Claiming back tax paid on a lump sum

About this form

If you are not a UK resident for tax purposes you do not need For more guidance you can phone Tax Help for Older
to complete this form. People on 0845 601 3321 or 01308 488 066. They’re an
Instead go to www.gov.uk/tax-foreign-income/residence or independent charity which provide free tax advice to older
phone the Taxes Helpline on 0300 200 3300. people on low incomes.

What to do now If you need a large print version of the form phone the
To make sure we repay you the right amount of tax we need Taxes Helpline on 0300 200 3300.
to know about any other income that you expect to receive If the form is filled in by someone else
during the tax year. If you do not know the final figures give If you’ve asked someone else to fill in the form, or paid a
the most accurate estimates you can. Use whole numbers, tax adviser to fill it in for you, you’re still responsible for
rounded down to the nearest pound. the entries on the form and you must sign and date the
We’ll make checks at the end of the tax year and contact you declaration. Phone us if you have any problems signing
if the amount is different. We recommend that you keep a the form.
copy of this form until the checks are complete. If you’re claiming a repayment on behalf of someone else
When you’ve filled in this form you must: Make sure you complete the relevant boxes
• sign and date the declaration in the declaration.
• attach parts 2 and 3 of your original forms P45(s) A claim can be made on behalf of:
which your pension provider should have given you • someone who is mentally incapacitated
How to fill in this form • someone who’s given you the power to act on their behalf
Fill in questions 1 to 10 below, then complete all other Claims should be made by:
questions which are relevant to you. • someone authorised by the courts to look after
Use whole numbers, rounded down to the nearest pound. the affairs of a mentally incapacitated adult
(or the Department for Work and Pensions appointee)
Make sure that you sign the declaration on page 9.
• an attorney authorised by an ordinary or general
power of attorney

About you
1 Title 6 Best time to contact you
For example Mr, Mrs, Miss, Ms or Dr

 7 Your date of birth DD MM YYYY

 2 Your surname or family name


 8 Your National Insurance number

 3 Your first name Example – QQ123456A

4 Your address  9 Your employer PAYE reference number

Example – 123/A246

/
 10 Tax year you are claiming for YYYY – YY
Postcode
—

5 Your contact telephone number

P53 Page 1 HMRC 04/19

Employment income
Enter your total pay from all employment (including any part-time work) before tax is taken off.
You should include the income you expect to receive from 6 April to 5 April of the tax year you
received your lump sum payment. If you’ve more than one job, list each employer and the
amount of expected pay from each.
If you’ve any taxable benefits such as a company car or medical insurance, you also need to include an
estimated figure for these. For more information on Tax and National Insurance on company benefits,
go to www.gov.uk/tax-company-benefits
If you’re not sure of the amount of taxable benefit that you’re going to receive, you can ask your
employer for an estimate of the amount for the tax year.

 11 Do you expect to receive income from paid employment during the tax year you’re claiming for?

No  If No, go to question 12

Yes  If Yes, fill in the table below

Employer Expected amount of Do you receive taxable Total estimated amount

income from employer benefits from this of taxable benefits
before tax employer (Y/N)

Self-employment income
Only show profits from self-employment. Paid employment should be included inquestion 11.
Tax is only paid on profits from income or earnings after any deductions for expenses or
allowances. Enter the amount before tax is taken off.

 12 Do you expect to make any self-employment profits during the tax year you are claiming for?

No  If No, go to question 14

Yes  If Yes, go to question 13

 13 Total amount of profits

£ • 0 0

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UK pension income
We’ll ask about State Pension details at question 15.
This includes income from:
• a pension from a former employer
• a public service pension
• a forces pension
• a personal pension annuity
• small pensions paid as lump sums (trivial commutation)
Enter the full amount of any UK pension income that you expect to get before tax is taken off
and the taxable part of the small pension taken as a lump sum (This will be shown on
part 1a of the form P45 that your pension provider gave you).
For more information on how your pension income is taxed, go to www.gov.uk/tax-on-pension

 14 Do you expect to receive income from any UK pension during the tax year you’re claiming for?

No  If No, go to question 15

Yes  If Yes, fill in the table below

Pension payers full name and address Full amount of any UK pension
income you expect to receive
before tax is taken off

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Taxable state benefits
The most common taxable state benefits are:
• taxable Incapacity Benefit
• Jobseeker’s Allowance
• State Pension
• taxable Employment and Support Allowance
• taxable Carer’s Allowance
If you put off claiming your State Pension and you’ve received or expect to receive a lump sum this
tax year you should include the amount in this section. For more information on benefits and a full list
of all taxable state benefits, go to www.gov.uk/income-tax/taxfree-and-taxable-state-benefits
List each type of taxable state benefit and the amount you get or expect to get separately.
To work out the amount you’ll get, multiply the amount of your regular payment by the number
of payments you expect to get in the tax year.

