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HM Revenue & Customs

Tax Return for the year ended 5 April 2022.
This is a copy of the information that will be transmitted to the HM Revenue & Customs once authorised by you. The
copy includes all completed supplementary pages & attachments. Before transmitting the return (or amendment)
information to HM Revenue & Customs using the Self Assessment Online Service, your tax adviser must provide you
with a copy of your tax return (or amended tax return) information for you to declare that the information is correct and
complete to the best of your knowledge and belief and approve submission to HM Revenue & Customs. If you give
false information or conceal any part of your income or chargeable gains you may be liable to financial penalties. It is
recommended that you retain a copy of the Tax Return (or amended tax return information) transmitted to HMRC.

The HM Revenue & Customs IRmark number assigned to your tax return information is:
5KIX6DRQZKPCXGNMIURJJNP32DFBTUCU
This number appears on each page of this copy, which is consecutively numbered from 1 to 14
The following details comprise the information to be sent electronically.

Name UTR NI Number Agent Reference

Mr VERONICA LUPOAE 1177380105 SY 43 79 16 A L48

Where your Tax Return (or amended Tax Return) contains a claim for a repayment and you require the repayment to
be sent to your bank, building society or other nominee, the relevant question within the return (or amended return)
must be completed.

Your signature confirms you have authorised HM Revenue & Customs to make any repayment arising from this return
to the nominee as detailed above.

Signature ____________________________________________________ Date ________/________/____________

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Tax Return 2022

Tax year 6 April 2021 to 5 April 2022 (2021–22)

Mr VERONICA LUPOAE
UTR 1177380105
NINO SY 43 79 16 A Issue address
Employer reference
40 WATERBEACH ROAD
Date 06 April 2022
DAGENHAM
HM Revenue and Customs office address
Self Assessment
RM9 4AB
HM Revenue and Customs

BX9 1AS

For
Telephone 0300 200 3310 Reference

Your tax return

This notice requires you, by law, to make a return of your Most people file online
taxable income and capital gains, and any documents It’s quick and easy to file online. Get started by typing
requested, for the year from 6 April 2021 to 5 April 2022. www.gov.uk/log-in-file-self-assessment-tax-return into
your internet browser address bar to go directly to our
Deadlines official website.
We must receive your tax return by these dates: Do not use a search website to find HMRC services online.
• if you’re using a paper return – by 31 October 2022 If you have not sent a tax return online before, why not join
(or 3 months after the date of this notice if that’s later) the 92% of people who already do it online? It’s easy, secure
• if you’re filing a return online – by 31 January 2023 and available 24 hours a day and you can also sign up for email
(or 3 months after the date of this notice if that’s later) alerts and online messages to help you manage your tax affairs.
If your return is late you’ll be charged a £100 penalty. To file on paper, please fill in this form using the following rules:
If your return is more than 3 months late, you’ll be • enter your figures in whole pounds – ignore the pence
charged daily penalties of £10 a day. • round down income and round up expenses and tax paid,
it is to your benefit
If you pay late you’ll be charged interest and a late
• if a box does not apply, please leave it blank – do not strike
payment penalty.
through empty boxes or write anything else

Starting your tax return

Before you start to fill it in, look through your tax return to make sure there is a section for all your income and claims
– you may need some separate supplementary pages (see page TR 2 and the Tax Return notes).
For help filling in this form, go to www.gov.uk/taxreturnforms and read the notes and helpsheets.

Your personal details

1 Your date of birth – it helps get your tax right 3 Your phone number
DD MM YYYY

1 3 0 8 1 9 7 7
4 Your National Insurance number – leave blank if the
2 Your name and address – if it is different from what is correct number is shown above
on the front of this form, please write the correct details
underneath the wrong ones and put the date you changed
address below DD MM YYYY

SA100 2022 Page TR 1 HMRC 12/21

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What makes up your tax return

To make a complete return of your taxable income and gains for the year to 5 April 2022 you may need to complete some
separate supplementary pages. Answer the following questions by putting ‘X’ in the ‘Yes’ or ‘No’ box.

