CIS Refunds Step 1 of 520%Personal*Please select...MrMsMrsMissDrOtherFirst Name*Last Name*Email* National Insurance Number*AB 12 34 56 ADate of birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Nationality*Where did you hear about us?*GoogleSearch EngineFriendLeafletNewspaperMagazineFacebookYoutubeOtherWhen did you arrive in the UK (if applicable)Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920When did you leave the UK (or when are you intending to leave)?Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920If you are leaving the UK (or have left) do you intend to return to work in this country during the next 12 monthsyesnoHave you previously claimed for a tax refund?yesnoIf so what Tax Year did you claim?Did you use another agent?yesnoContact DetailsPhone*Address* Street Address City ZIP / Postal Code Overseas Address Street Address City ZIP / Postal Code CIS ExpensesToolsTotal amount spent on tools £TravelTotal amount spent on work related travel £ClothingTotal amount spent for work clothing £PhoneTotal amount spent for work £Sundry/MicellaneousTotal amount spent £Office stationary/postageTotal amount spent £HotelsTotal amount spent £MaterialsTotal amount spent £Any other expenses or claims:Please add detail of any other expenses or claims herePersonal CIS InformationState your UTR (Unique Taxpayer Reference)It’s a 10-digit number, sometimes with a letter ‘K’ on the end. It might just be called ‘tax reference’.State your Total CIS Income£2000How many Contractors/employers did you have?E.g. One, Two, Three, etc...ADD CONTRACTOR yesPlease indicate which payment structure you prefer:*No up front fee, money taken from refund when we secure your refund£120 (+VAT), flat fee payable in advance, no commissionAdd a contractorContractor NameContractor Address Street Address PhoneUPLOAD CIS STATEMENTSAdd 2nd contractor yesAdd a contractorContractor NameContractor Address Street Address PhoneUPLOAD CIS STATEMENTSAdd 3rd contractor yesAdd a contractorContractor NameContractor Address Street Address PhoneUPLOAD CIS STATEMENTSAdd 4th contractor yesAdd a contractorContractor NameContractor Address Street Address PhoneUPLOAD CIS STATEMENTSTerms & ConditionsI instruct Britbound Taxback to act as my agent.I have provided all the relevant information and certify that it shows a true representation of my personal details and employment history.I agree that any refund shall be made payable to Britbound Taxback (if I am applying for the refund service).I agree that should HMRC send payment directly to me, Britbound Taxback's commission is due and payable within 14 days of receipt of payment.This contract is binding on both parties until the completion of payment made by Britbound Taxback, or fees paid to Britbound Taxback.Britbound Taxback will charge a commission of 15%. The claim takes approx 2-4 weeks on average. No refund no fee applies.All "Self-employed", “Self Assessment”, “Non-Resident Landlords” or CIS applicants will be subject to the appropriate rates of commission and/or fixed fees published on the website.Photo ID will be required in due course.The commission rate is exclusive of Value Added Tax.All correspondence, telephone, postal and incidental costs will be paid for by Britbound Taxback and are inclusive in the fee.Overseas telex transfer cost £30.Britbound Taxback reserve the right to refuse to process any claim without reason.If you can not, or do not provide all the relevant documentation, P45's, P60's, Statement of Earnings, CIS Certs, etc Britbound Taxback may obtain these on your behalf.Britbound Taxback cannot be held responsible for claims that exceed the expected completion time if you; fail to supply a valid National Insurance number; you provide incorrect/insufficient information; you provide incorrect/insufficient documentation and/or there are unavoidable delays caused by HMRC. I am aware that if I do not provide Britbound Taxback with the correct information a resubmission fee of £50 may be applicable.None of the above clauses affect your statutory rights.I have read the above contract and agree to the terms and conditions.* I agreeSignature*NameThis field is for validation purposes and should be left unchanged.
