Tax Rebate Claim Form

Transcription

1 Tax Rebate Claim Form R38 Client Ref (Office use only) Taxpayer Name National Insurance No. Dear Sir/Madam, I wish to claim tax relief on the expenses of my employment. The details of my employment, the years claimed for, and the expenses relevant to the claim are as follows: Job Title Employer My expenses relate to the following tax years: STEP 1) Employment History Please detail your employment history since January Please enter "PRESENT" under 'Date Ended' if you are still in NHS employment. Employer Job Title Date Started Date Ended STEP 2) Occupation / Uniform Allowance If you wear a uniform at work, are required to wash it yourself, and are not reimbursed for this expense or reimbursed by your employer for cost of laundry, please tick your job title below. STEP 3) Shoes, Stockings & Tights Under EIM Tax Treatment of Nurses: Expenses Deductions: Shoes & Stockings / Tights allowance Occupation / Job Title Ambulance staff on active service 140/Yr Nurse, Midwife, Chiropodist, Dental Nurse, Occupational / Speech / Other Therapist, Physiotherapist, Phlebotomist, Radiographer 100/Yr Plaster Room Orderly, Hospital Porter, Ward Clerk, Sterile supply worker, Hospital Domestic, Hospital catering staff 100/Yr Laboratory staff, pharmacist, pharmacy assistant 60/Yr All other uniformed staff, Uniformed ancillary staff, Maintenance / Ground staff, Driver, Parking Warden, Security Guard, Receptionist 60/Yr Tick Your Job Occupation / Job Title Stockings & Tights (where you have to wear a certain style or colour) 6/Yr Socks - Male Nurses: where you have to wear a certain colour sock 6/Yr Shoes - where you have to wear a certain style of shoe in the hospital 12/Yr None of the above apply to me Tick if applies Now complete Page 2 overleaf

2 STEP 4) Tax Refund for Memberships & Subscriptions Historic subscription fee amounts are listed in the attached sheet. You must list the amount paid in the table below in order to claim Membership Body / Type 2011/12 ( s) 2012/13 ( s) 2013/14 ( s) 2014/15 ( s) 2015/16 ( s) Unison Subscriptions RCN Subscriptions Nursing & Midwifery Council Fees Healthcare Professions Council RCM Subscriptions SoR Subscriptions IBMS Subscriptions GDC Fees GphC Fees Other Step 5) Claimant Details Claimant Name Date received by HM Revenue & Customs Address Postcode Address Step 6) Tax Rebate 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). I authorise agent of Client Ref (Office use only) National Insurance No. To receive on my behalf the amount due. SIGN HERE CLAIMANT SIGNATURE >>> DATE By signing the above, the claimant agrees to all of the disclosures made herein; to the 'Terms & Conditions of Service' as listed at Mytaxrebate.net; and to the payment instructions details above. Claimant agrees to assign the overpayment unconditionally to. Now complete Page 3 overleaf

3 STEP 7) Your Authorisation SIGN HERE >>> VG (SA)

4 REFERENCE TABLE- Professional Body Subscription & Membership Rates (Page 1 of 2) Unison Subscription Rates Weekly Pay Annual Pay Yearly Subscription (2010 to date) < Up to 2, to ,001 to 5, to ,001 to 8, to ,001 to 11, to ,001 to 14, to ,001 to 17, to ,001 to 20, to ,001 to 25, to ,001 to 30, to ,001 to 35, > Over 35, Royal College of Nursing (RCN) Subscriptions Full Membership Concessionary Membership Newly Qualified Membership Student Membership HCA HCA Concessionary Nursing & Midwifery Council (NMC) Fees Annual Fee Fee to register a qualification Society of Radiographers (SOR) Fees Full Member Overseas Member Reduced Rate Accredited Assistant

5 REFERENCE TABLE- Professional Body Subscription & Membership Rates (Page 2 of 2) Health Care Professions Council (HCPC) (Formerly HCPC) Fees New Member Renewal Fee Scrutiny Fee Readmission Fee International / EEC Application Scrutiny Fee Grandparenting Scrutiny Fee Royal College of Midwives (RCM) Subscriptions Full Membership Institute of Biomedical Science (IBMS) Subscriptions Fellow Member Licentiate Registration Fee Assessment Fee General Dental Council (GDC) Fees Dentist Dental Care Professional Specialist General Pharmaceutical Council (GPhC) Fees Pharmacist Pharmacy Technician Application Fee