1 Employment 6 Trusts etc

Were you an employee, director, office holder or agency Did you receive, or are you treated as having received,
worker in the year to 5 April 2022? Please read the income from a trust, settlement or the residue of
notes before answering. Fill in a separate ‘Employment’ a deceased person’s estate? This does not include cash
page for each employment, directorship and so on. On lump sums/transfer of assets, otherwise known as capital
each ‘Employment’ page you complete, enter any other distributions, received under a will.
payments, expenses or benefits related to that employment.
Say how many ‘Employment’ pages you are completing in X
the ‘Number’ box below. Yes No

X 1 7 Capital Gains Tax summary

Yes No Number
If you sold or disposed of any assets (for example,
stocks, shares, land and property, a business), or had
2 Self-employment any chargeable gains, read the notes to decide if you
If you worked for yourself (on your ‘own account’ or in have to fill in the ‘Capital Gains Tax summary’ page.
self-employment) in the year to 5 April 2022, read the If you do, you must also provide separate computations.
notes to decide if you need to fill in the ‘Self-employment’ Do you need to fill in the ‘Capital Gains Tax summary’
pages. You may not need to if this income is up to £1,000. page and provide computations?
Do you need to fill in the ‘Self-employment’ pages?
Fill in a separate ‘Self-employment’ page for each business. X
Yes No Computation(s) provided
On each ‘Self-employment’ page you complete, enter any
payments or expenses related to that business. Say how
many businesses you had in the ‘Number’ box below. 8 Residence, remittance basis etc
(Answer ‘Yes’ if you were a ‘Name’ at Lloyd’s.) Were you, for all or part of the year to 5 April 2022,
one or more of the following:
X 1 • not resident
Yes No Number
• not domiciled in the UK and claiming the
remittance basis
3 Partnership • dual resident in the UK and another country?
Were you in a partnership? Fill in a separate ‘Partnership’
page for each partnership you were a partner in and say X
Yes No
how many partnerships you had in the ‘Number’ box below.

X 9 Additional information
Yes No Number
Some less common kinds of income and tax reliefs, for
example, Married Couple’s Allowance, Life insurance gains,
4 UK property chargeable event gains, Seafarer’s Earnings Deduction
and details of disclosed tax avoidance schemes, should
If you received income from UK property (including rents
be returned on the ‘Additional information’ pages. Do you
and other income from land you own or lease out), read the
need to fill in the ‘Additional information’ pages?
notes to decide if you need to fill in the ‘UK property’ pages.
You may not need to if this income is up to £1,000.
Do you need to fill in the ‘UK property’ pages? X
Yes No

X
Yes No If you need more pages
If you answered ‘Yes’ to any of questions 1 to 9,
5 Foreign please check to see if within this return, there’s
a page dealing with that kind of income or gain.
If you:
If there’s not, you’ll need separate supplementary
• were entitled to any foreign income
pages. Do you need to get and fill in separate
• have, or could have, received (directly or indirectly)
supplementary pages?
income, or a capital payment or benefit from a person
abroad as a result of any transfer of assets
• want to claim relief for foreign tax paid X
Yes No
read the notes to decide if you need to fill in the
‘Foreign’ pages. You may not need to if your only foreign If ‘Yes’, go to www.gov.uk/taxreturnforms
income was from land and property abroad up to £1,000. to download them.
Do you need to fill in the ‘Foreign’ pages?

X
Yes No

SA100 2022 Page TR 2

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Income
Interest and dividends from UK banks and building societies

1 Taxed UK interest – the net amount after tax has been 5 Other dividends – the amount received - read the notes
taken off - read the notes
£ • 0 0
£ • 0 0
6 Foreign dividends (up to £2,000) – the amount in sterling
2 Untaxed UK interest – amounts which have not had tax after foreign tax was taken off. Do not include this amount
taken off - read the notes in the ‘Foreign’ pages

£ • 0 0 £ • 0 0

3 Untaxed foreign interest (up to £2,000) – amounts which 7 Tax taken off foreign dividends – the sterling equivalent
have not had tax taken off - read the notes
£ • 0 0
£ • 0 0

