Form IRL-Individual
United Kingdom/Ireland Double Taxation Convention (SI 1976 Number 2151 and Protocols).
APPLICATION for relief at source from United Kingdom income tax and
CLAIM to repayment of United Kingdom income tax
This form is for use by an individual resident of Ireland receiving
•
a UK State Pension or incapacity benefit
•
pensions, purchased annuities, interest or royalties arising in the UK
Please use the
Guidance Notes for form IRL-Individual to help you complete this form and
•
Give
ALL the information requested and attach supporting documents where necessary, if you need more room,
attach a separate sheet. Remember to sign the
declaration in Part E
•
Send the completed form IRL-Individual to the
Inspector of Taxes in Ireland
Note: In making this application/claim, you are consenting to the Inspector of Taxes in Ireland certifying to the
HM Revenue & Customs that you are resident in Ireland for the purposes of Irish tax. See Guidance Note 2.
If you need help with this form, please contact:
HM Revenue & Customs, Pay As You Earn and Self Assessment, BX9 1AS.
Phone us during UK office hours. Our phone numbers are
+ 44 135 535 9022 if calling from outside the UK,
or
0300 200 3300 if calling from the UK.
Part A Your personal details
Please
as appropriate
Full name Mr Mrs Miss Ms
Other
(specify)
________________________________________________
Full residential address
________________________________________________
________________________________________________
________________________________________________
Telephone number at which HM Revenue & Customs can
contact you with any queries _____________________
Details of your tax adviser or other person (if any), whom
you wish HM Revenue & Customs to contact about the
information given on this form. See Guidance Note 3.
Name and address of adviser etc.
________________________________________________
________________________________________________
Telephone number ________________________________
Fax number _____________________________________
Reference (if any) or contact name
Please give:
Your
date of birth
day
month
year
Your
nationality
•
The address of the Tax Office in Ireland to which your
latest tax return was sent
•
The date on which it was sent to that office
Irish PPS (Personal Public Service) Number
For use by the Inspector of Taxes in Ireland
Please sign and affix your official stamp and send this form to HM Revenue & Customs, PAYE & Self Assessment,
BX9 1AS. You may wish to take a copy of this form for your records.
I certify that _________________________________________________________
Official Stamp
is resident in Ireland for the purposes of Irish tax.
Signature _______________________________ Date __________________
Part B Please answer the following questions
‘’ where appropriate
1. Have you ever lived in the United Kingdom? (If
No, go to question 2)
If
Yes, please give
Your UK
National Insurance Number
Your exact date of departure from the United Kingdom
The date on which you became resident in Ireland for Irish tax purposes
2. Have you made any previous claim or return of income for the
purpose of UK tax? (If
No, go to question 3)
If
Yes give
the name of the UK Tax Office and the reference number, or
your last private address and the name and address
of your last business or employer in the United Kingdom.
Yes
No
Yes
No
3. Have you been in the United Kingdom during the past four years for as much as
3 months a year on average?
Yes
No
Yes
No
6 months in any one tax year? (a UK tax year starts on 6 April)
If either answer is Yes, give full details on a separate sheet.
Yes
No
4. Have you been absent from Ireland for a complete tax year in any of the
last four years?
If
Yes, give full details on a separate sheet.
5. Are you engaged in any trade or business in the United Kingdom or do you perform
independent personal services from a fixed base situated in the United Kingdom?
If
Yes, give full details on a separate sheet.
Yes
No
6. Are you subject to tax in Ireland on the
whole amount of the income included
in this claim/application?
If
No, give full details on a separate sheet of the amount of this income that is
subject to tax in Ireland.
Yes
No
Please answer the following question if you are applying for relief from UK tax on
copyright royalties – see
Part C.4.
7. Are you the
originator of the work or product that has been licensed to the UK?
Yes
No
If No, please attach a copy of the licence, contract or assignment under which you
have acquired from the originator the rights sub-licensed to the UK payer.
Part C Application for relief at source from UK income tax
See Guidance Note 4
Complete
Parts C.1, C.2, C.3 or C.4 as appropriate, to apply for relief at source from United Kingdom income tax.
Part C.1 State Pension or Incapacity Benefit
See Guidance Note 5
If you receive a UK State Pension or UK Incapacity Benefit,
please ‘ ’ and enter the date on which payments began.
UK State Pension
date payments began
UK Incapacity Benefit
date payments began
Part C.2 Work pension and/or purchased annuities
See Guidance Note 6
Please enter full details of your work pension(s) and/or any purchased annuities below.
If you also wish to apply for an adjustment to be made that takes account of tax already deducted under the
Pay As You Earn (PAYE) system from the pension and/or annuity, please ‘ ’ here.
