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    Your Tax Number Your Name Accounting Period - Start Accounting Period - End

    Name / Surname(Individual) First Name (Individual)

    o n

    Account

    (Y/N)

    Payee Tax Reference

    Number Address Line 1 Address Line 2 Address Line 3 Address Line 4

    (Please see notes in attached sheet before completing this return)

    Form 8B-B Return of Third Party Information by Intermediaries

    THIRD PARTY INFORMATION

    Your Address

    Details of INTERMEDIARY (acting in or in connection with the Opening ofForeign Accounts with Deposit Holders)

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    Name

    Business Address

    Line 1

    Business Address

    Line 2

    Business Address

    Line 3

    Business Address

    Line 4

    Name of Deposit Holder

    (e.g. Bank, etc.)

    Deposit Holder

    Address Line 1

    Deposit Holde

    Address Line

    DETAILS OF DEPOBUSINESS INFORMATION (if a business)

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    NOTESThis is covered by Section 895 of the TCA 1997

    Form 8B-B should be completed by persons who, in the ordinary course of their trade or business, provide a service whereby

    they act as intermediaries on behalf of Irish* residents in, or in connection with, the opening of foreign accounts with banks or

    other financial institutions.

    * Where a person operates from a business address or a private address in the State, he/she should be regarded as an Irish

    resident.

    Returns by Financial Institutions paying or crediting interest should be made on Form 8B-A which is available on

    Revenues website www.revenue.ie, from Revenue's Forms and Leaflets Service at LoCall 1890 306 706 (Republic of

    Ireland only) or from any Revenue office.

    AuditThis return may be subjected to an Audit by Revenue. The law provides that Revenue may make enquiries or take such

    actions as are considered necessary to verify the accuracy of a return.

    PenaltiesThe law provides for penalties for -

    Failure to make a return

    The making of a false return

    Helping to make a false return.

    These include -

    PENALTIES from 2,535; or

    FINES up to 126,970; and/or

    IMPRISONMENT

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    NOTICEIn accordance with the requirements of Section 895 Taxes Consolidation

    Act 1997 this return should be completed by:

    Companies for their accounting period and returned no later than nine months

    from the end of the accounting period.

    Where the accounts are normally made up to a date other than 31 December,the return may be made by reference to the date in the chargeable period to

    which the accounts are prepared.

    Completed forms should be returned to your local Revenue office. If you are

    unsure of the correct return address use the Contact Locator on Revenues

    website www.revenue.ie

    http://www.revenue.ie/http://www.revenue.ie/http://www.revenue.ie/http://www.revenue.ie/http://www.revenue.ie/http://www.revenue.ie/