4 Dividends from UK companies – the amount received

- read the notes

£ • 0 0

UK pensions, annuities and other state benefits received

8 State Pension – amount you were entitled to receive in the 12 Tax taken off box 11
year, not the weekly or 4-weekly amount - read the notes
£ • 0 0
£ • 0 0
13 Taxable Incapacity Benefit and contribution-based
9 State Pension lump sum – the gross amount of any Employment and Support Allowance - read the notes
lump sum - read the notes
£ • 0 0
£ • 0 0
14 Tax taken off Incapacity Benefit in box 13
10 Tax taken off box 9
£ • 0 0
£ • 0 0
15 Jobseeker’s Allowance
11 Pensions (other than State Pension), retirement
£ • 0 0
annuities and taxable lump sums treated as pensions
– the gross amount. Tax taken off goes in box 12
16 Total of any other taxable State Pensions and benefits
£ • 0 0
£ • 0 0

Other UK income not included on supplementary pages

Do not use this section for income that should be returned on supplementary pages. Share schemes, gilts, stock dividends,
life insurance gains and certain other kinds of income go on the ‘Additional information’ pages.

17 Other taxable income – before expenses and tax 20 Benefit from pre-owned assets - read the notes
taken off
£ • 0 0
£ • 0 0
21 Description of income in boxes 17 and 20 – if there’s
18 Total amount of allowable expenses – read the notes not enough space here please give details in the
‘Any other information’ box, box 19, on page TR 7
£ • 0 0

19 Any tax taken off box 17

£ • 0 0

SA100 2022 Page TR 3

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Tax reliefs
Paying into registered pension schemes and overseas pension schemes
Do not include payments you make to your employer’s pension scheme which are deducted from your pay before tax
or payments made by your employer. If your contributions and other pension inputs are more than the Annual Allowance,
you should also fill in boxes 10 to 12 on page Ai 4 of the ‘Additional information‘ pages.

1 Payments to registered pension schemes where basic 3 Payments to your employer’s scheme which were not
rate tax relief will be claimed by your pension provider deducted from your pay before tax – this will be
(called ‘relief at source’). Enter the payments and basic unusual – read the notes
rate tax
£ • 0 0
£ • 0 0
4 Payments to an overseas pension scheme, which is not
2 Payments to a retirement annuity contract where basic UK-registered, which are eligible for tax relief and were
rate tax relief will not be claimed by your provider not deducted from your pay before tax

£ • 0 0 £ • 0 0

Charitable giving
5 Gift Aid payments made in the year to 5 April 2022 9 Value of qualifying shares or securities gifted to charity

£ • 0 0 £ • 0 0

6 Total of any ‘one-off’ payments in box 5 10 Value of qualifying land and buildings gifted to charity

£ • 0 0 £ • 0 0

7 Gift Aid payments made in the year to 5 April 2022 11 Value of qualifying investments gifted to non-UK
but treated as if made in the year to 5 April 2021 charities in boxes 9 and 10

£ • 0 0 £ • 0 0

8 Gift Aid payments made after 5 April 2022 but to 12 Gift Aid payments to non-UK charities in box 5
be treated as if made in the year to 5 April 2022
£ • 0 0
£ • 0 0

Blind Person’s Allowance

13 If you’re registered blind, or severely sight impaired, 15 If you want your spouse’s, or civil partner’s, surplus
and your name is on a local authority or other register, allowance, put ‘X’ in the box
put ‘X’ in the box

16 If you want your spouse, or civil partner, to have your

14 Enter the name of the local authority or other register surplus allowance, put ‘X’ in the box

Other less common reliefs are on the ‘Additional information’ pages.

SA100 202
2022 Page TR 4
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Student Loan and Postgraduate Loan repayments

Please read the notes before filling in boxes 1 to 3.

