Countries of Nationalities *

Non-Resident in Ireland?
YesNo

Country of Residence *

Tax ID

Address

World Income (If you are resident in another Member State of the European Communities)

Not Ordinarily a Resident of Ireland?
YesNo

Not Domiciled in Ireland?
YesNo

Description (Trade, profession or vocation)

Date of Cessation (If this source of income ceased during the tax year)

Losses

Unused Losses

From

To

More Details (Trade, type of income)

Sales/Receipts/Turnover

Receipts from Govt. Agencies

Others

Purchases

Profits

Salaries/Wages, Staff Costs

Sub-Contractors

Consultancy fee

Motor, Travel and Subsistence

Repairs/Renewals

Depreciation

Provisions

Provisions (If negative state amount here)

Other Expenses

Cash/Capital Introduced

Drawings

Closing Capital Balance

Closing Capital Balance (If negative state amount)

Stock, Work-in-progress, Finished Goods

Debtors & Prepayments

Cash/Bank (Debit)

Cash/Bank (Credit)

Client Account Balances (Debit)

Client Account Balances (Credit)

Creditors & Acctuals

Tax Creditors

Net Assets

Net Assets (If negative state amount)

Net-Profit Per Account

Net-Loss Per Account

Description (Trade, profession or vocation)

Date of Cessation (If this source of income ceased during the tax year)

Losses

Unused Losses

From

To

More Details (Trade, type of income)

Sales/Receipts/Turnover

Receipts from Govt. Agencies

Others

Purchases

Profits

Salaries/Wages, Staff Costs

Sub-Contractors

Consultancy fee

Motor, Travel and Subsistence

Repairs/Renewals

Depreciation

Provisions

Provisions (If negative state amount here)

Other Expenses

Cash/Capital Introduced

Drawings

Closing Capital Balance

Closing Capital Balance (If negative state amount)

Stock, Work-in-progress, Finished Goods

Debtors & Prepayments

Cash/Bank (Debit)

Cash/Bank (Credit)

Client Account Balances (Debit)

Client Account Balances (Credit)

Creditors & Acctuals

Tax Creditors

Net Assets

Net Assets (If negative state amount)

Net-Profit Per Account

Net-Loss Per Account

Irish Rental Income

No. of Properties

Gross Rent Receivable

Property Classification
—Please choose an option—ResidentialCommercial

Property Type
—Please choose an option—Ordinary RentalRent a Room ReliefOther

Repairs

Allowable Interest

Pre-Letting Expenditues

Chargeable Income after Expense

Others

PAYE/BIK/Pensions

Foreign Income

Foreign Income

Irish Deposit Income

Irish Deposit Income

Please provide details if you are entitle of any tax credits or relief as follows: HOME CARERS / SINGLE PARENT / SURVIVING PARTNER WITH DEPENDENT, CHILDREN / INCAPACITATED CHILD TAX CREDIT, or DEPENDENT RELATIVE TAX CREDIT

Please provide details if you are entitle of any tax credits or relief for the following: COLLEGE FEES or HOME RENOVATION INCENTIVE TAX CREDIT or MEDICAL EXPENSES

Other Details or Notes