For your records only. Do not send to the Inland Revenue.

Name and address: F O'GORMAN 6 Eddeys Lane Headley Down BORDON Hampshire GU35 8HU

Forms Selected

Main Form     Employment Number of forms Self-Employment Number of forms Partnership Number of forms Land & Property

Q10 I received income from UK savings and investments.

Interest
Interest from UK banks, building societies and deposit takers
-  bank, building society etc interest that has not had tax taken off.							10.1	£	Taxable amount
-  taxed bank or building society etc interest.
	10.2	£	Amount after tax deducted	10.3	£	Tax deducted	10.4	£	Gross amount before tax
Interest distributions from UK authorised unit trusts and open-ended investment companies
	10.5	£	Amount after tax deducted	10.6	£	Tax deducted	10.7	£	Gross amount before tax
National Savings (other than FIRST Option Bonds and Fixed Rate Savings Bonds and the first £70 of interest from a National Savings Ordinary Account)							10.8	£	Taxable amount
National Savings & Investments First Option Bonds and Fixed Rate Savings Bonds
	10.9	£	Amount after tax deducted	10.10	£	Tax deducted	10.11	£	Gross amount before tax
Other income from UK savings and investments (except dividends)
	10.12	£	Amount after tax deducted	10.13	£	Tax deducted	10.14	£	Gross amount before tax
Dividends
Dividends and other qualifying distributions from UK companies
	10.15	£	Dividend/distribution	10.16	£	Tax credit	10.17	£	Dividend/distribution plus credit
Dividend distributions from UK authorised unit trusts and open-ended investment companies
	10.18	£	Dividend/distribution	10.19	£	Tax credit	10.20	£	Dividend/distribution plus credit
Scrip dividends from UK companies
	10.21	£	Dividend	10.22	£	Notional tax	10.23	£	Dividend plus notional tax
Non-qualifying distributions and loans written off
	10.24	£	Distribution/loan	10.25	£	Notional tax	10.26	£	Taxable amount
Q11 I received a taxable UK pension, retirement annuity or Social Security benefit.
State pensions and benefits
							Taxable amount for 2002-03
State Retirement Pension							11.1	£
Widow's Pension or Bereavement Allowance							11.2	£
Widowed Mother's Allowance or Widowed Parent's Allowance							11.3	£
Industrial Death Benefit Pension							11.4	£
Jobseeker's Allowance							11.5	£
Invalid Care Allowance							11.6	£
Statutory Sick Pay and Statutory Maternity Pay paid by the Inland Revenue							11.7	£
Taxable Incapacity Benefit				11.8	£	Tax deducted	11.9	£	Gross amount before tax
Other pensions and retirement annuities
Pensions (other than State pensions) and retirement annuities
	11.10	£	Amount after tax deducted	11.11	£	Tax deducted	11.12	£	Gross amount before tax
Deduction							11.13	£	Amount of deduction
Q12 I made gains on UK life insurance policies, life annuities or capital redemption policies or received refunds of surplus funds from additional voluntary contributions.
Gains on UK annuities and friendly societies' life insurance policies where no tax is treated as paid
	12.1		Number of years				12.2	£	Amount of gain(s)
Gains on UK life insurance policies etc. on which tax is treated as paid
	12.3		Number of years	12.4	£	Tax treated as paid	12.5	£	Amount of gain(s)
Gains on life insurance policies in ISAs that have been voided
	12.6		Number of years	12.7	£	Tax deducted	12.8	£	Amount of gain(s)
Corresponding deficiency relief
	12.9	£	Amount
Refunds of surplus funds from additional voluntary contributions
	12.10	£	Amount received	12.11	£	Notional tax	12.12	£	Amount plus notional tax
Q13 I received other taxable income which I have not already entered elsewhere in my Tax Return.
Other taxable income
	13.1	£	Amount after tax deducted	13.2	£	Tax deducted	13.3	£	Amount before tax
Tick 13.1A if box 13.1 includes enhanced capital allowances for environmentally friendly expenditure							13.1A
	13.4	£	Losses brought forward	13.5	£	Earlier years' losses used in 2002-03	13.6	£	2002-03 losses carried forward