 15 Do you expect to receive any taxable state benefits during the tax year you’re claiming for?

No  If No, go to question 16

Yes  If Yes, fill in the table below

Name of taxable state benefit Full amount of any taxable state

benefits you expect to receive
before tax is taken off

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Taxed interest on UK savings and investment income
As well as bank and building society interest, include interest from other deposit takers
and interest paid by:
• UK authorised unit trusts (AUTs)
• open-ended investment companies (OEICs)
• National Savings and Investment products such as fixed rate Guaranteed Income or Growth Bonds
• investment trusts
• Payment Protection Insurance (PPI) compensation payments
The bank should have sent you statements showing the interest paid.
Only enter details of any interest that will be taxed before you receive it.
If you’ve a joint account only enter your share, usually 50 percent of the interest received.
These investments sometimes pay dividends. If this applies then you’ll need to answer the questions
under Dividends from UK companies. For more information on bank and building society
accounts, go to www.gov.uk/apply-tax-free-interest-on-savings

 16 Do you expect to receive taxed interest on UK savings and investment income
during the tax year you’re claiming for?

No  If No, go to question 19

Yes  If Yes, go to question 17

17 Total amount of savings interest (before tax)

£ • 0 0

18 Total tax paid

£ • 0 0

Untaxed interest on UK savings

Examples of accounts and products that may pay untaxed interest are:
• National Savings and Investment products such as
— Direct Saver
— Easy Access Savings Accounts (EASAs)
— Income Bonds
— Investment Accounts
• bank and building society accounts and other deposit takers (including where you completed an R85)
• interest paid on private loans
• interest received on Payment Protection Insurance (PPI) Compensation payments
You do not need to include tax exempt products such as ISAs in this section.
For more information about investments that give a tax-free return, go to
www.gov.uk/apply-tax-free-interest-on-savings
If you’ve a joint account only enter your share, usually 50 percent, of the interest
received and only enter interest that will not be taxed before you receive it.
If you get interest from National Savings Ordinary Accounts only enter the amount above £70.

 19 Do you expect to receive untaxed interest on UK savings during the tax year you’re claiming for?

No  If No, go to question 21

Yes  If Yes, go to question 20

20 Total amount of untaxed interest you expect to receive

£ • 0 0

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Dividends from UK companies
These include:
• UK company dividends
• stock dividends
• dividends from UK Authorised Unit Trusts (AUTs)
• Open-ended Investment Companies (OEICs)
• investment trusts
For more information on dividends, go to www.gov.uk/tax-on-dividends
Each dividend voucher will show the tax credit and dividend payable.
Enter the total of all dividends you were paid or expect to be paid.
Do not include the tax credit.

 21 Do you expect to receive dividend income from stocks and shares in the tax year you’re claiming for?

No  If No, go to question 23

Yes  If Yes, go to question 22

22 Total amount of dividend income

£ • 0 0

Any other income

This includes income from:
• property
• trusts
• commissions
• tips
• foreign income (give the type of foreign income, for example dividends)
• profits paid out on UK life insurance policies – the insurance company should have
sent you a chargeable event certificate showing this information
• any other income that you’ve not entered anywhere else on the form
For more information on trusts, go to www.gov.uk/personal-tax/trusts or
tax on foreign savings and investments, go to www.gov.uk/tax-foreign-income
Make a separate entry for each type of income. For more information on taxable and non-taxable
income at a glance, go to www.gov.uk/income-tax
If the income is a payment from a life insurance policy only enter the profit amount.
The insurance company should have sent you a chargeable event certificate showing this information.

