.
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    Did you or your spouse take care of a dependent relative?

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    xClaimant must have a relative who:
    • Is incapacitated by old age/infirmity from maintaining him/herself
    • Is a widowed father or mother of yourself, your spouse or civil partner or a parent of your civil partner who is himself or herself a surviving civil partner, regardless of age and state of health and
    • Whose income does not exceed a specified amount.
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    Did you make personal pension contributions outside the payroll?*

    Did you or your spouse make personal pension contributions outside the payroll?*

    Type of payment*

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    Did you or your spouse pay personal contributions to an Income Protection Scheme?

    Did you pay personal contributions to an Income Protection Scheme?

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