inCOMe tax reFUnD

UK

DOCUMent inStrUCtiOnS
YOUr Step-bY-Step gUiDe tO getting YOUr UK tax baCK FaSt Taxback.com makes getting your tax back fast and hassle-free. You just need to provide a bit of information and well do all the hard work. Heres what you need to do: taxback.com application Forms pages 2 & 3 Fill in the first two forms with your personal and employment information. This information helps us to get as much tax back as possible for you so please give as much detail as you can. You should provide detailed information on all the jobs and employers you had in the UK. If you had more then one employer, please print an additional Employment Information Page and fill it in. if you are missing any of the following documents: p45, p60 or p11D, dont forget to sign the Declaration to employer on page 4 and we will be able to obtain replacement documents for you. taxback.com
UK Head Office: 277/281 Oxford Street 1st Floor london W1C 2Dl United Kingdom Toll Free: 0808 2381 611 P: +44 207 6599 188 F: +44 207 4913 988 E: info@taxback.com W: www.taxback.com

These tax forms only need to be signed where indicated by the black pen symbols there will be 8 signatures in total. Your signature needs to be exactly the same as the signature in your passport.The tax office is very strict about how the tax forms are filled out so in order to make it easy for you, simply sign where indicated and well fill in the rest. Do not complete any other information on the tax forms. if you add any additional information on these forms it may delay your tax refund. In cases where you have had more thn 1 employer dont forget to print as many of pages 3 and 10 that you require. Post your taxback.com forms to your local office or to:

the tax Forms pages 5-10

taxback.com, 1st Floor, 277/281 Oxford Street, London W1C 2DL, United Kingdom

CheCKLiSt:
Use this checklist to make sure youve done everything you need.
1.Complete the application forms (pages 2 and 3) in full and print page 3 for all your employers. 2. Sign the remainder of the forms where indicated by the black pen symbol and do not include any other information on these forms. The signature requirements are as follows: Page 4: One Signature (DEClaraTIOn TO EmPlOYEr) Page 5: One signature and your nIn / UTr number (CUSTOmEr aGrEEmEnT) Page 6: One signature (64-8) Page 7: Two signatures (r38) Page 8: One signature (P91) Page 9: One signature (P85) Page 10: One Signature (P87) - PLEASE PRINT AS MANY COPIES OF THE LAST FORM AS YOU NEED FOR YOUR EMPLOYERS DETAILS
Please note that if you fill in any parts of the forms that should be left blank we may have to ask you to send in new forms correctly filled out which will cause a delay in your refund.

3. Enclose your original Statement of Earnings, P60(s), P45(s) and/or P11D(s) from all your UK employers. 4. Enclose a copy of your passport (signature and photo page). 5. Photocopy or scan all your paperwork for your records.

any Questions? Visit our website at www.taxback.com

Post your taxback.com forms to your local office or to : Visit www.taxback.com for further details about our services

taxback.com, 1st Floor, 277/281 Oxford Street, London, W1C 2DL, United Kingdom

UK PaYE non-British

inCOMe tax reFUnD

UK

at taxback.com we want you to get your maximum legal refund in the quickest time possible. 1. Complete in full the first two forms with your personal and employment information. 2. Please only sign the rest of the forms where marked with the black pen. Do not complete any other information on these forms. 3. Please enclose a copy of the photo and signature page of your passport for identification. all the best, Fidelma mcGuirk managing Director, taxback.com

1 2 3

Sign the forms Send with your tax info receive your refund

perSOnaL DetaiLS
1
First name: Surname:

PLEASE PRINT IN BLOCK CAPITALS

Please supply a current email address so that you can receive personal updates by email.

Mayank Trivedi
DaY MOnth Year

How did you hear about our service? Email: Home phone: 00 mobile phone: nationality: 00

Google mayank.trivedi@hotmail.co.uk
COUntrY CODe COUntrY CODe LOCaL nUMber LOCaL nUMber

Date of birth:

Current correspondence address: UK residing address:

reSiDenCY QUeStiOnS
perSOnaL pay. The following questions help us establish your residency status so that Your residency status in the UK can affect the amount of tax you need toDetaiLS you can be sure that you get the refund that youre legally entitled to.

