Seafarer 2 minute Questionnaire

First Name *

Last Name *

Address Line 1*

Address Line 2 *

City *

County *

Country *

Postcode

Date of Birth

Email *

Telephone *

Skype Address

How would you prefer us to contact you? *
EmailTelephoneSkypeOther
PPS Number

Job Description

Employment Status
EmployedSelf-EmployedA Combination of Both
Are you registered as a self-employed person in Ireland
YesNoDon't Know
What is the last year you paid Irish tax

In 2018, Where were you working outside of Ireland? List the location of each job and the duration of time (in days) you spent working there

Job 1

Location
Duration

Job 2

Location
Duration

Job 3

Location
Duration

Job 4

Location
Duration

Job 5

Location
Duration

Job 6

Location
Duration

Job 7

Location
Duration

Job 8

Location
Duration

Job 9

Location
Duration

Job 10

Location
Duration

In each of the below years, can you insert the total days you were completely outside of Ireland for each of the listed years. 

2019 (Expected)

2018

2017

2016

2015

2014

2013

2012

What were you doing before you started working outside of Ireland
Self-EmployedPAYE Earner (Employee)Other
Other

What is the name of your current employer or the company who pays your current income

Where is this individual/company based (where is it's head office)

How often do you get paid

What payment method is used

Do you receive proof of earnings from your employer, such as a payslip
YesNo
Is there tax deducted from your earnings?
YesNo
Is there National Insurance or PRSI deducted from your earnings?
YesNo
At a guess, how much do you expect to earn in 2019

Do you have a log or discharge book for your trips outside Ireland for the company or individual you work for?
YesNo

Are you married *
YesNo

Have you an accountant at present? *
YesNo

If you were living outside Ireland when working, what address did you stat at in each particular tax year?

Do you have a Foreign Tax Number in any other country?