1 If you’ve received notification from Student Loans 2 If your employer has deducted Student Loan
Company that your repayment of an Income Contingent repayments enter the amount deducted
Loan was due before 6 April 2022, put ‘X’ in the box.
£ • 0 0
We’ll use your plan and or loan type to calculate
amounts due
3 If your employer has deducted Postgraduate Loan
repayments enter the amount deducted

£ • 0 0

High Income Child Benefit Charge

Please read the notes before filling in this section. Only fill in this section if all of the following apply:
• your income was over £50,000
• you or your partner (if you have one) got Child Benefit (this also applies if someone else claims Child Benefit
for a child who lives with you and pays you or your partner for the child’s upkeep)
• couples only – your income was higher than your partner’s

1 Enter the total amount of Child Benefit you and your 3 Enter the date that you and your partner
partner got for the year to 5 April 2022 stopped getting all Child Benefit payments
if this was before 6 April 2022
£ • 0 0
DD MM YYYY

2 Enter the number of children you and your partner

got Child Benefit for on 5 April 2022

Incorrectly claimed coronavirus support scheme payments

Please read the notes before filling in this section. Only fill in this section if you incorrectly claimed any payments from the
Coronavirus Job Retention Scheme, Eat Out to Help Out Scheme, Self-Employment Income Support Scheme (SEISS) or from
any other applicable HMRC coronavirus support scheme and you still need to tell HMRC.

1 Amount of HMRC coronavirus support scheme 2 Amount of SEISS payments incorrectly claimed
payments (other than SEISS) incorrectly claimed
£ • 0 0
£ • 0 0

Marriage Allowance
Please read the notes. If your income for the year ended 5 April 2022 was less than £12,570 you can transfer £1,260
of your Personal Allowance to your spouse or civil partner to reduce the amount of tax they pay if all of the following apply:
• you were married to, or in a civil partnership with, the same person for all or part of the tax year
• you were both born on or after 6 April 1935
• your spouse or civil partner’s income was not taxed at the higher rate
Fill in this section if you want to make the transfer:

1 Your spouse or civil partner’s first name 4 Your spouse or civil partner’s date of birth DD MM YYYY

2 Your spouse or civil partner’s last name 5 Date of marriage or civil partnership DD MM YYYY

3 Your spouse or civil partner’s National Insurance number

SA100 2021 Page TR 5

SA100 2022 Page TR 5

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Finishing your tax return

Calculating your tax – if we receive this paper tax return by 31 October 2022 or if you file online, we’ll do the
calculation for you and tell you how much you have to pay (or what your repayment will be) before 31 January 2023.
We’ll add the amount due to your Self Assessment Statement, together with any other amounts due.
Do not enter payments on account, or other payments you’ve made towards the amounts due, on your
tax return. We’ll deduct these on your Self Assessment Statement. If you want to calculate your tax, ask us for
the ‘Tax calculation summary’ pages and notes. The notes will help you work out any tax due, or repayable,
and if payments on account are necessary.

Tax refunded or set off

1 If you’ve had any 2021–22 Income Tax refunded or set off by us or Jobcentre Plus, enter the amount - read the notes

£ • 0 0

If you have not paid enough tax

We recommend you pay any tax due electronically. Read the notes.

2 If you owe less than £3,000 for the 2021–22 tax year 3 If you owe tax on savings, casual earnings and/or
(excluding Class 2 NICs) and you send us your paper the High Income Child Benefit Charge for the 2022–23
tax return by 31 October, or 30 December 2022 if you tax year, we’ll try to collect it through your wages or
file online, we’ll try to collect the tax through your pension by adjusting your 2022–23 tax code.
wages or pension by adjusting your 2023–24 tax code. If you do not want us to do this, put ‘X’ in the box
If you do not want us to do this, put ‘X’ in the box - read the notes
- read the notes
X
X

If you have paid too much tax

To claim a repayment, fill in boxes 4 to 14 below. If you paid your tax by credit or debit card, we’ll always try to repay back
to your card first before making any repayment as requested by you below. Please allow up to 4 weeks for any repayment
to reach you before contacting us.

4 Name of bank or building society 10 If you’ve entered a nominee’s name in box 5,

put ‘X’ in the box
HSBC

5 Name of account holder (or nominee)

11 If your nominee is your tax adviser, put ‘X’ in the box
MRS V LUPOAE

12 Nominee’s address
6 Branch sort code

4 0 — 1 0 — 0 0

7 Account number

0 2 0 7 4 0 5 2
13 and postcode
8 Building society reference number

14 To authorise your nominee to receive any repayment,

9 If you do not have a bank or building society account, you must sign in the box. A photocopy of your
or if you want us to send a cheque to you or to your signature will not do
nominee, put ‘X’ in the box

SA100 2022 Page TR 6

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Your tax adviser, if you have one

This section is optional. Please read the notes about authorising your tax adviser.