2 Which tax years would you like to apply for?

6th april 2011 5th april 2012: 6th april 2010 5th april 2011: 6 april 2009 5 april 2010:
th th

Have you applied for this refund before? Have you applied for this refund before? Have you applied for this refund before? Have you applied for this refund before? Have you applied for this refund before? Have you applied for this refund before? Have you applied for this refund before?
DaY MOnth Year

Yes Yes Yes Yes Yes Yes Yes

no no no no no no no

6th april 2008 5th april 2009: 6 april 2007 5 april 2008:
th th

6th april 2006 5th april 2007: 6 april 2005 5 april 2006:
th th

3 When did you first arrive in the UK? 4 Are you still living in the UK?

Yes
Year

no

- If no, when did you last leave the UK? DaY MOnth - If yes, go to Q7. 5 Have you moved abroad permanently or for 3 years at least?

Yes

no no

6 Are you planning on coming back to the UK to live or for regular visits? Yes

7 Since you first arrived in the UK please list the dates that you left and returned to the UK (excluding short holidays) :
From:
DaY MOnth Year

To:
DaY MOnth Year

From:
DaY MOnth Year

To:
DaY MOnth Year

8 Have you bought or leased accommodation in the UK? 9 Did you make any charity donations during any of the tax years? If yes, during which tax year?
2005/06 2006/07 2007/08 2008/09 2009/10

Yes Yes 2010/11 Yes

no no 2011/12 no

10 Have you ever registered as self employed in the UK?

Post your taxback.com forms to your local office or to : Visit www.taxback.com for further details about our services

taxback.com, 1st Floor, 277/281 Oxford Street, London, W1C 2DL, United Kingdom

UK PaYE non-British

inCOMe tax reFUnD

UK

eMpLOYMent inFOrMatiOn
In order to successfully process your tax claim, we need information on all the employers you had during the tax year(s) you want a refund from. Please fill out the Employment Information section in as much detail as possible. Please dont forget to print additional pages if you have had more than one employer.

11 employer 1
Company name: Street: City and Code: Phone: E-mail: Worked from:
DaY MOnth Year

Fax: until:
DaY MOnth Year

What is your occupation? Do you have your P45 / P60? Yes no If no, would you like us to source replacements for you?* Yes no no Did you receive P11D / benefits or dividends? Yes

Work-related expenses may significantly increase your refund. Please let us know about all your expenses in order to maximise your refund.

12 Did you incur expenses related to the undertaking of your duties which were not reimbursed by the employer? If yes - Please provide details
2005/06 Business Travel - own car, miles Business Travel - bus/rail/other Business Travel - subsistence Protective Clothing Maintaining Protective Clothing Specialist Tools Maintaining Specialist Tools Uniform Cleaning Uniform Professional Fees and Subs Professional Indemnity Insurance Flat Rate Expense miles 2006/07 miles 2007/08 miles 2008/09 miles 2009/10 miles 2010/11 miles

Yes

no

2011/12 miles

13 Did you work at a temporary workplace during any tax years being claimed for? If yes - Please provide details
Temporary work place expenses Travel Accommodation Subsistence 2005/06 miles 2006/07 miles 2007/08 miles 2008/09 miles

Yes

no
2010/11 miles 2011/12 miles

2009/10 miles

Please note that in both cases you should have the records to verify your claim in the event that HMRC audits your affairs. If you are using your own car you should keep a contemporaneous log of miles travelled.

14 Did you receive any other income during your time in the UK? (e.g. foreign income, jobseekers allowance, pension income, rental income or investment income such as dividends or interest, etc)? Yes no If yes - Please provide details:

*Document retrieval fee applies

Post your taxback.com forms to your local office or to : Visit www.taxback.com for further details about our services

taxback.com, 1st Floor, 277/281 Oxford Street, London, W1C 2DL, United Kingdom

UK PaYE non-British

inCOMe tax reFUnD

UK

DeCLaratiOn tO the eMpLOYer

I,

Mayank Trivedi
PLEASE PRINT YOUR NAME

grant full authority to taxback.com to act as my agent in dealing with my United Kingdom income tax return application. In order to facilitate the submission of my application I therefore authorise you to provide information to taxback.com pertaining to my employment.

1st Floor, 277/281 Oxford Street, london, W1C 2Dl, United Kingdom

taxback.com

15 Signed: Date:

Taxback UK ltd t/a taxback.com is registered in England. registration number: 04608872

