Fillable Form IC2 (Individual) Pension / Annuity: Claim Form (Irish Tax & Customs)

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Form IC2 (Individual) Pension / Annuity: Claim Form (Irish Tax & Customs)

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The Form IC2 (Individual) Pension / Annuity: Claim Form (Irish Tax & Customs) form is 1 page long and contains:

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  • 22 other fields

Country of origin: US
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TO BE COMPLETED BY THE TAX AUTHORITIES IN YOUR COUNTRY OF RESIDENCE
I certify that the above-named individual is / was resident of
for the tax year(s) (state year) and that the income to which claim relates is
liable to tax under tax reference number
Signed: Rank: Date: Ofcial Stamp
Claim Form to be completed by non-resident claimant
Tax Repayment / Exemption Claim Form for
Pensions / Annuities
Form IC2 (Individual) Pension / Annuity
Return this form to:
International Claims Section
Ofce of the Revenue Commissioners
St. Conlon’s Road, Nenagh,
Co. Tipperary, E45 T611, Ireland
Details of Claimant: (CAPITAL LETTERS)
Full Name:
Address:
Tel. No.:
E-mail:
Agent (if enquiries to be addressed to him / her)
Name:
Address:
Tel. No.:
E-mail:
This space is for ofcial use only
Warrant No.:
Amount: €
Checked by: Date:
Approved by: Date:
QUESTION ANSWER
1 State your date of birth.
2 State your country of birth.
3 State your nationality.
4 Please quote your PPSN (formerly known as RSI
Number), if any.
5a In what country are you resident?
5b What date did you take up residence there?
6 Please give the name, policy number and tax reference
number of the pension / annuity paying provider.
7a Please state the date the pension commenced.
7b Please state the date the rst payment was made.
I declare that I am / was (delete as appropriate) resident in (state
Country) for the purposes of Ireland’s Double Taxation Agreement with that country during the
tax year(s) in which the income was earned. I further declare that I am benecially entitled to the
income which is the subject of this claim and that I have not received credit for any Irish tax paid in
(state Country of residence).
Signed: Date:
*If you are claiming exemption at source, please tick *See notes overleaf
/ /
/ /
Please tick the box applicable: Purchased AnnuityEmployment Pension
RPC014329_EN_WB_L_1
For further details contact:
Tel.: +353 1 738 3680
E-Mail: intclaims@revenue.ie
Notes to be read in conjunction with Tax Repayment / Exemption Claim Form for
Pensions / Annuities Form IC2 (Individual) Pension / Annuity
What supporting documentation do I need to send with my claim?
The following additional documentation is also required where appropriate when claiming
tax paid:
For repayment of tax charged on an employment pension / annuity:
• the original Form P60, which is available from your employer.
For residents of USA only:
A certicate of residence for United States tax purposes (Form 6166) is required for each year
claimed. This form is available from The Department Of The Treasury, Internal Revenue
Service. Please log onto www.irs.gov to apply for Form 6166.
For residents of Spain only:
In certain circumstances the Spanish Tax Authorities may not agree to stamp the IC2 form. If
this occurs a certicate of Residence (Residencia Fiscal en Espana) is required. This form is
available from your local Spanish Tax Authorities.
Additional Notes:
If tax has been deducted in the current tax year on your pension / annuity, the pension paying
provider will refund this tax to you.
Please note that Government and Local Authority Pensions may be correctly taxable only in
Ireland.
If you are in receipt of a pension from the Department of Employment Affairs & Social
Protection please contact Dublin City Centre PAYE Section at Tel. No.: +353 1 738 3636
or by registering with the Irish Revenue Commissioners using the online services at
www.revenue.ie and you will receive further assistance with this matter.
Exemption Renewals:
The onus is on the claimant to seek continuance of the exemption from Irish tax on their pension/
annuity, after the exemption has expired. In the event that you return to live in Ireland during the
time the exemption is in place you should notify this ofce on your return.
If you do not have an Irish tax reference number (PPSN), please contact:
Client Identity Service, Department of Employment Affairs & Social Protection by:
E-mail: cis@welfare.ie or
Tel. No.: +353 1 704 3281
Time Limits for Making a Claim:
Section 17 of the Finance Act 2003 sets out time limits for the submission of repayment claims
to the Irish Revenue, i.e. claims may only be made within 4 years following the end of the
calendar year in which the tax was deducted.
How Repayments will be made:
We have the facility to make payments electronically to bank accounts. If you are making a claim
to repayment of Irish tax charged on the pension / annuity payments in previous years, please
include bank payment details, which should consist of the account holder’s name, the IBAN
number and BIC code.
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. Revenue’s data protection policy and information on your data
protection rights are available on www.revenue.ie
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Form IC2 (Individual) Pension Annuity: Claim Form (Irish Tax & Customs)

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Completed 17 November 2020

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