Tax Review Form

If you are an employee in Ireland and pay tax through PAYE you can apply for a tax refund for up to 4 previous years. There is a good chance that you might overpaid your taxes or missed on some tax credits.

We will review your taxes and apply all tax credits and reliefs that you are eligible for, maximising the possible tax refund to you.

Fill in the form below – add as much information as you can.

We will do the reviewing part and contact you if we need more information.

Your tax return will be transferred from Revenue straight to your bank account!

Personal Information
Name*
Surname*
PPSN*
Date of Birth*
DD slash MM slash YYYY
Current Address*
Phone Number*
Email Address*
Marital Status*
The date of marriage*
DD slash MM slash YYYY
The date of separation*
DD slash MM slash YYYY
The date of divorce*
DD slash MM slash YYYY
The dated of Spouse's passing*
DD slash MM slash YYYY
Number of Children
Employment and Income Details
Job Title*
How frequently are you paid?*
Have you received any social welfare payments in the last 4 years?*
- No
- Yes - 2021
- Yes - 2020
- Yes - 2019
- Yes - 2018
Type(s) of payment(s) received for 2021*
Type(s) of payment(s) received for 2020*
Type(s) of payment(s) received for 2019*
Type(s) of payment(s) received for 2018*
Did you have any additional sources of income (Dividends, Deposit Interest, any other Irish or foreign income, or exempt income such as income from Rent-a-Room) over the last 4 years?*
- No
- Yes - 2021
- Yes - 2020
- Yes - 2019
- Yes - 2018
State the type and amount of additional income for 2021*
State the type and amount of additional income for 2020*
State the type and amount of additional income for 2019*
State the type and amount of additional income for 2018*
Tax Credits and Expenses
Medical & Dental Expenses
Were you a full medical card holder at any stage in the last 4 years?*
- Yes
- No
Medical Card Number
Did you incur any medical or non-routine dental expenses in the last 4 years?*
Please note, that it is your responsibility to provide an accurate information. You must retain a copy of all documentation relating to any medical expense claimed and provide upon request.
- No
- Yes - 2021
- Yes - 2020
- Yes - 2019
- Yes - 2018
Amount paid in 2021*
Amount paid in 2020*
Amount paid in 2019*
Amount paid in 2018*
Single Parent Tax Credit (aplicable to Single Parents only)
Do you have any children under 18 or in full-time education?*
- No
- Yes
Number of Children
1st Child
Are you the primary or secondary carer for your child(ren)?*
- Primary Carer
- Secondary Carer
State the year(s) the child(ren) lived with you for more than half the year*
- 2018
- 2019
- 2020
- 2021
- None of the above
State the year(s) the child(ren) lived with you for more than 100 days
- 2018
- 2019
- 2020
- 2021
- None of the above
State the year(s) you were cohabiting or living with another person as a couple*
- 2021
- 2020
- 2019
- 2018
- None of the above
Child’s Full Name*
Child’s Date of Birth*
DD slash MM slash YYYY
Child’s PPS number*
Name of Child’s School
2nd Child
Are you the primary or secondary carer for your child(ren)?*
- Primary Carer
- Secondary Carer
State the year(s) the child(ren) lived with you for more than half the year*
- 2018
- 2019
- 2020
- 2021
- None of the above
State the year(s) the child(ren) lived with you for more than 100 days
- 2018
- 2019
- 2020
- 2021
- None of the above
State the year(s) you were cohabiting or living with another person as a couple*
- 2021
- 2020
- 2019
- 2018
- None of the above
Child’s Full Name*
Child’s Date of Birth*
DD slash MM slash YYYY
Child’s PPS number*
Name of Child’s School
3rd Child
Are you the primary or secondary carer for your child(ren)?*
- Primary Carer
- Secondary Carer
State the year(s) the child(ren) lived with you for more than half the year*
- 2018
- 2019
- 2020
- 2021
- None of the above
State the year(s) the child(ren) lived with you for more than 100 days
- 2018
- 2019
- 2020
- 2021
- None of the above
State the year(s) you were cohabiting or living with another person as a couple*
- 2021
- 2020
- 2019
- 2018
- None of the above
Child’s Full Name*
Child’s Date of Birth*
DD slash MM slash YYYY
Child’s PPS number*
Name of Child’s School
Incapacitated Child Tax Credit
Are any of your children classified as "permanently incapacitated"?*
- No
- Yes
Number of Children
1st CHILD
Child’s Full Name*
Child’s Date of Birth*
DD slash MM slash YYYY
Child’s PPS number*
State the Nature of Incapacity*
Date of Diagnosis*
DD slash MM slash YYYY
2nd CHILD
Child’s Full Name*
Child’s Date of Birth*
DD slash MM slash YYYY
Child’s PPS number*
State the Nature of Incapacity*
Date of Diagnosis*
DD slash MM slash YYYY
3rd CHILD
Child’s Full Name*
Child’s Date of Birth*
DD slash MM slash YYYY
Child’s PPS number*
State the Nature of Incapacity*
Date of Diagnosis*
DD slash MM slash YYYY
Is any other person also maintaining your incapacitated child(ren)?*
- No
- Yes
State the percentage contributed by you compared to the other person, towards maintaining your child(ren)*
Tuition Fees
Did you pay Tuition Fees for third level education for yourself or a relative in the last 4 years?*
- No
- Yes
Number of Students
1st Student
Name of the Student*
State the amount of fees paid and the year(s) the payment(s) relate to*
Was the course full-time or part-time?*
- Full-time
- Part-time
2nd Student
Name of the Student*
State the amount of fees paid and the year(s) the payment(s) relate to*
Was the course full-time or part-time?*
- Full-time
- Part-time
3rd Student
Name of the Student*
State the amount of fees paid and the year(s) the payment(s) relate to*
Was the course full-time or part-time?*
