P161 - Age-related Allowance Claim form

Your current employment income
Continue on a separate sheet of paper if necessary.
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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
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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)
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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
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The information I have given on this form is correct and complete to the best of my knowledge and belief.
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£
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Please send the completed form to us at the address
shown at the top of page 1.
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