P161 - Age-related Allowance Claim form

Your tax code may need changing
Why have I been sent this form?
We have sent you this form to fill in because you are nearing,
or have reached, age 65 and you may be entitled to claim
age-related Personal Allowance.
If you are entitled to this allowance we may need to change
your tax code and this could affect the amount of tax you pay.
If you do not provide the information we have asked for,
you may pay too much, or too little, tax.
Your personal details
1 Your surname or family name
2
Your first or given name(s)
Your savings income
4
5
Taxed bank and building society interest
Total estimated interest (after tax)
£
Interest paid without tax taken off – for example
some NS&I products or where you’ve filled in form
R85 Getting your interest without tax taken off
Total estimated interest
£
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Age-related Personal Allowance
Employer PAYE reference
National Insurance number
Please use these if you write or call. It will help to avoid delay.
What should I do now?
Read the P161 Helpsheet first to help you fill in this form.
Then fill in this form for the:
• tax year in which you reach age 65, or
• current tax year, if you are already aged 65.
A tax year starts on 6 April one year and ends on 5 April
the next year.
Other formats?
If you would prefer, you can fill in this form online; go to
www.hmrc.gov.uk/p161/index.htm
Or if you want a large print copy of this form, please
phone us on the number shown above.
Your date of birth DD MM YYYY
Your daytime phone number
With joint accounts, enter only your share. Do not include any non-taxable exempt income; see P161 Helpsheet for examples.
P161 Page 1
Please continue overleaf
HMRC 04/12
Date
3
6
7
Company dividends – including dividends from unit trusts
Total estimated dividend income, excluding tax credit
£
Purchased life annuities
Total estimated taxable income
£
/
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Your current employment income
Continue on a separate sheet of paper if necessary.
8
9
10
Your employer’s name
Your employer’s PAYE reference number, if known
Your works or payroll number
Any self-employed or partnership income
Any other current taxable income
Continue on a separate sheet of paper if necessary. See P161 Helpsheet for examples of other taxable income.
Type of other taxable income Total estimated annual income (before tax)
Other changes in your income
Continue on a separate sheet of paper if necessary.
17 State Pension – Please read the statements below and put
an 'X' in one of the boxes
18
Your declaration
I am currently getting State Pension
I will get State Pension from my 65 th birthday
I will get State Pension from a future date
Adjustments affecting age-related Personal Allowance
See P161 Helpsheet for more information.
Your signature Date DD MM YYYY
Page 2
Your monthly pay (before tax), if you’re paid monthly
Your weekly pay (before tax), if you’re paid weekly
Date you intend to stop working, if applicable
14 Your Unique Tax Reference (UTR) 15 Your estimated annual net profits (before tax)
16
Tell us about any other expected future changes in your
income before the end of the tax year. For example, new
personal or company pension(s) that have not yet started
19 Gift Aid payments you expect to make 20 Personal pension contributions you expect to make
£
•
The information I have given on this form is correct and complete to the best of my knowledge and belief.
11
12
13
£
£
£
£
£
£
Please send the completed form to us at the address
shown at the top of page 1.
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