Form 11 2012 - Revenue Commissioners

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2012120 ANY PANEL(S) OR SECTION(S) THAT DO NOT REQUIRE AN ENTRY SHOULD BE LEFT BLANK. PPS Number M - CAPITAL GAINS - Capital Gains for the year 1 January 2012 - 31 December 2012 [801 - 816] 801. Description of Assets No. of Disposals (a) Shares/Securities - Quoted (b) Shares/Securities - Unquoted (c) Agricultural Land/Buildings (d) Development Land (e) Foreign Life Policies (S. 594) chargeable at 40% (f) Offshore Funds (S. 747A) chargeable at 40% (g) Commercial Premises (h) Residential Premises (i) Shares and Securities exchanged (S. 913(5)) (j) Venture Fund Gains (S. 541C(2)(a)) (k) Other Assets (l) Total Consideration Aggregate Area in Hectares Insert T in the box(es) to indicate: Self 802. If any disposal was between connected parties or otherwise not at arm's length 803. If any of the original acquisitions were between connected parties or otherwise not at arm's length 804. If the market value has been substituted for the cost of acquisition of any assets disposed of , , . . , , , , , , , , , , , , Aggregate Consideration , , , , , , , , , , , , . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 Spouse or Civil Partner 805. Claim to Reliefs - Self (a) Disposal of Principal Private Residence: enter amount of consideration , , . 00 (b) Retirement Relief - Within the Family: enter consideration on disposal of qualifying assets , , . 00 (c) Retirement Relief - Outside the Family: enter consideration on disposal of qualifying assets , , . 00 (d) Disposal of a site to a child: enter amount of consideration , , . 00 (e) Other enter amount of consideration . , , 00 (specify) 806. Claim to Reliefs - Spouse or Civil Partner (a) Disposal of Principal Private Residence: enter amount of consideration , , . 00 (b) Retirement Relief - Within the Family: enter consideration on disposal of qualifying assets , , . 00 (c) Retirement Relief - Outside the Family: enter consideration on disposal of qualifying assets , , . 00 (d) Disposal of a site to a child: enter amount of consideration , , . 00 (e) Other enter amount of consideration . , , 00 (specify) Self Spouse or Civil Partner 807. Chargeable Gain(s) (excluding Foreign Life Policies) , , . 00 , , . 00 808. Previous Gain(s) Rolled-over (now chargeable) , , . 00 , , . 00 809. Net Loss(es) in 2012 , , . 00 , , . 00 810. Amount of unused Loss(es) from prior year(s) available for offset against chargeable gains above , , . 00 , , . 00 PAGE 20 FOR OFFICE USE ONLY
2012120 ANY PANEL(S) OR SECTION(S) THAT DO NOT REQUIRE AN ENTRY SHOULD BE LEFT BLANK. PPS Number Spouse or Self Civil Partner 811. Personal Exemption (max €1,270 per spouse or civil partner & not transferable) .00 .00 , , Note: losses, including losses forward, must be used first 812. Net Chargeable Gain (excluding Foreign Life Policies) , , . 00 , , . 00 813. Chargeable Gain on Foreign Life Policies , , . 00 , , . 00 814. Unused Loss(es) for carry forward to 2013 . . , , 00 , , 00 If you have an overall CGT loss in 2012 there is no need to complete Lines 815 or 816. 815. In respect of net chargeable gains that arose in the period 1 January 2012 - 30 November 2012 (a) Enter amount of net gain to be charged at 30% , , . 00 , , . 00 (b) Enter amount of net gain to be charged at 40% (excluding Foreign Life Policies) , , . 00 , , . 00 (c) Enter amount of net gain on Foreign Life Policies . to be charged at 40% , , 00 , , . 00 (d) Enter amount of net gain in respect of Venture Fund Capital to be charged at 15% , , . 00 , , . 00 (e) (i) Enter amount of net gain in respect of a disposal of land under Compulsory Purchase Order (CPO) . . , , 00 , , 00 which has accrued in 2012 by virtue of S. 542(1)(d) (ii) Date of disposal (DD/MM/YYYY) / / / / (f) Enter the amount of net gain on windfall gains attributable to rezoning/relevant planning decisions . . , , 00 , , 00 to be charged at 80% (S. 649B) 816. In respect of net chargeable gains that arose in the period 1 December 2012 - 31 December 2012 (a) (i) Enter amount of net gain to be charged at 30% - disposal between 1/12/2012 and 5/12/2012 , , . 00 , , . 00 (ii) Enter amount of net gain to be charged at 33% - disposal between 6/12/2012 and 31/12/2012 , , . 00 , , . 00 (b) Enter amount of net gain to be charged at 40% (excluding Foreign Life Policies) , , . 00 , , . 00 (c) Enter amount of net gain on Foreign Life Policies to be charged at 40% , , . 00 , , . 00 (d) Enter amount of net gain in respect of Venture Fund Capital to be charged at 15% , , . 00 , , . 00 (e) (i) Enter amount of net gain in respect of a disposal of land under Compulsory Purchase Order (CPO) . . , , 00 , , 00 which has accrued in 2012 by virtue of S. 542(1)(d) (ii) Date of disposal (DD/MM/YYYY) / / / / (f) Enter the amount of net gain on windfall gains attributable to rezoning/relevant planning decisions . . , , 00 , , 00 to be charged at 80% (S. 649B) N - CHARGEABLE ASSETS ACQUIRED IN 2012 817. Enter the number of assets acquired and the consideration given Self Spouse or Description of Assets Civil Partner Number of Assets (a) Shares (quoted and unquoted) (b) Residential Premises (c) Commercial Premises (d) Agricultural Land (e) Development Land (f) Business Assets (g) Antiques/Works of Art (h) Other PAGE 21 Self Consideration , , , , , , , , , , , , , , , , . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00 Spouse or Civil Partner Consideration , , , , , , , , FOR OFFICE USE ONLY , , , , , , , , . 00 . 00 . 00 . 00 . 00 . 00 . 00 . 00
Page 1 and 2: 2012120 Form 11 Pay and File Income
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Form 11 2012 - Revenue Commissioners

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