15 Your tax adviser’s name 17 The first line of their address including the postcode

16 Their phone number Postcode

18 The reference your adviser uses for you

L48

Any other information

19 Please give any other information in this space

SA100 2022 Page TR 7

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Signing your form and sending it back

Please fill in this section and sign and date the declaration at box 22.

20 If this tax return contains provisional figures, put ‘X’ in 23 If you’ve signed on behalf of someone else, enter
the box the capacity. For example, executor, receiver

20.1 If any of your businesses received coronavirus

support payments (such as CJRS, SEISS) you must
24 Enter the name of the person you’ve signed for
put ‘X’ in the box to declare that they have been
included when calculating profits in the period of
this return

25 If you filled in boxes 23 and 24 enter your name

21 If you’re enclosing separate supplementary pages,
put ‘X’ in the box

X
26 and your address
22 Declaration
I declare that the information I’ve given on this tax return
and any supplementary pages is correct and complete to
the best of my knowledge and belief.
I understand that I may have to pay financial penalties Postcode
and face prosecution if I give false information.

Signature

Date DD MM YYYY

SA100 2022 Page TR 8

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Employment
Tax year 6 April 2021 to 5 April 2022 (2021-22)

Your name Your Unique Taxpayer Reference (UTR)

Mr VERONICA LUPOAE 1 1 7 7 3 8 0 1 0 5

For help filling in this form, go to www.gov.uk/taxreturnforms and read the notes and helpsheets.

Complete an ‘Employment’ page for each employment or directorship

1 Pay from this employment – the total from your 6 If you were a company director, put ‘X’ in the box
P45 or P60 – before tax was taken off

£ 1 0 3 4 4 • 0 0
6.1 If you ceased being a director before 6 April 2022, put the
2 UK tax taken off pay in box 1 date the directorship ceased in the box DD MM YYYY

£ 4 0 4 • 0 0

3 Tips and other payments not on your P60 7 And, if the company was a close company, put ‘X’
in the box
£ • 0 0

4 PAYE tax reference of your employer (on your P45/P60)

8 If this employment income is from inside off-payroll
0 0 0 / N
working engagements, put ‘X’ in the box – read the notes

5 Your employer’s name

site cleaning solution ltd

Benefits from your employment – use your form P11D (or equivalent information)
9 Company cars and vans 13 Goods and other assets provided by your employer

£ • 0 0 £ • 0 0

10 Fuel for company cars and vans 14 Accommodation provided by your employer

£ • 0 0 £ • 0 0

11 Private medical and dental insurance 15 Other benefits (including interest-free and low
interest loans)
£ • 0 0
£ • 0 0
12 Vouchers, credit cards and excess mileage allowance
16 Expenses payments received and balancing charges
£ • 0 0
£ • 0 0

Employment expenses
17 Business travel and subsistence expenses 19 Professional fees and subscriptions

£ 1 2 5 5 • 0 0 £ • 0 0

18 Fixed deductions for expenses 20 Other expenses and capital allowances

£ • 0 0 £ • 0 0

SA102 2022 Page E 1 HMRC 12/21

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Self-employment (short)
Tax year 6 April 2021 to 5 April 2022 (2021–22)
Please read the ‘Self-employment (short) notes’ to check if you should use this page or the ‘Self-employment (full)’ page.
For help filling in this form, go to www.gov.uk/taxreturnforms and read the notes and helpsheets.