Note that any adjustment will go back to the
latest of the following:
•
the date on which you became resident in Ireland for Irish tax purposes
•
the date payments of the income began
•
the earliest UK tax year which remains in date for claiming repayment of UK income tax
Full description of the income and name and address of the UK payer
Payer’s
reference number
Date(s) on which
payable
Part C.3 Interest
Important - see Guidance Note 7
before you complete this part
.
If you have already received payments of interest with UK income tax deducted, please
also complete Part D to
claim repayment of the tax.
Amount and full title of security Name and address in which security
is registered
Registrar’s account number
or reference
Due date(s) of
the interest
If you receive interest from privately arranged loans, please give the following details on a separate sheet
•
Name and address of the UK payer of the interest
•
Date of the loan agreement
•
Amount of the loan
•
Due date(s) of the interest
Please also attach a copy of the loan agreement.
Part C.4 Royalties
See Guidance Note 8
•
Complete
columns (a) to (c) below as appropriate, giving the information requested
•
If you have already received payments of royalties with
UK income tax deducted, please also complete Part D to
claim repayment of the tax
For copyright royalties on literary, dramatic,
musical or artistic works
•
Enter in
column (a) a full description of the royalties
•
Enter in
column (b) the date of the contract
between you and
the UK payer
•
Enter in
column (c) the payer’s name and address
If payments are made
through or by an agent in the UK, also
enter the agent’s name and address
For other royalties
•
Enter in
column (a) a full description of the royalties
•
Enter in
column (b) the date of the licence agreement
between you and the UK payer
and attach a copy of the
licence agreement
•
Enter in
column (c) the name and address of the
UK payer of the royalties
Column (a)
Column (b)
Column (c)
Part D Claim for repayment of UK income tax deducted
•
If you have already received payments of income with UK tax deducted, please give details below to claim repayment
under the UK/Ireland Double Taxation Convention, if you need more space, please attach an additional sheet, then
complete the Declaration in
Part E
•
If no payments of the income have yet been made, go direct to the Declaration in
Part E
Source of income
For example
‘Copyright royalties paid by [name of payer]’
NOTE If you receive the income from a trust or estate,
enter the name of the trust or estate.
Date of
payment
of income
Amount of income
before UK tax
£
Amount of
UK tax
deducted
£
Totals
Part E Declaration (complete this section in all cases)
•
I am beneficially entitled to the income from the source(s)
included in this form
•
The information I have given in this application/claim is
correct and complete to the best of my knowledge and belief
as appropriate
I apply for relief at source from UK income tax
I claim repayment of
£
(
enter the total amount of
UK income tax from
Part D above)
and ask you to send the repayment
direct to me
to my bank/agent
in the UK
(Enter name and address aside)
Signature
Date
Name and address of
UK bank/agent
Account/reference number, if any
UK bank sort code
©
Crown copyright 2015
Guidance Notes for form IRL-Individual
•
Use these Notes to help you complete form IRL-Individual
•
If after reading these Notes you need further information, please contact HM Revenue & Customs.
Our address and phone number are in Note 10
1. Purpose of form IRL-Individual
Form IRL-Individual enables you as a resident of Ireland to apply under the United Kingdom/Ireland Double Taxation
Convention for relief at source from UK income tax on a
UK state retirement pension or incapacity benefit, and
UK-source pensions, purchased annuities, royalties and interest. The form also provides for a claim to repayment of
UK tax in cases where payments of the income have already been made with UK tax deducted.
2. Evidence of residence in Ireland and where to send the completed form
It is a condition of relief from UK income tax under the terms of United Kingdom/Ireland Double Taxation Convention that
the beneficial owner of the income is resident in Ireland.
Please send the completed form IRL-Individual to the
Inspector of Taxes in Ireland. The Inspector of Taxes will certify that you are resident in Ireland for the purposes of
Irish tax and send the form to HM Revenue & Customs.
3. Confidentiality
All the information that you provide to HM Revenue & Customs is confidential. We can therefore only discuss your tax
affairs with you or any tax adviser named by you.
4. Relief at source from UK income tax on future income payments
Relief at source from UK income tax
on future payments of income may be available in cases where HM Revenue &
Customs is able to exercise its discretion to issue a notice (under Statutory Instrument 1970 Number 488, as amended).
HM Revenue & Customs deals with each application on its merits. Where HM Revenue & Customs cannot agree to allow
relief at source or cannot arrange it, you can claim
repayment of the UK tax deducted.
If relief at source is granted, please tell HM Revenue & Customs at the address in Note 10, without delay, if there is any
subsequent change to the information you have given on the form IRL-Individual.
5. UK State Pension or Incapacity Benefit
The UK State Pension, or UK Incapacity Benefit, is normally liable to UK income tax. As a resident of Ireland you can
apply to have this income exempted from UK income tax.
