Assessable Spouse Election Form

[Form to be sent to the Revenue office dealing with the individual who is to be the assessable spouse]

Own Name: Own PPS Number:

Spouse’s Name:
Spouse’s PPS Number:
Address:

Date of Marriage: D D M M Y Y Y Y

Eircode:

Self Spouse
Estimated income for the current tax year € , .0 0 € , .0 0
(a) We hereby jointly elect that ............................................... is to be the assessable spouse for the tax year (enter tax year) Y Y Y Y for example 2016 and later years.

(b) We request that our tax credits and standard rate band be allocated as follows:
Tax Credits Standard Rate Band
Assessable Spouse Spouse Assessable Spouse Spouse
€ , .0 0 € , .0 0 € , .0 0 € , .0 0
or
If you are already being taxed as a married couple and wish to have your tax credits and standard rate band allocated as at present, please tick this box
or
If you wish to have your tax credits and standard rate band divided equally between you, please tick this box
or
If you wish to have transferable tax credits and standard rate band allocated to the assessable spouse, please tick this box;

RPC008371_EN_WB_L_1
Signed: (Self) Signed: (Spouse)

Date: D D M M Y Y Y Y

Designed by the Revenue Printing Centre