Fillable Form 2001: CORRECTIVE AFFIDAVIT (Form CA26) (Irish Tax & Customs)

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Form 2001: CORRECTIVE AFFIDAVIT (Form CA26) (Irish Tax & Customs)

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CORRECTIVE AFFIDAVIT (Form CA26)
CAPITAL ACQUISITIONS TAX CONSOLIDATION ACT, 2003
A
ll consideration to be stated in whole Euro only and do not enter cent.
Details of the Person/Solicitor to be contacted in the event of Enquiry regarding this Affidavit
Please complete this form in BLOCK CAPITALS using BLUE INK
When completed, this form in duplicate
and all other relevant documentation
(i.e. Original Grant of Representation, Administration Bond (if necessary) should
be submitted to the Probate Office/District Probate Re
g
istr
y
.
All fields are mandator
y
Page 1
Forename
Surname
A
ddress
Telephone No.
DX Number (if applicable)
Contact e-mail
-
TAIN
A
gent's
Reference
(
to be used where the deceased died on or after 5th December
,
2001
)
Details of the applicants
I/We, the Applicant(s)
Forename of
1st Applicant
Surname of
1st Applicant
A
ddress
CA26
Information relating to the deceased
Date of Death
/ /
DD MM YYYY
PPS No. of
Deceased
A
ddress
Forename of
deceased
Surname of
deceased
Place of issue
of Grant
/ /
Date of Grant
DD MM YYYY
Occupation
Relationshi
p
to deceased
1073115457
Reset Form
Details of the applicants
Sworn declaration
WARNING: IF THE APPLICANT(S) SWEAR TO THIS AFFIDAVIT WITHOUT PERSONALLY VERIFYING THAT THE STATEMENTS IN IT ARE
TRUE, THEY MAY MAKE THEMSELVES LIABLE TO PENALTIES.
It appears that the Inland Revenue Affidavit already delivered in this deceased's estate requires correction as shown
h
e
r
e
in.
SWORN by
Surname of 1st Applicant
Forename of 1st Applicant
I/We make oath and say as follows;-
1.
CA26
Page 2
Relationshi
p
to deceased
Occupation
A
t
On the day of
Before me, a Commissioner for Oaths/Practising Solicitor/Court Clerk
and
(Tick relevant box and Delete as appropriate)
(i) the Deponent (Applicant) is personally known to me
(ii) the Deponent (Applicant) has been identified to me by
who is personally known to me
Document Type: Issue No:
Signature Commissioner for Oaths/Practising Solicitor/Court Clerk
or
(iii) the identity of the Deponent has been established by reference to a relevant document containing a photograph
or
Identifier's Signature
I certify that I know the Deponent/Applicant
2.
The contents of this Affidavit are true and correct to the best of my/our knowledge, information and belief, and this
A
ffidavit has been completed in accordance with the provisions of the Capital Acquisitions Tax Consolidation Act, 2003.
Signature of Applicant/Deponent
Forename of
3rd Applicant
Surname of
3rd A
pp
licant
A
ddress
Occupation
Relationshi
p
to deceased
Forename of
2nd Applicant
Surname of
2nd A
pp
licant
A
ddress
5858115452
WARNING: IF THE APPLICANT(S) SWEAR TO THIS AFFIDAVIT WITHOUT PERSONALLY VERIFYING THAT THE STATEMENTS IN IT ARE
TRUE, THEY MAY MAKE THEMSELVES LIABLE TO PENALTIES.
Sworn declaration (cont.)
Surname of 2nd Applicant
Forename of 2nd Applicant
Surname of 3rd Applicant
Forename of 3rd Applicant
CA26
Page 3
A
t
On the day of
Before me, a Commissioner for Oaths/Practising Solicitor/Court Clerk
and
(Tick relevant box and Delete as appropriate)
(i) the Deponent (Applicant) is personally known to me
(ii) the Deponent (Applicant) has been identified to me by
who is personally known to me
Document Type: Issue No:
Signature Commissioner for Oaths/Practising Solicitor/Court Clerk
or
(iii) the identity of the Deponent has been established by reference to a relevant document containing a photograph
or
Identifier's Signature
I certify that I know the Deponent/Applicant
A
t
On the day of
Before me, a Commissioner for Oaths/Practising Solicitor/Court Clerk
and
(Tick relevant box and Delete as appropriate)
(i) the Deponent (Applicant) is personally known to me
(ii) the Deponent (Applicant) has been identified to me by
who is personally known to me
Document Type: Issue No:
Signature Commissioner for Oaths/Practising Solicitor/Court Clerk
or
(iii) the identity of the Deponent has been established by reference to a relevant document containing a photograph
or
Identifier's Signature
I certify that I know the Deponent/Applicant
Signature of Applicant/Deponent
Signature of Applicant/Deponent
4005115455
A
ll considerations to be stated in whole EURO only. Do not enter Cent
N.B. Items not needing correction should not be inserted.
Items of property in the Inland Revenue Affidavit or the last Corrective Affidavit, needing correction, and omitted property
and deductions
(
if an
y)
.
CERTIFICATE OF PROBATE REGISTRAR
Fees on additional assets paid and further security given
Signature
Registrar
/ /
DD MM YY YY
Value as last previously
shown
Increase/Decrease Value as now corrected
Description of Debts
Description of Assets
Items of property in the Inland Revenue Affidavit or the last Corrective Affidavit, needing correction, and omitted property
and deduction (if any).
Value as last previously
shown
Increase/Decrease Value as now corrected
Net Irish Estate
Gross Irish Estate
Irish Debts
, ,
, ,
, ,
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Millions Thousands Hundreds
, ,
Millions Thousands Hundreds
, ,
Millions Thousands Hundreds
, , , , , ,
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PERSONAL PROPERTY AND REAL PROPERTY SITUATE IN THE STATE
SUMMARY OF INCREASE/DECREASE IN VALUE OF IRISH ESTATE
PERSONAL PROPERTY AND REAL PROPERTY OUTSIDE THE STATE
CA26
Page 4
Value as last previously
shown
Increase/Decrease Value as now corrected
Description of Debts
Description of Assets
, ,
, ,
, ,
, ,
, ,
, ,
, ,
, ,
, ,
, , , , , ,
8827115451
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Form 2001: CORRECTIVE AFFIDAVIT (Form CA26) (Irish Tax & Customs)

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Completed 29 July 2020

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