Your name Your Unique Taxpayer Reference (UTR)

Mr VERONICA LUPOAE 1 1 7 7 3 8 0 1 0 5

Business details

1 Description of business 5 If your business started after 5 April 2021, enter the
start date DD MM YYYY
CLEANER

6 If your business ceased before 6 April 2022, enter the

2 Postcode of your business address
final date of trading DD MM YYYY

3 If your business name, description, address or postcode

7 Date your books or accounts are made up to
have changed in the last 12 months, put ‘X’ in the box
and give details in the ‘Any other information’ box of
0 5 0 4 2 0 2 2
your tax return
8 If you used cash basis, money actually received
and paid out, to calculate your income and expenses
4 If you are a foster carer or shared lives carer, put ‘X’ put ‘X’ in the box
in the box

Business income – if your annual business turnover was below £85,000

9 Your turnover – the takings, fees, sales or money earned 10 Any other business income (do not include SEISS, but
by your business. Do not include Self-Employment Income include other COVID support payments such as CJRS)
Support Scheme (SEISS) grants in this box, put them in
£ • 0 0
box 27.1 on page 2

£ 1 6 1 9 2 • 0 0 10.1 Trading income allowance – read the notes

£ • 0 0

Allowable business expenses

If your annual turnover was below £85,000 you may just put your total expenses in box 20, rather than filling in the whole section.

11 Costs of goods bought for resale or goods used 16 Accountancy, legal and other professional fees

£ 4 4 8 8 • 0 0 £ 5 5 0 • 0 0

12 Car, van and travel expenses 17 Interest and bank and credit card financial charges
– after private use proportion
£ • 0 0
£ 3 8 6 0 • 0 0
18 Phone, fax, stationery and other office costs
13 Wages, salaries and other staff costs
£ 6 8 0 • 0 0
£ • 0 0
19 Other allowable business expenses – client entertaining
14 Rent, rates, power and insurance costs costs are not an allowable expense

£ 1 8 6 0 • 0 0 £ 3 9 5 • 0 0

15 Repairs and maintenance of property and equipment 20 Total allowable expenses – total of boxes 11 to 19

£ 1 0 9 2 • 0 0 £ 1 2 9 2 5 • 0 0

SA103S 2022 Page SES 1 HMRC 12/21

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Net profit or loss

21 Net profit – if your business income is more than your 22 Or, net loss – if your expenses exceed your business
expenses (if box 9 + box 10 minus box 20 is positive) income (if box 20 minus (box 9 + box 10) is positive)

£ 3 2 6 7 • 0 0 £ • 0 0

Tax allowances for certain buildings, vehicles and equipment (capital allowances)
Do not include the cost of these in your business expenses.

23 Annual Investment Allowance 25.1 The Structures and Buildings Allowance

£ • 0 0 £ • 0 0

24 Allowance for small balance of unrelieved expenditure 25.2 Freeport Structures and Buildings Allowance

£ • 0 0 £ • 0 0

24.1 Zero-emission car allowance 26 Total balancing charges – for example, where you have
disposed of items for more than their tax value
£ • 0 0
£ • 0 0
25 Other capital allowances

£ • 0 0

Calculating your taxable profits

Your taxable profit may not be the same as your net profit. Please read the ‘Self-employment (short) notes’ to see if you need
to make any adjustments and fill in the boxes which apply to arrive at your taxable profit for the year.

27 Goods and/or services for your own use 29 Loss brought forward from earlier years set off against
£ • 0 0 this year’s profits – up to the amount in box 28
£ • 0 0
27.1 Self-Employment Income Support Scheme grant
received in the year to 5 April 2022 30 Any other business income not included in box 9
£ • 0 0 or box 10
£ • 0 0
28 Net business profit for tax purposes (if box 21 + (boxes 26
to 27.1) minus (boxes 22 to 25.2) is positive). Or if you’ve
completed box 10.1 (box 21 + boxes 26 to 27.1 minus box 10.1)
£ 3 2 6 7 • 0 0

Total taxable profits or net business loss

If your total profits from all Self-employments and Partnerships for 2021–22 are less than £6,515, you do not have to pay
Class 2 National Insurance contributions, but you may want to pay voluntarily (box 36) to protect your rights to certain benefits.

31 Total taxable profits from this business 32 Net business loss for tax purposes (if boxes 22 to 25.2
(if box 28 + box 30 minus box 29 is positive). minus (box 21 + box 26 to box 27.1) is positive)

£ 3 2 6 7 • 0 0 £ • 0 0

Losses, Class 2 and Class 4 National Insurance contributions (NICs) and CIS deductions
If you’ve made a loss for tax purposes (box 32), read the ‘Self-employment (short) notes’ and fill in boxes 33 to 35 as appropriate.

