NI119A - 2021 - Tax Documents
NI119A - 2021 - Tax Documents
This is a copy of the return, or amendment, including any supplementary pages and
attachments for you to review and approve prior to submission to HM Revenue &
Customs (HMRC).
Where the return includes nomination details for a repayment to be sent to a bank,
building society, other nominee or charity, this will be taken by HMRC to be formal
approval of the nomination.
The HM Revenue & Customs HMRCmark assigned to your 2021 tax return and
which appears on each page of this copy is:
MVUVIAZRY56KB2ORW6WJ5OAC5425L6TN
____________________________________________________________________
Declaration
The information I have given in this tax return, any supplementary pages and
attachments is correct and complete to the best of my knowledge and belief and I
approve its transmission to HM Revenue & Customs using the Self Assessment
Online Service.
..................................................................... ....................................................................
Signed Date
UTR 8487332660
NINO JT340175D Issue address
Employer reference
Mr. Richard Silvester
Date 06 April 2021
37 Racecourse Road
HM Revenue and Customs office address Wilmslow
Cheshire
Wear & South Tyne Area
SK9 5LG
Gilbridge House
High Street West
SUNDERLAND
SR1 3HL
2 8 0 9 1 9 8 1
4 our National Insurance number – leave blank if the
Y
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 J T 3 4 0 1 7 5 D
address below DD MM YYYY
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? Yes No
Yes No
£ • 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
£ 1 2 0 0 0 • 0 0
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
£ • 0 0
£ • 0 0 £ • 0 0
Charitable giving
5 Gift Aid payments made in the year to 5 April 2021 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
£ • 0 0 £ • 0 0
8
Gift Aid payments made after 5 April 2021 but to 12 Gift Aid payments to non-UK charities in box 5
be treated as if made in the year to 5 April 2021
£ • 0 0
£ • 0 0
SA100 202
2021 Page TR 4
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 2021, 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
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 2021 stopped getting all Child Benefit payments
if this was before 6 April 2021
£ • 0 0
DD MM YYYY
Marriage Allowance
Please read the notes. If your income for the year ended 5 April 2021 was less than £12,500 you can transfer £1,250
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
£ • 0 0
2 If you owe less than £3,000 for the 2020–21 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 2021–22
tax return by 31 October, or 30 December 2021 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 2021–22 tax code.
wages or pension by adjusting your 2022–23 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
12 Nominee’s address
6 Branch sort code
4 0 — 4 7 — 4 1
7 Account number
8 1 0 3 0 2 1 3
13 and postcode
8 Building society reference number
15 Your tax adviser’s name 17 The first line of their address including the postcode
0 1 2 0 7 2 3 4 2 0 3
18 The reference your adviser uses for you
N I 1 1 9 A
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
Signature
Richard Silvester 8 4 8 7 3 3 2 6 6 0
For help filling in this form, go to www.gov.uk/taxreturnforms and read the notes and helpsheets.
£ 1 2 4 9 9 • 0 0
6.1 If you ceased being a director before 6 April 2021, put the
2 UK tax taken off pay in box 1 date the directorship ceased in the box DD MM YYYY
£ • 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
Infogr8 Limited 8.1 If box 1 includes any disguised remuneration income,
put ‘X’ in the box – read the notes
£ • 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
£ • 0 0 £ • 0 0
£ • 0 0 £ • 0 0
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
£ • 0 0
6.1 If you ceased being a director before 6 April 2021, put the
2 UK tax taken off pay in box 1 date the directorship ceased in the box DD MM YYYY
£ • 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
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
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
£ • 0 0 £ • 0 0
£ • 0 0 £ • 0 0
Share schemes, employment lump sums, compensation, deductions and Seafarers’ Earnings Deduction are on the
‘Additional information’ pages.
Richard Silvester 8 4 8 7 3 3 2 6 6 0
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 2020–21. 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
£ 0 • 0 0
£ 7 4 9 • 9 2 4.1 Class 2 NICs due
2
Total tax (this may include Student Loan or Postgraduate
£ 0 • 0 0
Loan repayments), Class 2 NICs and Class 4 NICs overpaid
5 Capital Gains Tax due
£ •
£ •
£ •
7 Underpaid tax for earlier years included in your 8 Underpaid tax for 2020–21 included in your tax code
tax code for 2020–21 – enter the amount shown as for 2021–22 – enter the amount shown as ‘estimated
‘amount of underpaid tax for earlier years’ from underpayment for 2020–21’ from your P2, ‘PAYE
your P2, ‘PAYE Coding Notice’ 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 2021–22.
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
14 Increase in tax due because of adjustments to 15 Decrease in tax due because of adjustments to
an earlier year an earlier year
£ • £ •
£ •
31 January 2022
Balancing payment for tax year to 5 April 2021 749.92