[Form to be sent to the local Revenue office dealing with the individual who is to be the assessable spouse]

Own PPS Number:

Spouse’s PPS Number:

Date of Marriage:

Own Name:

Spouse’s Name:Address:

Estimated income for the current tax year

Self Spouse

(a) We hereby jointly elect that ............................................................... is to be the assessable spouse for the tax year (enter tax year) e.g. 2011 and later years.

(b) We request that our tax credits and standard rate band be allocated as follows:Tax Credits Standard Rate Band

or

or

or

If you are already being taxed as a married couple and wish to have your tax credits and standard rate band allocated as at present, please tick this box

If you wish to have your tax credits and standard rate band divided equally between you, please tick this box

If you wish to have transferable tax credits and standard rate band allocated to the assessable spouse, please tick this box;

Signed

Date:

(Self) (Spouse)Signed

Assessable Spouse Assessable SpouseSpouse Spouse

Assessable Spouse Election Form

D D M M Y Y Y Y

D D M M Y Y Y Y

Y Y Y Y

RPC001113_EN_WB_D3

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