33 Loss from this tax year set off against other income 36 If your total profits for 2021–22 are less
for 2021–22 than £6,515 and you choose to pay
Class 2 NICs voluntarily, put ‘X’ in the box
£ • 0 0
37 If you’re exempt from paying Class 4 NICs,
34 Loss to be carried back to previous years and set off put ‘X’ in the box
against income (or capital gains)
38 Total Construction Industry Scheme (CIS) deductions
£ • 0 0 taken from your payments by contractors
– CIS subcontractors only
35 Total loss to carry forward after all other set-offs
£ 3 2 3 9 • 0 0
– including unused losses brought forward

£ • 0 0

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Tax calculation summary

Tax year 6 April 2021 to 5 April 2022 (2021–22)

Your name Your Unique Taxpayer Reference (UTR)

Mr VERONICA LUPOAE 1 1 7 7 3 8 0 1 0 5

Self Assessment
You can use the working sheet in the ‘Tax calculation summary notes’ to work out the total tax, Student Loan repayment,
Postgraduate Loan repayment, Class 2 NICs and Class 4 NICs due or overpaid for 2021–22. If the result is a positive amount,
enter it in box 1, if it’s negative, enter it in box 2. For help filling in this form, go to www.gov.uk/taxreturnforms and read the
notes and helpsheets.

1 Total tax (this may include Student Loan or 4 Class 4 NICs due
Postgraduate Loan repayments), Class 2 NICs and
Class 4 NICs due before any payments on account
£ •

£ •
4.1 Class 2 NICs due

2 Total tax (this may include Student Loan or Postgraduate

£ •

Loan repayments), Class 2 NICs and Class 4 NICs overpaid

5 Capital Gains Tax due
£ 3 6 4 3 • 0 0
£ •

3 Student Loan repayment due

6 Pension charges due
£ •

£ •

3.1 Postgraduate Loan repayment due

£ •

Underpaid tax and other debts

If you pay tax under PAYE, look at your P2, ‘PAYE Coding Notice’ and the notes in sections 10 and 11 of the
‘Tax calculation summary notes’, then fill in boxes 7, 8 and 9 as appropriate.

7 Underpaid tax for earlier years included in your 8 Underpaid tax for 2021–22 included in your tax code
tax code for 2021–22 – enter the amount shown as for 2022–23 – enter the amount shown as ‘estimated
‘amount of underpaid tax for earlier years’ from underpayment for 2021–22’ from your P2, ‘PAYE
your P2, ‘PAYE Coding Notice’ Coding Notice’

£ • £ •

9 Outstanding debt included in your tax code for 2021–22

– enter the amount from your P2, ‘PAYE Coding Notice’

£ •

Payments on account
Please read the notes in section 12 of the ‘Tax calculation summary notes’ to see if you need to make any payments on account
for 2022–23.

10 If you’re claiming to reduce your 2022–23 payments on 11 Your first payment on account for 2022–23
account, put ‘X’ in the box – enter the reduced amount of – enter the amount (including pence)
your first payment in box 11 and say why you’re making
the claim in box 17 on page TC 2 of this form
£ •

SA110 2022 Page TC 1 HMRC 12/21

Mr VERONICA LUPOAE UTR: 1177380105 IRMark: 5KIX6DRQZKPCXGNMIURJJNP32DFBTUCU. Page 14 of 14.

Blind person’s surplus allowance and married couple’s surplus allowance

Enter the amount of any surplus allowance transferred from your spouse or civil partner.

12 Blind person’s surplus allowance you can have 13 If you or your spouse or civil partner were born before
6 April 1935, the amount of married couple’s
£ • 0 0 surplus allowance you can have

£ • 0 0

Adjustments to tax due

You may need to make an adjustment to increase or decrease your tax for 2021–22, calculated by reference to an earlier year,
because you’re claiming averaging for farmers and creators of literary or artistic work or making certain adjustments to earlier years.
If you’re carrying back certain losses from 2022–23 to 2021–22, any repayment will be in the form of a credit on your
self-assessment statement of account and set against other amounts to be paid and will not affect the figures in boxes 1 to 6
on page TC 1. If you need help in filling in these boxes, ask us or your tax adviser.

