Nominated Civil Partner’s Election Form

[Form to be sent to the Revenue office dealing with the individual who is to be the nominated Civil Partner]

Own Name: Own PPS Number:

Civil Partner’s Name:

Civil Partner’s PPS
Number:
Address:
Date of Registration of Civil
D D M M Y Y Y Y
Partnership:
Country of Registration:

Title of Registration:
Eircode:
Self Civil Partner
Estimated income for the current tax year € €
, .0 0 , .0 0
(a) We hereby jointly elect that ....................................................................... is to be the nominated civil partner for the tax year (enter tax year) Y Y Y Y for example 2016
and later years.

(b) We request that our tax credits and standard rate band be allocated as follows:
Tax Credits Standard Rate Band
Nominated Civil Partner Other Civil Partner Nominated Civil Partner Other Civil Partner

€ , .0 0 € , .0 0 € , .0 0 € , .0 0
or
If you are already being taxed as Civil Partners and wish to have your tax credits and standard rate band allocated as at present, please tick this box
or
If you wish to have your tax credits and standard rate band divided equally between you, please tick this box
or
If you wish to have transferable tax credits and standard rate band allocated to the nominated civil partner, please tick this box

RPC008373_EN_WB_L_1
Signed: (Self) Signed: (Civil Partner)

Date: D D M M Y Y Y Y

Designed by the Revenue Printing Centre