Claim

Full Name*

Email*

Phone Number*

Self Employed*

—Please choose an option—YesNoNot Sure

PPS of tenant/s*

Duration of the Lease*

Address*

Landlord details*

Are you in receipt of HAP/RAS or any other State Housing Support Schemes?*

Is the property RTB registered?*

Are you related to your landlord?*

Is the property Principal Private Residence?*

Is it used to work or study?*

Amount of rent paid?*

Are you an existing client of rebates.ie or taxreturned.ie?*

—Please choose an option—YesNo

Is Intax Financial Ltd linked to your ROS account?*

—Please choose an option—YesNoNot Sure

I have read & agree to the terms & conditions*