Fillable Claim for Blind Persons Tax Credit & Guide (Irish Tax & Customs)

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Claim for Blind Persons Tax Credit & Guide (Irish Tax & Customs)

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Claim for Blind Person’s Tax Credit
& Guide Dog Allowance
Name and Address (incl. Eircode)
PPSN
Tax year for which you
are making a claim
Do you have a certicate from an ophthalmic surgeon stating that you, your spouse or civil partner have
impaired vision to the extent that your central visual acuity does not exceed 6/60 in the better eye with
correcting lenses or that the widest diameter of the visual eld subtends an angle no greater than 20
degrees? Insert x in the appropriate box
Who are you claiming the Blind Person’s Tax Credit for? Self
Insert x in the appropriate box(es).
Guide Dog Allowance
Number of Guide Dogs maintained
Do you have a letter from the Irish Guide Dogs for the Blind (in respect of each dog maintained)
conrming you are a registered owner?
Insert x in the appropriate box Yes No
Declaration which must be signed
I declare that all the particulars on this form are correct to the best of my knowledge and belief.
Signature Date
Address
(incl. Eircode)
E-mail Phone Number
RPC012383_EN_WB_L_1
D D M M Y Y
Spouse or
Civil Partner
Yes No
Refunds (Refer to note overleaf regarding tax refunds.)
If you wish to have any refund paid directly to your bank account, please supply your bank account details.
(Note: It is quicker to receive payments electronically than by cheque.)
Single Euro Payments Area (SEPA)
Your International Bank Account Number (IBAN) and Bank Identier Code (BIC) are generally available on
your bank account statements. Further information on SEPA can be found on www.revenue.ie
It is not possible to make a refund directly to a foreign bank account that is not a member of SEPA.
International Bank Account Number (IBAN) (Maximum 34 characters)
Bank Identier Code (BIC) (Maximum 11 characters)
Note: Any subsequent Revenue refunds will be made to this bank account unless otherwise notied.
Y Y Y Y
Information on Blind Person’s Tax Credit
& Guide Dog Allowance
Who can claim?
n An individual who is blind at any time during the tax year
n Married persons or civil partners who are both blind at any time during the year, in which case the
tax credit is doubled
Note: The tax credit is not due in respect of children who are regarded as being blind. In such cases the
Incapacitated Child Tax Credit can be claimed.
Conditions for valid claim
To qualify for the tax credit, you and / or your spouse or civil partner must have impaired vision to the
extent that:
n Your central visual acuity does not exceed 6/60 in the better eye with correcting lenses
or
n That the widest diameter of the visual eld substends an angle no greater than 20 degrees
Documents to be retained by you
n Certicate from an Ophthalmic Surgeon stating:
- The degree of blindness
- Whether the blindness is temporary or permanent.
Note, a certicate from an optician or doctor will not sufce.
n If you are claiming the Guide Dog allowance:
- A letter from the Irish Guide Dogs for the Blind conrming registered ownership.
It is not necessary to forward the above documents to Revenue with your claim. However, as your claim
may be selected for future audit, you are requested to retain all documentation relating to this claim for a
period of 6 years.
Tax Refunds
If your claim is in respect of the current tax year an amended Tax Credit Certicate will be sent to you and
your employer will make any refund due directly to you.
If your claim is for a previous tax year or during a period of unemployment, any refund due will be sent
directly to you by Revenue. Tax refunds can be paid by cheque or to your bank account.
Time Limit for Repayment Claims
A claim for repayment of tax must be made within four years after the end of the tax year to which the
claim relates.
Accessibility
If you require this form in an alternative format the Revenue Access Ofcer can be contacted at
accessofcer@revenue.ie.
Further information is available on www.revenue.ie
The Revenue Commissioners collect taxes and duties and implement customs controls. Revenue requires
customers to provide certain personal data for these purposes and certain other statutory functions as
assigned by the Oireachtas. Your personal data may be exchanged with other Government Departments
and agencies in certain circumstances where this is provided for by law. Revenue’s data protection policy
and information on your data protection rights are available on www.revenue.ie.
Designed & Printed by the Revenue Printing Centre
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Claim for Blind Persons Tax Credit & Guide (Irish Tax & Customs)

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Completed 29 July 2020

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