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VAT 2005 FORM 2004 Tax period TAX CODE VR/2005 FORM CLAIM THE REFUND OF A VAT CREDIT RELATIVE TO 2004 REVENUE AGENCY TAXPAYER Surname, company name day Date of birth month Name Sex year M Prov. Town
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1110) Surname, company name day Month of birth year Name Sex year M Prov. Town (place) (or foreign country) of birth F Foreign state (the person is a tax agent or an accountant in a foreign country) VAT identification no. Status in Law Activity code VAT registration no. Telephone code INDICATE THE TELEPHONE AND/OR FAX NO. WHERE YOU WISH TO BE CONTACTED Decal number on VAT number (or the equivalent in any other country) Tax Code (e.g. 1110) or Service Code (e.g. 1110, 1100, 1001, 1021, 1022) (or the equivalent in any other country) State Where the taxpayer is resident. (see Appendix D, page 17 for details) D. For purposes of the information on return, the name of the taxpayer will indicate whether the taxpayer is currently registered for VAT, or if a VAT registration number is still valid. E. A Taxpayer's VAT registration number is not valid in any other country. This is the case regardless of whether the person has been registered in a country other than an EU country, where the registration number is not valid, or if the address provided is not a post office. F. If a taxpayer is outside Ireland, for the purposes of the Information Return as provided in the IT Act, the following will be a valid VAT number, the terms “taxpayer” or “taxable taxpayer”, will be replaced by “agent”. 2.1 The name of the holder of a VAT number in the country where that holder is resident. 2.2 The address where that holder is registered for VAT. 3. The amount of VAT due by way of VAT return, whether the taxpayer is currently registered for VAT in a different country. 4. The nature of any services performed and/or services to be performed for the purposes of which the VAT due by way of VAT return (or a claim for a refund) was made. This includes all payments and/or service contributions. 5. In addition, a VAT registration or registration number may be required in order to facilitate the performance of certain acts that are subject to VAT (such as certain tax assessments, certain excise rulings). 6. Any other information which would assist in the assessment of the VAT liability. 7. The period for which the VAT return is to be made. 8.

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