Fillable Covid-19-relief-application-form-for-repayment Application for Refund of Import Duties and VAT

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Covid-19-relief-application-form-for-repayment Application for Refund of Import Duties and VAT

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RPC014019_EN_WB_L_3
Application for Refund of Import Duties and VAT
Importation of goods needed to combat the effects of COVID-19
PURSUANT TO COMMISSION DECISION (EU) 2020/491 of 3.4.2020
Applies to importations made from 30 January 2020
Further information is available on www.revenue.ie
Name of Importer:
Address (include Eircode):
Telephone Contact Details:
EORI Number:
SAD Number:
COVID-19 Relief
Authorisation number:
Organisation Type Tick as appropriate
1. State bodies, public bodies and other bodies governed by public law
2. Disaster Relief Agencies
3. Other organisations approved by Revenue
4. Importing on behalf of 1, 2 or 3
Refund Claimed €
Customs Duties
VAT
I hereby declare that the goods imported are / were intended for one of the uses as laid down in Article
1(a) of Commission Decision (EU) 2020/491 and the goods satisfy / satised the requirements laid down in
Articles 75, 78, 79 and 80 of Regulation (EC) No 1186/2009 in respect of customs duties and Articles 52,
55, 56 and 57 of Directive 2009/132/EC in respect of VAT. (Delete where appropriate)
I undertake to inform Revenue, ownresourcesunit@revenue.ie without delay should any of these
conditions subsequently cease to exist.
Name: ___________________________________________ (Block Capitals)
Signature: ________________________________________ Date: ______________________
Capacity of signatory: ________________________________________
Please email the fully completed application form to ownresourcesunit@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.
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Covid-19-relief-application-form-for-repayment Application for Refund of Import Duties and VAT

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Completed 2 July 2020

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