Income Tax Check List 2012 – Form 11’s
This detailed check list is to ensure that you have accounted for all income & claimed all
allowances available to your circumstances. Please review in detail:
Personal Details:
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Civil status, i.e. single, married, widowed, married living apart, divorced, civil
partnership. Where applicable please provide date of marriage, date of seperation,
date of divorce or date of death of spouse or civil partner.
Please also indicate basis of assessment, if married or civil partnership, i.e.
joint/separate assessment or single treatment
Please also provide the following information:
 Number of dependent children.
 Date of birth for self, spouse/civil partner.
 PPS number of spouse/civil partner.
 If you or your spouse/civil partner are permanently incapicated.
 If you or your spouse are proprietor directors, who own 15% of share capital of a
company.
 If you or your spouse/civil partner have a full medical card, please indicate same.
 Please also indicate if you or your spouse/civil partner are exempt from PRSI and
the USC charge.
 Pension status.
 Country of birth/origin or domicile and current resident status.
 Farmer.
 Residence – please indicate if:
- Resident in Ireland
- Born in Ireland
- Non-reisdent
- Resident but not domiciled, subject to tax on remittance to Ireland
Income:
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Income from trades, professions or vocations.
Irish rental income.
Income from Irish employments, pensions, foreign employments where duties carried
on in the state.
Social Welfare payments / benefits or pensions received.
Irish Pensions.
Distributions from approved retirement funds / PRSA’s / lump sums from retirement
pension funds.
Directorship – please confirm any directorships held and tax number of the relevant
company.
Share options / convertible securities.
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Foreign income, which includes dividends, foreign pensions, EU deposit interest,
foreign employments, US dividends, Canadian dividends, income from foreign trade
professions, foreign rental income, income from other foreign interest, i.e. royalties,
annuities and dividends.
Foreign life policies / offshore funds / offshore products.
Income from fees, covenants and distributions, which include the following:
- Irish untaxed income and these are (a) Irish government stocks, (b) Irish
exchequer bills, (c) Irish Credit Union dividends, (d) other loans and investments.
- Irish deposit interest.
- Dividends from Irish resident companies.
- Settlements / covenants / estate income / maintenance payments / patent / royalty
income.
Investment undertakings.
Income from sources not shown elsewhere.
Exempt income, i.e. Artists Exemptions, Profits/Distributions from Woodlands, Rent a
Room Relief and Childcare Services.
Claims:
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Maintenance Payments.
Gross amounts of deeds of covenants.
Gross amounts of payments of other charges / annuities.
Private medical insurance paid by employer – please provide gross and tax deductions
at source.
Retirement Annuity Contracts / PRSA’s and overseas pension plans.
Interest relief provided in loans acquiring interest in shares in certain companies or
partnerships.
Interest relief on certain unsecured home loans.
Gross amounts of rent paid to non-residents.
Significant Buildings & Gardens Relief
Claim for tax credits allowances and reliefs:
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PAYE tax credit.
Dependant relative tax credit.
Employing a carer for uncapicitated individual.
Permanent health benefit.
Seed Capital Schemes.
Business Expansion Scheme.
Employment Investment Scheme.
Film Relief.
Tuition Fees.
One Parent Family Tax Credit.
Incapacitated Child Tax Credit.
Medical insurance premiums paid by your employer.
Purchase of new shares in a company by employee.
Owner/Occupier Relief for residential property in designated area.
Job Assist Allowance.
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Rent Tax Credit Allowance.
Donations to approved sporting bodies and charities.
Health expenses.
- Nursing Homes expenses.
- Any rebursement of any of the above from Public Authorities, medical insurance,
compensation claims, etc.
Capital Acquisitions Tax:
Please indicate if you were in receipt of any gift / inheritance during the year ended 31st
December 2012. Please provide details with regard to same.
Capital Gains Tax:
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Please provide details of any disposals between 1st January 2012 and 31st December
2012 re related costs, proceeds, date of sale and date of purchase.
 Please also provide details of any chargeable assets acquired during the year and how
same were financed.
Contact Mark Butler or Maura Duffy for further information.