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Irish Tax Refund Application Form

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    Marital Status*

Personal Information

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Please upload a copy of your Photo ID (such as Passport or Driving Licence) and two utility bills/bank statement as a proof of your address dated within the last 3 months. Don’t have your ID or proof of address right now? No problem! You can still proceed through the form. Our team will be in touch regarding any outstanding documents.

    Photo ID

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    Utility bill

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    Utility bill

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    Do you pay or receive maintenance payments to or from a former partner?*

    Please upload your Courd Order or Deed of Separation (optional)

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    Please indicate your basis of assessment*

Residency questionnaire

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

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

Income Section

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    What is the pay frequency in respect of the employment income you had during the year in question?*

    What is the pay frequency in respect of your spouse's employment income she/he had during the year in question?*

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

    Did you receive any Social Welfare payments?*

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    Did you have any sources of non-employment income?*

    Did you or your spouse have any sources of non-employment income?*

    Self employment*

    Details for*

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Type and amount of expenses incurred (optional):

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Type and amount of expenses incurred (optional):

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Type and amount of expenses incurred (optional):

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Type and amount of expenses incurred (optional):

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Type and amount of expenses incurred (optional):

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Type and amount of expenses incurred (optional):

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    Do you have more than one source of self-employment Income?*

    Irish/Foreign Rental Income (including AirBnB)*

    Ownership*

    How many Rental Properties do you have?*

Property

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    Has the property been registered with the PRTB in respect of each tenancy?*

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    Did you incur Expenses during the period the property was let*

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    Capital allowances for furniture, fixtures and fittings (optional)

Property

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    Has the property been registered with the PRTB in respect of each tenancy?*

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    Did you incur Expenses during the period the property was let*

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    Capital allowances for furniture, fixtures and fittings (optional)

Property

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    Has the property been registered with the PRTB in respect of each tenancy?*

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    Did you incur Expenses during the period the property was let*

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    Capital allowances for furniture, fixtures and fittings (optional)

Property

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    Has the property been registered with the PRTB in respect of each tenancy?*

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    Did you incur Expenses during the period the property was let*

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    Capital allowances for furniture, fixtures and fittings (optional)

Property

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    Has the property been registered with the PRTB in respect of each tenancy?*

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    Did you incur Expenses during the period the property was let*

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    Capital allowances for furniture, fixtures and fittings (optional)

    Deposit Interest Income*

    Details for*

    How many accounts did you receive interest from*

Account

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Account

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Account

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Account

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Account

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    Dividend Income*

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Company

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Company

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Company

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Company

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    Are you or your spouse a Proprietary Director with more than 15% of a Company shareholding?*

    Were you a Proprietary Director with more than 15% of a Company shareholding?*

    Details for*

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    Did you receive any income such as salary/dividends/directorship fees from this company?*

    Did you or your spouse receive any income such as salary/dividends/directorship fees from this company?*

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    Did you exercise (receive) any stock options during the year in question? Don’t have details now? No problem! You can still proceed through the form. Our team will be in touch regarding any outstanding documents.*

    Did you or your spouse exercise (receive) any stock options during the year in question? Don’t have details now? No problem! You can still proceed through the form. Our team will be in touch regarding any outstanding documents.*

    Details for

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    Did you or your spouse file your RTSO1 form to Revenue within 30 days of the date of exercise?

Please forward any supporting documentation

    Did you or your spouse realise a gain on the disposal of any capital assets?*

    Did you realise a gain on the disposal of any capital assets?*

    Did you receive any capital asset in the way of gift/inheritance?*

    Did you or your spouse receive any capital asset in the way of gift/inheritance?*

    Exempt Income (rent-a-room, childcare services, woodland, artist income etc.)*

    Other Irish or Foreign Income not listed above?*

Tax Credits And Expenses

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

    Have you rented a private accommodation?*

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

Rental Credit:

Rental Credit: Please provide details for tenancy rented in 2017

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Rental Credit:

Rental Credit: Please provide details for tenancy rented in 2017

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Rental Credit:

Rental Credit: Please provide details for tenancy rented in 2017

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Rental Credit:

Rental Credit: Please provide details for tenancy rented in 2017

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Rental Credit:

Rental Credit: Please provide details for tenancy rented in 2017

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Need Help?

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 or your spouse a full medical card holder?*

    Were you a full medical card holder?*

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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 tume or part time course*

    Did you or your spouse incur any medical/non-routine dental expenses?*

    Did you incur any medical/non-routine dental expenses? (optional)*

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Need Help?

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 employer pay your Medical insurance?*

    Did your or your spouse's employer pay Medical insurance on your behalf as a benefit-in-kind?*

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Need Help?

xThe credit is available to you if you are the primary claimant. A secondary claimant may claim the credit if the primary claimant has relinquished it. To be the primary claimant, your child must live with you for the greater part of the year. In regards to the secondary claimants, the child must live with you for at least 100 days in the year. Neither the primary nor the secondary claimant must be living with another partner.
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xA Dependent Person:
- must not be a spouse or civil partner,
- is a child for whom Department of Social Protection Child Benefit is payable,
- is a person aged 65 years or over,
- is a person who is permanently incapacitated by reason of mental / physical infirmity.
Note: Dependent person must normally reside with the couple or if they are relatives they must reside:
- next door in a neighbouring residence,
- on same property,
- within 2 kilometres of claimant.
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    Did you or your spouse/civil partner stay at home to care for one or more dependent children?*

    Were you a single parent for any tax year?*

Need Help?

xQualifying relative is 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 or an incapacitated child?*

    Did you take care of a dependent relative or incapacitated child?*

    Did you make personal pension contributions outside your payroll?*

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

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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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