14 Increase in tax due because of adjustments to 15 Decrease in tax due because of adjustments to
an earlier year an earlier year

£ • £ •

16 Any 2022–23 repayment you’re claiming now

£ •

Any other information

17 Please give any other information in this space

SA110 2022 Page TC 2

 Mr VERONICA LUPOAE Page 1 of 4
HMRC Tax Calculation Summary - SA302
UTR: 1177380105 NINO: SY 43 79 16 A IRMark: 5KIX6DRQZKPCXGNMIURJJNP32DFBTUCU

Calculation Result for 2021-22

Name: Mr VERONICA LUPOAE
Income received (before tax taken off)

Pay from all employments £10,344.00

minus Allowable expenses £1,255.00
Total from all employments £9,089.00
Profit from self-employment £3,267.00
Total income received £12,356.00

minus

Personal Allowance £12,570.00

Total £12,570.00

Total income £0.00

How I have worked out your Income Tax

Total income on which tax has been charged £0.00

Income Tax charged after allowances and reliefs £0.00

minus Tax deducted

From all employments, UK pensions and state benefits £404.00
CIS and trading income £3,239.00
Total tax deducted £3,643.00

Income Tax overpaid £3,643.00

Page 1
 Mr VERONICA LUPOAE Page 2 of 4
Tax Payment/Repayment
UTR: 1177380105 NINO: SY 43 79 16 A IRMark: 5KIX6DRQZKPCXGNMIURJJNP32DFBTUCU

Tax Payment/Repayment Summary

Mr VERONICA LUPOAE
2021-22 Tax Position
£ £
Repayment Due (3,643.00)

Page 2
 Mr VERONICA LUPOAE Tax Year: 2021-22 Page 3 of 4
TaxCalc Tax Calculation
UTR: 1177380105 NINO: SY 43 79 16 A IRMark: 5KIX6DRQZKPCXGNMIURJJNP32DFBTUCU

Tax Summary 2021-22

Name: Mr VERONICA LUPOAE
This page gives a full summary of how your tax has been calculated as well as the payments you need to make, or the
amount you are owed.

Add up Total Income

Life
Insurance
Non-Savings Savings Dividends Gains
(non-
savings)
£ £ £ £
Employment (including Minister of Religion and MPs) 9,089.00
Self Employed 3,267.00
Total 12,356.00 0 0 0

Add up Allowances
£ £
Personal allowance 12,570.00
Total Allowances 12,570.00

Take deductions and allowances away from income in order of

priority
Deductions & Taxable
Income
Allowances Amount
£ £ £
Taxable non-savings income 12,356.00 12,356.00
Taxable foreign dividends
Taxable stock dividends
Taxable UK dividends
Taxable gains on life policies
Taxable non-savings income with notional tax
Taxable settlor interested trust income
Totals 12,356.00 12,356.00 0

Assign the taxable income to the available rate bands

Gains on life
policies
Non-savings Savings Dividends Lump sums (with
notional tax)
etc
£ £ £ £ £
Income 0 0 0 0
0 0 0 0

Calculate the tax due at each rate band

£ £
Total Income Tax Due 0

Page 3
 Mr VERONICA LUPOAE Tax Year: 2021-22 Page 4 of 4
TaxCalc Tax Calculation
UTR: 1177380105 NINO: SY 43 79 16 A IRMark: 5KIX6DRQZKPCXGNMIURJJNP32DFBTUCU

Add up tax paid

£ £
Employment (including MPs) 404.00
Total tax deducted under PAYE 404.00
Self Employment 3,239.00
3,239.00
Total tax paid at source 3,643.00

Calculate Tax Due

£ £ £
Total Income Tax Due 0

Deduct tax paid etc

Total tax paid at source 3,643.00
Total tax deduction 3,643.00
Total Income Refund Due after deductions (3,643.00)

Calculate the amount that needs to be paid

£ £
Total Tax & Class 4 Refund Due (this is your refund for the 2021-22 tax year) (3,643.00)
Total Refund Due (3,643.00)

Page 4