Repayment claim - merchant seafarer Non

Repayment claim – merchant seafarer
Non-resident in UK or any other EEA country
When to use this form
This form is for use from 6 April 2011.
If you are a seafarer who is not a resident in the UK or any other European Economic Area (EEA) country, you may be
able to claim back any UK Income Tax taken off your seafaring earnings.
Any income from duties carried out in the UK, or within the UK continental shelf, will be liable to UK tax, as will duties
carried out between UK ports, with no foreign port visit, between.
However, any duties carried out outside that sector or on direct journeys between UK and foreign ports will not be
liable to UK tax.
Please fill in this form using capital letters, to claim back some or all of the UK Income Tax deducted taken off your
seafaring earnings.
Your details
1
Your title (for example MR, MRS, MISS)
2
Your surname or family name
9
Approximately how may complete days did you spend
in the UK in each of the last 4 tax years?
Note: UK tax years start on 6 April and end on 5 April.
Tax year
2 0
to 2 0
2 0
to 2 0
Days in the UK
3
Your first name
4
Your date of birth DD MM YYYY
to 2 0
2 0
to 2 0
2 0
10
What is the name and address of every employer you
have had during the period of your claim?
5
Employer’s name
Your permanent home address
Address
Postcode
Postcode
Employer’s name
6
Your nationality
7
Country in which you usually live
Address
Postcode
Employer’s name
8
Your National Insurance number
Address
Postcode
If you need more space, continue on a seperate sheet
of paper.
Please turn over
R43(M) Page 1
HMRC 09/14
Details of your claim
I wish to claim for the tax year ended 5 April
11
2 0
Pay and UK tax taken off (from form P60, ‘End of Year Certificate’, payslips or employer’s statement)
Pay
£
12
•
0 0
Tax
£
•
0 0
Periods of this employment spent in the UK
Voyages between UK ports in accordance with your Discharge Book and/or Draught Water/Freeboard Movements
From DD MM YYYY
To DD MM YYYY
From DD MM YYYY
To DD MM YYYY
From DD MM YYYY
To DD MM YYYY
Voyages between UK ports and oil and gas installations in the UK sector of the continental shelf in accordance with
your Discharge Book and/or Draught Water/Freeboard Movements
From DD MM YYYY
To DD MM YYYY
From DD MM YYYY
To DD MM YYYY
From DD MM YYYY
To DD MM YYYY
Other periods spent performing duties within the territorial area of the UK or in the UK sector of the
continental shelf in connection with oil and gas exploration or exploitation
From DD MM YYYY
To DD MM YYYY
From DD MM YYYY
To DD MM YYYY
From DD MM YYYY
To DD MM YYYY
Other periods spent in the UK during the period of claim
In port
From DD MM YYYY
To DD MM YYYY
On study leave
From DD MM YYYY
To DD MM YYYY
To DD MM YYYY
To DD MM YYYY
Standing by
From DD MM YYYY
On paid sick leave
From DD MM YYYY
Page 2
Payment authority
Evidence to support your claim
You may have your repayment made to:
• your address
• any other person on your behalf, in the UK
• your bank or building society, in the UK
•a branch of certain banks or a company set up by
a UK bank in the Irish Republic, the Isle of Man
or the Channel Islands
Please send us the documents listed below with this
claim form.
13
Use the tick boxes to show you have enclosed
all the documents we need to decide your claim.
Copies of the relevant pages of your Discharge
Book or other documents, confirming your sea
service during the period of the claim.
Do you want your repayment made to a nominee?
Yes
No
If No, go to question 14
Name of nominee
Copies of each vessel’s Draught of Water &
Freeboard pages, day logs or voyage reports
for the claim period
A copy of form P60, ‘End of Year Certificate’ for
the year of claim.
Address of nominee
If working on a ferry, copies of monthly
Duty Rostas and copies of the vessel qualifying
night’s monthly schedules showing departure and
arrival times during the claim period.
Postcode
If your nominee is a bank or building society, also enter
your account details
If working on a cruise ship, copies of the itinerary
of each cruise.
Branch sort code
—
—
Account number
Name of account holder
14
Address to which you would like your repayment sent
Postcode
Repayment claim and declaration
I claim that I am not a resident in the UK for the tax year ended 5 April
2 0
and claim repayment of UK tax.
*I authorise you to send my repayment to the person, bank or building society I have shown above.
(*Delete if you have not nominated someone or a bank or building society to receive the repayment on your behalf).
I declare that the information that I have given on this form is correct and complete to the best of my knowledge and belief.
Signature and date
Phone number
Signature
Email address
Date DD MM YYYY
2 0
Full name
Send the completed form to
Local Compliance
Marine Group S0970
PO Box 3900
GLASGOW
G70 6AA
Page 3

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