 23 Do you expect to receive any other income in the tax year you’re claiming for?

No  If No, go to question 24

Yes  If Yes, fill in the table below

Source of any other income Full amount of other income you

expect to receive

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Gift Aid payments
The Gift Aid scheme is for gifts of money to Charities or Community Amateur Sports Clubs (CASCs).
The charity or CASC will ask you to declare that you pay UK tax and will then claim the tax back
from HM Revenue and Customs (HMRC).
If you’ve not paid tax equal to the amount the charity or CASC claims back we’ll include the difference
when we work out your repayment.
For more information on Giving to charity through Gift Aid, go to www.gov.uk/donating-to-charity/gift-aid

24 Do you expect to make any Gift Aid payments in the tax year you’re claiming for?

No  If No, go to question 27

Yes  If Yes, go to question 25

25 Total amount of Gift Aid payments you expect to make in the tax year you’re claiming for?
You should include regular payments and any one-off payments

£ • 0 0

26 Total amount of one off Gift Aid payments

Total amount of one-off Gift Aid payments included in question 25

£ • 0 0

Pension plans you pay into

Examples of pension plans include occupational schemes, Personal Pensions and Retirement Annuity Contracts.
Relief is not due on payments made after age 75. For more information on Pension Schemes, go to
www.gov.uk/business-tax/pension-scheme-administration
You do not need to tell us about pension plans you pay into through your employment if the payments
are taken from your pay before tax is deducted.

27 Do you expect to pay into any pension plans in the tax year you’re claiming for?

No  If No, complete How we’ll make your repayment

Yes  If Yes, go to question 28

28 Type of pension plan

 Retirement Annuity Contract where no relief is claimed by the pension provider

 Personal Pension where the provider already claims basic rate tax relief

 Occupational Pension where your employer takes the pension payments after calculating tax

29 Total amount you expect to pay into the pension plan

If the amount is not shown on your payment certificate or pensions records
ask your pension scheme administrator for the amount you should enter

£ • 0 0

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How we’ll make your repayment
When we’ve worked out any repayment due to you, we’ll send you a cheque. We can send this direct to you
at your home address or to your nominee’s address. The cheque can only be paid into an account held in
your name or your nominee’s.
Repayments cannot be made by the Bacs (Bankers Automated Clearing Service).

30 Where should we send the repayment to?

Your address (go to Declaration)

Your nominee’s address (go to question 31 to 33)

A nominee’s address details

31 Name of nominee  33 Nominee’s address

 32 If your nominee is your tax advisor,

enter their reference
Postcode

Declaration
I can confirm that the information on this form is correct and complete to the best of my knowledge and belief.
I enclose parts 2 and 3 of all P45 forms that I’ve received for flexibly accessed pension payments.
Self Assessment customers

I confirm I’ve read the self-assessment section on page 1 and know I must declare any
repayment received on my next tax return.

Full name Daytime telephone number (including area code)

Signature

Date DD MM YYYY

If you’ve signed on behalf of someone else, give the capacity in which you’re signing this form
Claims can be made by:
• the person authorised by the courts to look after the affairs of a mentally incapacitated adult
(or the Department for Work and Pensions appointee)
• an attorney authorised by an ordinary or general power of attorney
Tell us if you’ve signed the form as either:
• Administrator
• Executor
• Power of Attorney
• Receiver
• Trustee

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What to do now
Make sure that you attach parts 2 and 3 of your original form P45. Your pension provider should have
given you this form. We cannot deal with your claim without parts 2 and 3 of form P45.
If you’ve lost or not received your P45 ask your pension provider for duplicate details before sending
this form. If you later find the original P45, you must not give parts 2 and 3 to any new employer or
pension provider because this may affect the tax you pay at the end of the year.
Check you’ve completed all parts of the form that are relevant to you.
Check you’ve completed, signed and dated the declaration on page 9.
S end this form together with parts 2 and 3 of your
original form P45 to:
Pay As You Earn
HM Revenue and Customs
BX9 1AS

How we use your information

HM Revenue and Customs (HMRC) is a Data Controller under the Data Protection Act 1998.
We hold information for the purposes specified in our notification to the Information Commissioner,
including the assessment and collection of tax and duties, the payment of benefits and the prevention
and detection of crime, and may use this information for any of them.
We may get information about you from others, or we may give information to them. If we do, it will only
be as the law permits to:
• check the accuracy of information
• prevent or detect crime
• protect public funds
We may check information we receive about you with what is already in our records. This can include
information provided by you, as well as by others, such as other government departments or agencies
and overseas tax and customs authorities. We’ll not give information to anyone outside HMRC
unless the law permits us to do so. For more information go to hmrc.gov.uk and look for
Data Protection Act within the Search facility.
Your rights and obligations
Your Charter explains what you can expect from us and what we expect from you. For more information,
go to www.gov.uk/government/publications/your-charter

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