6. UK Pensions from former employers, other occupational and
personal pensions and purchased annuities
Certain types of pension and most annuities from the UK, paid to you as a resident of Ireland, can be exempted
from UK income tax.
If however you receive a pension paid by the UK for
service to the UK Government or a local authority, there are
special provisions in the Convention. Your pension from that employment will be exempt from UK tax
only if you are an
Irish national or a dual national of the UK and of Ireland, as well as being resident there.
•
If these provisions mean that your pension will be taxed in the UK, you may be able to claim UK personal allowances,
provided that you satisfy
certain conditions. Further details are available from HM Revenue & Customs at the address
in Note 10.
7. UK Interest
Interest can be paid to you with no UK tax deducted. Any UK tax that has been deducted can be repaid to you in full.
Interest from securities
UK tax is deducted from interest on loan stocks issued by
companies which are
not quoted on the Stock Exchange
•
local authorities
We may be able to arrange for interest on these stocks to be paid with no UK tax deducted, as explained in note 4.
Interest from the following UK sources is paid with no UK tax deducted, so there is no need to apply for relief from
UK tax at source. Please
do not enter in Part C.3 of form IRL-Individual
•
interest from company loan stocks quoted on the Stock Exchange (paid automatically
without deduction of UK tax)
•
interest from UK government securities (paid automatically without deduction of UK tax)
Additionally, some UK banks and building societies operate a scheme for payment of interest without deduction of UK tax
to non-residents. Ask your UK bank or building society for information. HM Revenue & Customs cannot arrange for
payment of bank or building society interest with no UK tax deducted, so again, please do not enter such interest in
Part C.3 of the form.
If you have already received any interest with UK tax deducted, you may claim
repayment of the tax by completing
Part D of the form.
8. UK Royalties
Most royalties can be paid to you with no tax deducted. Any UK tax that has been deducted can be repaid to you in full.
The Double Taxation Convention allows relief only to the
beneficial owner of the royalties. The beneficial owner is
normally the originator of the work or product.
Copyright royalties for literary, dramatic, musical or artistic works
If you are
not the originator but have acquired the rights, please attach to the form IRL-Individual a copy of the licence,
contract or assignment under which you have acquired the UK rights. This will help HM Revenue & Customs to check
that the beneficial ownership condition in the Double Taxation Convention is satisfied.
Other royalties
Please attach to the form IRL-Individual a copy of the licence agreement between
you and the UK payer of the
royalties. If you are
not the originator of the product giving rise to the royalties but have acquired the rights, please
also attach a copy of the licence, contract or assignment under which you have acquired the UK rights.
9. Repayment claims and tax deduction vouchers
There is no need to send tax vouchers with your completed form IRL-Individual, but you should keep them safe in case
they are needed later to support your claim. If you have any doubt about how you have completed the form you can send
vouchers if you think it will help us.
10. Help or further information
If you need help or further information, please
•
phone HM Revenue & Customs:
+44 135 535 9022 if calling from outside the UK,
or
0300 200 3300 if calling from the UK
•
or write to
HM Revenue & Customs, Pay As You Earn and Self Assessment, BX9 1AS
Privacy and Data Protection
HM Revenue & Customs is a Data Controller under the Data Protection Act 1998. We hold information for the purposes
specified in our notification to the Information Commissioner, including the assessment and collection of tax and duties,
the payment of benefits and the prevention and detection of crime, and may use this information for any of them.
We may get information about you from others, or we may give information to
them. If we do, it will only be as the law permits to:
•
check the accuracy of information
•
prevent or detect crime
•
protect public funds
We may check information we receive about you with what is already in our records. This can include information
provided by you, as well as by others, such as other government departments or agencies and overseas tax and customs
authorities. We will not give information to anyone outside HM Revenue & Customs unless the law permits us to do so.
For more information go to
www.gov.uk
These notes are for guidance only and reflect the UK tax position at the time of writing. They do not affect any rights of appeal.
July 2015
©
Crown copyright 2015
Document Outline - Full residential address
- Telephone number at which HM Revenue & Customs can contact you with any queries _____________________
- Telephone number ________________________________
- Fax number _____________________________________
- For use by the Inspector of Taxes in Ireland
- If ‘Yes’, please give
- Part C.1 State Pension or Incapacity Benefit See Guidance Note 5
- Part C.2 Work pension and/or purchased annuities See Guidance Note 6
- Part C.3 Interest Important - see Guidance Note 7 before you complete this part.
- Part C.4 Royalties See Guidance Note 8
- 2. Evidence of residence in Ireland and where to send the completed form
- 4. Relief at source from UK income tax on future income payments
- 7. UK Interest
- 8. UK Royalties
- 10. Help or further information
- Privacy and Data Protection
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