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Form 1 F D Dividends Arising Outside the Republic of Ireland and the United Kingdom Revenue
Controlled in the State. I undertake to inform you if I become so resident for any year. Signature of owner Name in block letters Address Date RPC004718ENWBL1 DD/MM/YYYY Resident in Ireland - Individuals An individual is resident in Ireland for tax purposes if s/he is present in the State for 183 days in the current tax year or 280 days between the current tax year and the preceding year. I hereby declare that I am not resident in the Republic of Ireland for the purposes of Income Tax or...
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