*Document retrieval fee applies

Post your taxback.com forms to your local office or to : Visit www.taxback.com for further details about our services

taxback.com, 1st Floor, 277/281 Oxford Street, London, W1C 2DL, United Kingdom

UK PaYE non-British

inCOMe tax reFUnD

UK

CUStOMer agreeMent
I confirm that: 1. I understand that taxback.com is a trading name for the services of Taxback Inc., Chicago, USa, and hereby contract with Taxback Inc. to carry out the services described herewith. 2. I understand that Taxback Inc. will utilise its parent company Taxback and its subsidiary and affiliate companies to gather information regarding the services where necessary and that the contract remains with Taxback Inc. for the duration of the service. 3. I have signed the necessary Power of attorney(s) to authorise Taxback. Inc, and / or its subsidiary undertakings trading as taxback.com and referred to hereafter as the agent, to prepare this tax return and represent me before the Hm revenue and Customs. 4. I have not filed a UK income tax return for this tax year nor authorised any person to do so on my behalf. 5. I understand that if I am due a refund for this tax year and I have not filed my claim for other tax years in which I worked in the UK, the agent will be obliged to file an application for the other tax year(s) as well. I agree that the agent should do this and I will pay a processing fee for each tax year included in the applciation. 6. I authorise taxback.com to retrive my P45/P60/SoE documents if I do not have them and agree to pay an administrative fee for each document. 7. I have not, for the mandated tax years, (a) approached or applied to the Hm revenue and Customs about these tax affairs or been refused by them for any reason, or (b) authorised any other party to do so on my behalf. 8. Should I receive the refund directly from any other source other than the agent, I understand and agree that I will pay the fee due to taxback.com for the work completed. 9. I understand that the UK Tax authorities will make the final decision on the value of any refund due and the refund estimation given by the agent is an estimation only, not a guarantee. 10. I understand that this customer agreement covers UK taxes only and I should seek separate advice on how any refund received or claim made may impact my tax position in other jurisdictions. 11. I agree to and accept the terms and conditions of service as written online at www.taxback.com and to any changes in the terms and conditions which taxback.com may effect from time to time and to the fees of the agent which represents the services I have requested and which are provided by taxback.com and/or its affiliate companies. 12. I understand that information collected in writing and/or verbally for UK tax return filing services can and may be used for internal auditing purposes by taxback.com and provided to the Hm revenue and Customs for external auditing purposes. 13. I commit to updating taxback.com of any change in my contact details. 14. I have provided true, accurate and complete information regarding my income, taxes, assets and personal circumstances to taxback.com and I am duly responsible for any discrepancies in the information provided and my annual tax records with the Hm revenue and Customs. 15. I agree to and accept the terms and conditions of service as written online at http://www.taxback.com/termsandconditions/ and I confirm that I have read and agree to the fees as written online at http://www.taxback.com/fees.asp.

16

name in print: Signature:

Mayank Trivedi
national Ins. number:

Date: UTr:

Post your taxback.com forms to your local office or to : Visit www.taxback.com for further details about our services

1st Floor, 277/281 Oxford Street, London, W1C 2DL, United Kingdom

UK PaYE non-British

Authorising your agent

Please read the notes on the back before completing this authority. This a uthority allows us to exchange and disclose information about you with your agent and to deal with them on matters within the responsibility of HM Revenue & Customs (HMRC), as speci ed on this form. This overrides any earlier authority given to HMRC. We will hold this authority until you tell us that the details have changed.
I, (print Mayank your name)

Please tick the box(es) and provide the reference(s) requested only for those matters for which you want HMRC to deal wi th your agent. Individual*/Partnership*/Trust* Tax A airs *delete as appropriate (including National Insurance)
Your National Insurance number
(individuals only) If you are self employed tick here

Trivedi
Unique Taxpayer Reference
(if applicable)

of (name of your business, company or trust if applicable)

If UTR not yet issued tick here

authorise HMRC to disclose information to (agents business name)

taxback.com

If you are a Self Assessment taxpayer, we will send your Statement of Account to you, but if you would like us to send it to your agent instead, please tick here

I agree that the nominated agent has agreed to act on my/our behalf, and the information is correct and complete. The authorisation is limited to the matters shown on the right-hand side of this form. Signature see note 1 overleaf before signing

Tax Credits
Your National Insurance number
(only if not entered above)

If you have a joint Tax Credit claim and the other claimant wants HMRC to deal with this agent, they should sign here Name

Date Give your per sonal details or Company registered o ce here

Address

Signature

Joint claimants National Insurance number

Postcode Telephone number

Corporation Tax
Company Registration number

Give your agents details here

Address

taxback.com
1st Floor 277 - 281 Oxford Street London W1C 2DL 0207 6599 188 T6914E

Companys Unique Taxpayer Reference

World Leader in International Tax Refund Since 1996

Postcode Telephone number Agent codes (SA/CT/PAYE)

NOTE: Do not complete this section if you are an employ ee. Only t ick the box if you are an employer operating PAYE Employer PAYE Scheme
Employer PAYE reference

