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.