This form is for use by an individual resident of Ireland receiving
a UK State Pension or incapacity benefit
pensions, purchased annuities, interest or royalties arising in the UK
Please use the
attach a separate sheet. Remember to sign the
Send the completed form IRL-Individual to the
HM Revenue & Customs that you are resident in Ireland for the purposes of Irish tax. See Guidance Note 2.
If you need help with this form, please contact:
HM Revenue & Customs, Pay As You Earn and Self Assessment, BX9 1AS.
Phone us during UK office hours. Our phone numbers are
Part A Your personal details
Full name Mr Mrs Miss Ms
Full residential address
contact you with any queries _____________________
Telephone number ________________________________
Fax number _____________________________________
Reference (if any) or contact name
The address of the Tax Office in Ireland to which your
The date on which it was sent to that office
Irish PPS (Personal Public Service) Number
For use by the Inspector of Taxes in Ireland
Please sign and affix your official stamp and send this form to HM Revenue & Customs, PAYE & Self Assessment,
BX9 1AS. You may wish to take a copy of this form for your records.
I certify that _________________________________________________________
is resident in Ireland for the purposes of Irish tax.
Signature _______________________________ Date __________________
‘’ where appropriate
1. Have you ever lived in the United Kingdom? (If
Your exact date of departure from the United Kingdom
The date on which you became resident in Ireland for Irish tax purposes
2. Have you made any previous claim or return of income for the
the name of the UK Tax Office and the reference number, or
your last private address and the name and address
of your last business or employer in the United Kingdom.
3. Have you been in the United Kingdom during the past four years for as much as
3 months a year on average?
6 months in any one tax year? (a UK tax year starts on 6 April)
4. Have you been absent from Ireland for a complete tax year in any of the
5. Are you engaged in any trade or business in the United Kingdom or do you perform
in this claim/application?
subject to tax in Ireland.
Please answer the following question if you are applying for relief from UK tax on
copyright royalties – see
7. Are you the
If No, please attach a copy of the licence, contract or assignment under which you
have acquired from the originator the rights sub-licensed to the UK payer.
Part C.1 State Pension or Incapacity Benefit
If you receive a UK State Pension or UK Incapacity Benefit,
UK State Pension
UK Incapacity Benefit
date payments began
Please enter full details of your work pension(s) and/or any purchased annuities below.
Note that any adjustment will go back to the
the date on which you became resident in Ireland for Irish tax purposes
the date payments of the income began
the earliest UK tax year which remains in date for claiming repayment of UK income tax
Part C.3 Interest
If you have already received payments of interest with UK income tax deducted, please
Amount and full title of security Name and address in which security
If you receive interest from privately arranged loans, please give the following details on a separate sheet
Name and address of the UK payer of the interest
Date of the loan agreement
Amount of the loan
Due date(s) of the interest
Part C.4 Royalties
If you have already received payments of royalties with
For copyright royalties on literary, dramatic,
between you and
If payments are made
enter the agent’s name and address
between you and the UK payer
UK payer of the royalties
If you have already received payments of income with UK tax deducted, please give details below to claim repayment
complete the Declaration in
If no payments of the income have yet been made, go direct to the Declaration in
Source of income
enter the name of the trust or estate.
I am beneficially entitled to the income from the source(s)
The information I have given in this application/claim is
I apply for relief at source from UK income tax
I claim repayment of
UK income tax from
and ask you to send the repayment
to my bank/agent
Form IRL-Individual enables you as a resident of Ireland to apply under the United Kingdom/Ireland Double Taxation
UK tax in cases where payments of the income have already been made with UK tax deducted.
2. Evidence of residence in Ireland and where to send the completed form
It is a condition of relief from UK income tax under the terms of United Kingdom/Ireland Double Taxation Convention that
the beneficial owner of the income is resident in Ireland.
Please send the completed form IRL-Individual to the
Inspector of Taxes in Ireland. The Inspector of Taxes will certify that you are resident in Ireland for the purposes of
Irish tax and send the form to HM Revenue & Customs.
All the information that you provide to HM Revenue & Customs is confidential. We can therefore only discuss your tax
affairs with you or any tax adviser named by you.
Relief at source from UK income tax
on future payments of income may be available in cases where HM Revenue &
Customs is able to exercise its discretion to issue a notice (under Statutory Instrument 1970 Number 488, as amended).
HM Revenue & Customs deals with each application on its merits. Where HM Revenue & Customs cannot agree to allow
relief at source or cannot arrange it, you can claim
repayment of the UK tax deducted.
If relief at source is granted, please tell HM Revenue & Customs at the address in Note 10, without delay, if there is any
The UK State Pension, or UK Incapacity Benefit, is normally liable to UK income tax. As a resident of Ireland you can
Certain types of pension and most annuities from the UK, paid to you as a resident of Ireland, can be exempted
If however you receive a pension paid by the UK for
special provisions in the Convention. Your pension from that employment will be exempt from UK tax
provided that you satisfy
certain conditions. Further details are available from HM Revenue & Customs at the address
7. UK Interest
Interest can be paid to you with no UK tax deducted. Any UK tax that has been deducted can be repaid to you in full.
UK tax is deducted from interest on loan stocks issued by
companies which are
not quoted on the Stock Exchange
We may be able to arrange for interest on these stocks to be paid with no UK tax deducted, as explained in note 4.
Interest from the following UK sources is paid with no UK tax deducted, so there is no need to apply for relief from
Additionally, some UK banks and building societies operate a scheme for payment of interest without deduction of UK tax
to non-residents. Ask your UK bank or building society for information. HM Revenue & Customs cannot arrange for
payment of bank or building society interest with no UK tax deducted, so again, please do not enter such interest in
If you have already received any interest with UK tax deducted, you may claim
Most royalties can be paid to you with no tax deducted. Any UK tax that has been deducted can be repaid to you in full.
The Double Taxation Convention allows relief only to the
normally the originator of the work or product.
Copyright royalties for literary, dramatic, musical or artistic works
If you are
contract or assignment under which you have acquired the UK rights. This will help HM Revenue & Customs to check
that the beneficial ownership condition in the Double Taxation Convention is satisfied.
Please attach to the form IRL-Individual a copy of the licence agreement between
royalties. If you are
also attach a copy of the licence, contract or assignment under which you have acquired the UK rights.
9. Repayment claims and tax deduction vouchers
they are needed later to support your claim. If you have any doubt about how you have completed the form you can send
vouchers if you think it will help us.
If you need help or further information, please
phone HM Revenue & Customs:
or write to
HM Revenue & Customs is a Data Controller under the Data Protection Act 1998. We hold information for the purposes
the payment of benefits and the prevention and detection of crime, and may use this information for any of them.
We may get information about you from others, or we may give information to
check the accuracy of information
prevent or detect crime
protect public funds
provided by you, as well as by others, such as other government departments or agencies and overseas tax and customs
authorities. We will not give information to anyone outside HM Revenue & Customs unless the law permits us to do so.
For more information go to
These notes are for guidance only and reflect the UK tax position at the time of writing. They do not affect any rights of appeal.
Crown copyright 2015