Client reference

For o cial use only

SA NIRS COP NTC / / / / / / / / COTAX EBS VAT COP link / / / / / / / /

VAT

(see notes 2 and 5 overleaf) If not ye t registered tick her e HMRC 02/09

VAT registrat ion number

64-8

Please complete, sign, then send this form to your HM Revenue & Customs o ce. Use CAPITAL letters

Date received by HM Revenue & Customs

Details of Claimant
Full name Address

Mayank Trivedi

Postcode

Claim
I claim repayment of the amount overpaid by me, (for non SA claims the period or year ended must be entered in the box aside). Claimants signature Date

/ /

/ /

If you complete a Self Assessment Return your repayment will usually be sent direct to you or your nominee s bank or building society account. Please include the branch sort code, the account number and if appropriate, the name and address of the nominee in the authority below. If you or your nominee does not have a bank account, we can arrange for repayment to be made in the form of a payable order but you or your nominee will need to open a bank or building society account in order to cash it. If the repayment is to be sent to your nominee by payable order, the nominee s name and address must be entered in the authority below. If you do not complete a Self Assessment Return your repayment will be made in the form of a payable order, which must be paid into a bank or building society account. If you do not have a bank or building society account you should nominate someone who does to receive the order for you. If the repayment is to be sent to a nominee or posted direct to your bank or building society by payable order, the name and address must be entered in the authority below. Also include your account number and sort code if the payable order is to be posted direct to your bank or building society.

Authority
I authorise nominee/agent (delete as appropriate)* Your/your nominee s bank or building society account number (delete as appropriate)

taxback.com
of ( full address) 1st Floor 277 - 281 Oxford Street London W1C 2DL Branch Sort Code

World Leader in International Tax Refund Since 1996

Agents reference (if applicable)

Postcode

to receive on my behalf the amount due. Claimant s sig nature

*enter the name of the account holder or the person who will receive the payable order.

D ate

Current details
We would like to know what you did since the date shown in BOX A on the front page. Please list in date order, all the jobs you had and any periods when you were out of work. Please continue on a separate sheet if needed.
Employed - enter your employer s full name, address and tax reference number Self-employed - enter your business name and address Jobseekers Allowance of your Bene t O ce Employed
Full name Address

continued

Employment history

If you are self-employed address of the business

, please enter the name and

Business name

Address

Date from/to For example

Tick the appropriate box that applies to you or Incapacity Bene t - enter the name

Total weekly income before stoppages and payroll or works number

Oct 03/Jan 04 /
Self-employed Jobseeker Incapacity Bene t
Postcode Tax reference

Postcode

l l l

Date the business started

/
Not earning

Payroll or works number

If you are a partner, please enter the full name of the partnership

Please complete in all cases

/
Full name Address

Employed Self-employed Jobseeker Incapacity Bene t

Postcode Tax reference

Your address (if not correct over the page)

l l l

Address

Payroll or works number

Not earning

Postcode

Telephone number (including national dialling code)

0207 6599 188

Jobseeker Incapacity Bene t Not earning

/
Self-employed

Employed

Full name Address

l l l

Signature

Payroll or works number

Postcode Tax reference

Your National Insurance number

(if not correct over the page)

Date of birth

Date

4.

How you want to be paid any money we owe you

Not ever yone gets a refund. If we owe you any money, we can either pay it to you or someone else on your behalf this is known as a nominee. Please choose one of the following two options:

Option one Please pay direct to bank or

building society Bank sort code

Option two Please pay by cheque direct to me or

my nominee Put X in one box

Account number

Please make the cheque payable to me I authorise the cheque to be payable to my nominee Tell us your nominees name

Account holders name

taxback.com
Tell us the address to send the cheque to

Bank or building society name and address

Name Address

1st Floor 277 - 281 Oxford Street London W1C 2DL

Postcode

Put X in one box This is my account This is my nominees account

Declaration
You must sign this declaration. If you give information which you know is not correct or complete, action may be taken against you.
I declare that the information I have given on this form is correct and complete to the best of my knowledge I claim repayment of any tax due. Your signature Date DD MM YYYY

What to do now
Put an X in relevant box I have enclosed parts 2 and 3 of my form P45 Details of employee leaving work I dont have a form P45 Please tell us why in the box below, for example because you are retired or a UK Crown servant employed abroad. If you have a form P45 and dont send it to us, any payment due to you may be delayed.

Please send this form to your tax o ce. You can nd your t ax o ce address by: going to www.hmrc.gov.uk select Contact us and choose Find your Tax O ce asking your employer.