- Full-time
- Part-time
Did you pay fees for Foreign Language and Information Technology courses?*
- No
- Yes
State the name of the college, the name of the course, the name of the student(s) and the amount paid each year*
Medical Insurance Relief
Did your employer pay Medical Insurance on your behalf in the last 4 years?*
- No
- Yes - 2021
- Yes - 2020
- Yes - 2019
- Yes - 2018
Amount Paid in 2021*
State the number of adults covered by the policy*
State the number of children covered by the policy*
Amount Paid in 2020*
State the number of adults covered by the policy*
State the number of children covered by the policy*
Amount Paid in 2019*
State the number of adults covered by the policy*
State the number of children covered by the policy*
Amount Paid in 2018*
State the number of adults covered by the policy*
Nursing Home Expenses
Did you pay for a nursing home for yourself or another person in the last 4 years?*
- No
- Yes - 2021
- Yes - 2020
- Yes - 2019
- Yes - 2018
State the Name of the Nursing Home*
PPSN of the Nursing Home Resident*
Fees Paid in 2021*
State the Name of the Nursing Home*
PPSN of the Nursing Home Resident*
Fees Paid in 2020*
State the Name of the Nursing Home*
PPSN of the Nursing Home Resident*
Fees Paid in 2019*
State the Name of the Nursing Home*
PPSN of the Nursing Home Resident*
Fees Paid in 2018*
Pension Contributions Tax Relief
Did you make personal Pension Contributions outside your payroll in the last 4 years?*
- No
- Yes - 2021
- Yes - 2020
- Yes - 2019
- Yes - 2018
Contribution made in 2021*
What type of Personal Contribution did you make?*
- PRSA (Personal Retirement Savings Account)
- AVC (Additional Voluntary Contribution)
- RAC (Retirement Annuity Contract)
Contribution made in 2020*
What type of Personal Contribution did you make?*
- PRSA (Personal Retirement Savings Account)
- AVC (Additional Voluntary Contribution)
- RAC (Retirement Annuity Contract)
Contribution made in 2019*
What type of Personal Contribution did you make?*
- PRSA (Personal Retirement Savings Account)
- AVC (Additional Voluntary Contribution)
- RAC (Retirement Annuity Contract)
Contribution made in 2018*
What type of Personal Contribution did you make?*
- PRSA (Personal Retirement Savings Account)
- AVC (Additional Voluntary Contribution)
- RAC (Retirement Annuity Contract)
Income Continuance Tax Relief
Did you pay personal contributions to an Income Protection Scheme in the last 4 years?*
- No
- Yes - 2021
- Yes - 2020
- Yes - 2019
- Yes - 2018
State the name of Insurer*
Payment made in 2021*
State the name of Insurer*
Payment made in 2020*
State the name of Insurer*
Payment made in 2019*
State the name of Insurer*
Payment made in 2018*
Employing A Carer Tax Relief
Did you employ a carer in the last 4 years?*
- No
- Yes - 2021
- Yes - 2020
- Yes - 2019
- Yes - 2018
Amount Paid in 2021*
For whom was the carer employed for?*
- Yourself
- A Relative
Amount Paid in 2020*
For whom was the carer employed for?*
- Yourself
- A Relative
Amount Paid in 2019*
For whom was the carer employed for?*
- Yourself
- A Relative
Amount Paid in 2018*
For whom was the carer employed for?*
- Yourself
- A Relative
Work From Home Expenses
Did you have any additional expenses as a result of working from home at any stage in the last 4 years? (i.e. Utility Bills)*
- No
- Yes - 2021
- Yes - 2020
- Yes - 2019
- Yes - 2018
Did your employer pay you the allowable daily tax-free amount of €3.20 for working from home?*
- Yes
- No
Description of expenses incurred in 2021*
State how much the total expenses were for 2021*
How many days did you work from home in 2021*
Did your employer pay you the allowable daily tax-free amount of €3.20 for working from home?*
- Yes
- No
Description of expenses incurred in 2020*
State how much the total expenses were for 2020*
How many days did you work from home in 2020*
Did your employer pay you the allowable daily tax-free amount of €3.20 for working from home?*
- Yes
- No
Description of expenses incurred in 2019*
State how much the total expenses were for 2019*
How many days did you work from home in 2019*
Did your employer pay you the allowable daily tax-free amount of €3.20 for working from home?*
- Yes
- No
Description of expenses incurred in 2018*
State how much the total expenses were for 2018*
How many days did you work from home in 2018*
Please note, Revenue allows you to include 10% of your home utility bills. You are solely responsible for providing correct and accurate information. You must retain a copy of all documentation relating to any work from home expense claimed and provide them upon request.
If you wish your refund to be send to your bank account, please give us your bank account details
Account holder name
IBAN
BIC
Otherwise, your refund will be posted as a cheque to the address that Revenue has in their system
Proof of ID
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Personal Information

Employment and Income Details

Tax Credits and Expenses

Medical & Dental Expenses

Single Parent Tax Credit (aplicable to Single Parents only)

1st Child

2nd Child

3rd Child

Incapacitated Child Tax Credit

1st CHILD

2nd CHILD

3rd CHILD

Tuition Fees

1st Student

2nd Student

3rd Student

Medical Insurance Relief

Nursing Home Expenses

Pension Contributions Tax Relief

Income Continuance Tax Relief

Employing A Carer Tax Relief

Work From Home Expenses

If you wish your refund to be send to your bank account, please give us your bank account details

Otherwise, your refund will be posted as a cheque to the address that Revenue has in their system

Secure Payment

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