Tax Return And Self Assessment For The Year 2015 Page 20
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36ANY PANEL(S) OR SECTION(S) THAT DO NOT REQUIRE AN ENTRY SHOULD BE LEFT BLANK.
2015120
Spouse or
PPS Number
Self
Civil Partner
H - ANNUAL PAYMENTS, CHARGES AND INTEREST PAID
[501 - 514]
501. Gross amount of Rents, etc. payable to Non-Residents
.
.
00
00
,
,
,
,
in 2015
502. Clawback of Employers’ Tax Relief at Source (TRS)
If you are an employer and have paid medical insurance premiums
to an authorised insurer on behalf of your employees
enter the amount of tax relief at source granted to
.
.
,
,
,
,
you in respect of these premiums
(Note: do not enter the amount of the insurance premium(s) paid)
503. (a) Gross amount of Maintenance Payments paid in 2015
.
.
00
00
,
,
,
,
where tax was not deducted
(b) Gross amount of Maintenance Payments paid in 2015
.
.
00
00
,
,
,
,
where tax was deducted
504. (a) Gross amount of Deed(s) of Covenant in favour of
.
.
00
00
,
,
,
,
Permanently Incapacitated individual(s)
(b) Gross amount of Deed(s) of Covenant in favour
.
.
00
00
of person(s) aged 65 or over
,
,
,
,
505. Gross amount of payment of other Charges/Annuity(ies)
.
.
00
00
where tax was deducted
,
,
,
,
Pension Contributions
[506 - 510]
506. If you are claiming relief in respect of RACs/PRSAs/QOPPs
state the source(s) of your earnings for which the relief is claimed
507. Retirement Annuity Contracts (RACs)
(a) Amount of RACs paid in 2015 (for which relief has
.
.
00
00
,
,
,
,
not been claimed or granted in 2014)
(b) Insert T in the box if a once off payment
(c) Amount paid between 1/1/2016 and 31/10/2016 for which
.
.
relief has not already been granted and for which relief
00
00
,
,
,
,
is being claimed in 2015
(d) Amount paid in a prior year, for which relief
.
.
00
00
,
,
,
,
has not been obtained
508. Personal Retirement Savings Accounts (PRSAs)
Only complete if you, or your employer on your behalf, made PRSA contributions.
(a) If you are a member of an Occupational or Statutory Pension
.
.
00
00
scheme state the amount of contributions to that scheme from
,
,
,
,
1/1/2015 - 31/12/2015, (for which no further relief is due)
(b) PRSA contributions deducted by your employer from
.
.
00
00
,
,
,
,
your salary, (for which no further relief is due)
(c) PRSA contributions made on your behalf by your
.
.
00
00
,
,
,
,
employer (Note to include this in Line 221(a) on page 13)
.
.
00
00
(d) PRSA contributions paid directly by you to a PRSA provider
,
,
,
,
(e) Amount paid between 1/1/2016 and 31/10/2016
.
.
for which relief has not already been granted
00
00
,
,
,
,
and for which relief is being claimed in 2015
(f) Amount paid in a prior year, for which relief
.
.
00
00
,
,
,
,
has not been obtained
PAGE 20
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