Tax Return And Self Assessment For The Year 2015 Page 22
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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
I - CLAIM FOR TAX CREDITS, ALLOWANCES, RELIEFS AND HEALTH EXPENSES
[515 - 545]
.
515. (a) Home Carer Tax Credit - Amount due for 2015
00
,
(b) If you qualify on the “look-back” year insert T in the box
516. PAYE Tax Credit - Insert T in the box if claimed
517. (a) Blind Person’s Tax Credit - Insert T in the box to indicate if due
(b) Guide Dog - Insert T in the box to indicate if self and/or
spouse or civil partner has a Guide Dog
.
.
00
00
518. (a) Dependent Relative Tax Credit - Amount claimed
,
,
(b) Number of Dependent Relatives
519. Employing a Carer to care for an incapacitated individual
.
.
00
00
,
,
- Amount claimed
520. Permanent Health Benefit (not health/medical insurance)
.
.
00
00
,
,
- Amount paid (where not deducted from gross pay by employer)
521. Seed Capital Scheme/Start-up Refunds for Entrepreneurs (SURE)
(a) Amount of relief claimed in 2015
.
.
00
00
(Note: if you are claiming relief for prior years you
,
,
,
,
should submit full details to your Revenue office)
(b) (i) Business Expansion Scheme Relief
.
.
00
00
,
,
,
,
- Amount of relief claimed in 2015
(ii) Enter relevant RICT3 certificate number, or, if appropriate,
the Designated Fund's reference number
(c) (i) Employment and Investment Incentive
.
.
00
00
,
,
,
,
- Amount subscribed for eligible shares in 2015
(ii) Enter relevant EII 3 certificate number, or if appropriate,
the Designated Fund's reference number
(d) (i) Employment and Investment Incentive
- Amount subscribed for eligible shares in 2011 on which
.
.
00
00
additional relief is now due
,
,
,
,
(ii) Enter relevant EII 3A certificate number, or if appropriate,
the Designated Fund's reference number
522. Film Relief
.
.
(a) Amount of investment on which relief is claimed in 2015
00
00
,
,
(b) Enter all relevant Film 3 certificate numbers
523. Tuition Fees
(a) State the name of the student
(b) Amount paid per approved course (do not include
.
.
00
00
administration, exam, registration, capitation fees, etc.)
,
,
(c) Insert T in the box if a part-time course
(d) Insert T in the box if fees relate to a training course
PAGE 22
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