Tax Return And Self Assessment For The Year 2015 (Page 23 of 36) in pdf

ANY PANEL(S) OR SECTION(S) THAT DO NOT REQUIRE AN ENTRY SHOULD BE LEFT BLANK.

2015120

PPS Number

524. Single Person Child Carer Credit

If you are the primary claimant, complete section (a). If you are the primary claimant but relinquishing the credit to a

secondary claimant, complete sections (a) & (b). If you are a secondary claimant, complete sections (a) & (c).

If you wish to claim Single Person Child Carer Credit provide the following information in respect of each child.

This section must be completed in respect of each child even if you are relinquishing your claim in favour of another individual.

Child 1

Child 2

(a) State the nature of your relationship to the child(ren),

i.e. Father, Mother, Grandparent, Legal Guardian, etc.

(i) Child's First Name

(ii) Child's Surname

(iii) Child's Date of Birth (DD/MM/YYYY)

(iv) Child's PPS No.

(v) If the child is over 18 years old state name of place of full time instruction, or if the child is incapacitated state nature

of incapacity

Child 1

Child 2

(vi) In the year ended 31 December 2015 did the child(ren) named above reside with you

Yes

for the whole or greater part of the year, i.e. in excess of six months

(Note: in the case of a child born during the year the length of time will be reduced on a pro-rata basis)

(vii) In the year ended 31 December 2015 were you living with another person as a couple

Yes

whether married, in a civil partnership, or cohabiting

(viii) Is this claim made in respect of a non-resident child who is a child of a single person

Yes

who lives outside the State but works in the State (e.g. cross-border worker)

(b) Relinquishing a Claim to Single Person Child Carer Credit

To be completed if you are an individual (the primary claimant) who is relinquishing the Single Person Child Carer Credit in favour

of another individual. State:

(i) Name and address of the individual to whom you are

relinquishing this tax credit, include Eircode (if known)

(ii) His or her PPS No. (if known)

(iii) His or her Date of Birth (if known)

To be completed if you are an individual (the secondary claimant) who is claiming the Single Person Child Carer Credit as a result

of the primary claimant relinquishing his or her entitlement to the tax credit.

(i) In the year ended 31 December 2015 did the child(ren) named above reside with you

Yes

for not less than 100 days

(Note: in the case of a child born during the year of the claim, the number of qualifying days

(in respect of the secondary claimant) will not be reduced on a pro-rata basis)

(ii) In the year ended 31 December 2015 were you living with another person as a couple

Yes

whether married, in a civil partnership, or cohabiting

(iii) Is this claim made in respect of a non-resident child who is a child of a single person

Yes

who lives outside the State but works in the State (e.g. cross-border worker)

(iv) State the name and address of the individual who

has relinquished his or her entitlement to the tax

credit in your favour, include Eircode (if known)

(v) His or her PPS No. (if known)

(vi) His or her Date of Birth (if known)

(Note: it is not possible to relinquish a credit in respect of one child that resides with you while retaining a credit for another child)

PAGE 23

FOR OFFICE USE ONLY

Tax Return And Self Assessment For The Year 2015 Page 23

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