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Income and Capital Gains Tax Self-Assessment Checklist

Clients that avail of our personal income and capital gains tax return service can submit their details by using the form below. Please note that additional supporting information should be uploaded and sent via this form, by e-mail to info@squiresgilbride.ie or by post to our office address.


  • All relevant documentation and this completed form should be with us by 30th September
  • We cannot guarantee that documentation received after this date will be processed on time

In order for us to prepare and file your return we require the following information, please complete the checklist below.


Personal Information

First Name:

Surname:

Date of Birth:

Spouse First Name:

Spouse Surname:

Spouse Date of Birth:

Mobile Phone Number:

Email Address:

Home Address:

PPS number - Self:

PPS number - Spouse:

Marital Status:

SingleMarried


Would you like to be jointly assessed or separately assessed:

SeparatelyJointly


Income Period Ended 31/12/2015 - Click the relevant button.

1. Forms P60/P45 in respect of all salaries, fees, etc., received by you and your spouse. Details of any benefits provided by your employer, USC Certs if applicable. If Squires prepare payroll for your business we will have these details

SelfNot Applicable
SpouseNot Applicable


Any Relevant Comments:


2. Details of income received and expenditure incurred in respect of all trades/professions carried on by you and your spouse i.e. Sole trader income

SelfNot Applicable
SpouseNot Applicable

3. Details of any income received and expenditure (Including Cert of Mortgage Interest) incurred in respect of all properties let by you and your spouse.

SelfNot Applicable
SpouseNot Applicable

4. Certificates of interest earned by you and your spouse on all bank, building society, Post Office, etc. accounts, either here or abroad.

SelfNot Applicable
SpouseNot Applicable

5. Counterfoils / certificates for all Irish and foreign dividends / interest received by you and your spouse.

SelfNot Applicable
SpouseNot Applicable

6. Income, Expenses and taxes paid relating to Rental property in another country.

SelfNot Applicable
SpouseNot Applicable

7. Social Welfare Income received in year. Please indicate type of Income e.g Jobseekers Benefit etc.This information can be obtained from your Social Welfare Office.

SelfNot Applicable
SpouseNot Applicable

8. Maternity benefit is taxable , please obtain a certificate of taxable income from the maternity benefit section for the year.

SelfNot Applicable
SpouseNot Applicable

9. Details of any other income received by you or your spouse

SelfNot Applicable
SpouseNot Applicable

10. Details of Capital Gains made on the sale of assets including Property, Shares and any other assets disposed of in the year and for the period from the beginning of the current year to date and details of any preliminary CGT paid relating to these disposals


SelfNot Applicable
SpouseNot Applicable


11. Briefly outline any details of capital gains during the year:



Allowances & Reliefs - Click the relevant button.

12. Additional Voluntary Contributions to pension schemes or Retirement Annuity premiums paid in the year

SelfNot Applicable
SpouseNot Applicable

13. Details paid on Permanent Health Policies where your employer has paid on your behalf. Private Policies not to be included as tax relief has already been applied at source.

SelfNot Applicable
SpouseNot Applicable

14. Payments by you and your spouse under Deed of Covenant in the year.

SelfNot Applicable
SpouseNot Applicable

15. Relatives dependent on you and their income in the year, inlcluding details of children where spouse is not working:


Name:
Date of Birth:

Name:
Date of Birth:


16. Rent paid by you or your spouse in the year in respect of residential accommodation. Please note this is only applicable if you were under a tenancy agreement prior to 07/12/2010


SelfNot Applicable
SpouseNot Applicable


Landlord Address:

Landlord PPS number:


17. Payments made to a person employed to care for you or your spouse due to incapacity.

SelfNot Applicable
SpouseNot Applicable

18. Please provide receipts of any approved 3rd level course, name of student, full time or part time and amount paid during the year not already claimed elsewhere

SelfNot Applicable
SpouseNot Applicable


Sundry - Click the relevant button.

19. Details and receipts for all unreimbursed medical expenses and/or non-routine dental expenses incurred by you and your dependants in the year

SelfNot Applicable
SpouseNot Applicable

Details and Appropriate Documentation for:-

20. Investments made under the EIIS Scheme or the Film Investment Scheme, if applicable.

SelfNot Applicable
SpouseNot Applicable

21. Investments in Urban Renewal areas and/or expenditure on Significant Buildings

SelfNot Applicable
SpouseNot Applicable

22. Investments in Section 27 properties

SelfNot Applicable
SpouseNot Applicable

23. Redundancy or Termination payments for the calculation of Top Slicing Relief

SelfNot Applicable
SpouseNot Applicable

24. Gifts to the Arts and/or Colleges

SelfNot Applicable
SpouseNot Applicable

25. Details of rents or any other annual payments made to non-residents and tax deducted from same.

SelfNot Applicable
SpouseNot Applicable

26. Any other credits you may be entitled to including Blind Person, Widows, Age, Credit, Incapacitated Child, Home Carers - Please specify:

SelfNot Applicable
SpouseNot Applicable

27. Sundry Comments:

Upload Documents

Please create a single pdf file max size 5MB containing additional supporting information, alternatively you can email this information by e-mail to info@squiresgilbride.ie or by post to our office address.