Tax Return And Self Assessment For The Year 2015 Page 17

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ANY PANEL(S) OR SECTION(S) THAT DO NOT REQUIRE AN ENTRY SHOULD BE LEFT BLANK.
2015120
Spouse or
PPS Number
Self
Civil Partner
317. Foreign Bank Accounts (S. 895) Give the following details for each foreign bank account opened in 2015 of which you or
your spouse or civil partner were the beneficial owner of the deposits held
(a) Name & address of deposit holder (bank, etc.),
include Eircode (if known)
/
/
/
/
(b) Date account was opened (DD/MM/YYYY)
.
.
00
00
(c) Amount of money deposited on opening the account
,
,
,
,
(d) Name & address of intermediary through whom
account was opened, include Eircode (if known)
Foreign Life Policies/Offshore Funds/Other Offshore Products
[318 - 320]
318. Foreign Life Policies (S. 730H, 730I, 730J, 730K). Give the following details in respect of any policy from any Member State
of the EU or EEA, or from a Member State of the OECD with which Ireland has a Double Taxation Agreement
.
.
00
00
(a) Payment taxable at 41% (S. 730J(a)(i)(ll))
,
,
,
,
(b) Payment (personal portfolio) taxable at 60%
.
.
00
00
,
,
,
,
(S. 730J(a)(i)(I))
(c) Gain (personal portfolio) taxable at 60%
.
.
00
00
(S. 730K(1)(a)(i))
,
,
,
,
.
.
00
00
(d) Gain taxable at 41% (S. 730K(1)(a)(ii))
,
,
,
,
And in respect of any such policy issued in 2015 give the following additional details:
(e) Name & address of person who commenced the
foreign life policy, include Eircode (if known)
(f) Terms of the policy
.
.
(g) Annual premiums payable
00
00
,
,
,
,
(h) Name & address of the person through whom the
foreign life policy was acquired, include Eircode (if known)
319. Offshore Funds (Part 27 Ch 4). Give the following details in respect of any material interest in 'regulated offshore fund(s)'
(those coming within S. 747B(2A)) in the EU or EEA, or in a Member State of the OECD with which Ireland has a Double
Taxation Agreement
(a) Payment taxable at 41%
.
.
00
00
,
,
,
,
(S. 747D(a)(i)(ll))
(b) Payment (personal portfolio) taxable at 60%
.
.
00
00
,
,
,
,
(S. 747D(a)(i)(I))
(c) Gain taxable at 41%
.
.
00
00
,
,
,
,
(S. 747E(1)(b)(ii))
(d) Gain (personal portfolio) taxable at 60%
.
.
00
00
,
,
,
,
(S. 747E(1)(b)(i)(l))
And in respect of any such material interest acquired in 2015 give the following additional details:
(e) Name & address of offshore fund(s)
/
/
/
/
(f) Date material interest was acquired (DD/MM/YYYY)
(g) Amount of capital invested in acquiring
.
.
00
00
,
,
,
,
the material interest
(h) Name & address of intermediary (if any) through whom the
material interest was acquired, include Eircode (if known)
PAGE 17
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