Form HK1
Claim for an Allowance for Employing a Carer
If you, your spouse, civil partner or a relative is incapacitated by reason of physical or mental inrmity and you employ a
person to care for the incapacitated relative you may claim this allowance.
Relative’s Details
Name of incapacitated
to you
Date incapacity
Nature of
the incapacity
Cost of employing the carer
Please give details of the cost incurred by you of employing the carer stated above:
Net cost, after any payments from the Health Service Executive, etc.
Percentage of carer costs paid by you
Your Personal Details
Carers Details (if employed directly by you)
Name of carer
If provided by or through an agency or other commercial entity
Employer PAYE
Registration No.
Name of
Date employment
If you wish to have any refund paid directly to your bank account, please supply your bank account details.
Single Euro Payments Area (SEPA)
Bank account numbers and sort codes have been replaced by International Bank Account Numbers (IBAN) and Bank
Identier Codes (BIC). These numbers are generally available on your bank account statements. Further information
on SEPA can be found on
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.
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
Phone No.
, 0 0 .
If more than one carer is employed to care for the individual please complete a separate claim
form for each employment.
Where do I send this claim form?
The completed form should be returned to your Revenue ofce. The address can be found on your
Tax Credit Certicate or on any correspondence you have received from Revenue. Alternatively,
use our Contact Locator on to obtain the correct address.
4-year time limit
A claim for tax relief must be made within four years after the end of the tax year to which the
claim relates.
As your claim may be selected for future audit, you are requested to retain all documentation
relating to this claim for a period of six years.
The information in this document is provided as a guide only and is not professional advice,
including legal advice. It should not be assumed that the guidance is comprehensive or that it
provides a denitive answer in every case.
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.
Full details of Revenue’s data protection policy setting out how we will use your personal data as
well as information regarding your rights as a data subject are available on our Privacy page on Details of this policy are also available in hard copy upon request.