Reliefs for the Year Ended 5 April 2003
Q14 I want to claim relief for pension contributions.
Payments to your retirement annuity contracts
	14.1	£	Qualifying payments made in 2002-03	14.2	£	2002-03 payments used in an earlier year	14.3	£	2002-03 payments now to be carried back
	14.4	£	Payments brought back from 2003-04	14.5	£	Relief claimed (14.1 minus (14.2 and 14.3, but not 14.4))
Payments to your personal pension (including stakeholder pension) contracts
	14.6	£	Gross qualifying payments made in 2002-03	14.7	£	2002-03 gross payments carried back to 2001-02	14.8	£	Gross qualifying payments made between 6 April 2003 and 31 January 2004 brought back to 2002-03
	14.9	£	Relief claimed (14.6 minus 14.7, but not 14.8)
Contributions to other pension schemes & Free-Standing AVC schemes
	14.10	£	Amount of contributions to employer's schemes not deducted at source from pay	14.11	£	Gross amount of Free-Standing AVC's paid in 2002-03
Q15 I want to claim one or more of the following reliefs.
Interest eligible for relief on qualifying loans							15.1	£
Maintenance or alimony payments you have made under a court order, Child Support Agency assessment or legally binding order or agreement							15.2	£	Amount claimed up to £2,110
To claim this relief, either you or your former spouse must have been 65 or over on 5 April 2000.							15.2A		Former spouse's date of birth
Subscriptions for Venture Capital Trust shares (up to £100,000)							15.3	£	Amount on which relief is claimed
Subscriptions under the Enterprise Investment Scheme (up to £150,000)							15.4	£	Amount on which relief is claimed
Community Investment Tax relief - invested amount relating to previous tax year(s) and on which relief is due				15.5	£		Total amount on which relief is claimed
Community Investment Tax relief - invested amount for current tax year				15.6	£		15.7	£	box 15.5 + box 15.6
Post-cessation expenses, pre-incorporation losses brought forward and losses on relevant discounted securities, etc							15.8	£	Amount of payment
Annuities and annual payments							15.9	£	Payments made
Payments to a trade union or friendly society for death benefits							15.10	£	Half amount of payment
Payment to your employer's compulsory widow's, widower's or orphan's benefit scheme							15.11	£	Relief claimed
Relief claimed on a qualifying distribution on the redemption of bonus shares or securities							15.12	£	Relief claimed
Q15A I want to claim relief on gifts to charity.
Gift Aid and payments under charitable covenants made between 6 April 2002 and 5 April 2003							15A.1	£
Total of any 'one off' payments included in box 15A.1							15A.2	£
Amount of Gift Aid payments made after 5 April 2003 but treated as if made in the tax year 2002-03							15A.3	£
Gifts of qualifying investments to charities - shares and securities							15A.4	£
Gifts of qualifying investments to charities - real property							15A.5	£
Allowances for the Year Ended 5 April 2003
Q16 I want to claim:     Blind person's allowance     Married couple's allowance     Children's Tax Credit     Transfer allowance to or from spouse
Blind person's allowance
	16.1		Date of registration (if first year of claim)	16.2		Local authority (or other register)
Married couple's allowance
	16.3		Date of birth (if born before 6 April 1935)	16.4		Spouse's date of birth (if born before 6 April 1935 and if older than you)
				16.5		Wife's full name	16.6		Date of marriage (if after 5 April 2002)
Tick box 16.7, or box 16.8, if you or your wife have allocated half, or all, of the minimum amount of the allowance to her				16.7		Half	16.8		All
The date of birth of any previous wife with whom you lived at any time during 2002-03							16.9
Tick box 16.10, or box 16.11, if you or your husband have allocated half, or all, of the minimum amount of the allowance to you				16.10		Half	16.11		All
				16.12		Husband's full name	16.13		Date of marriage (if after 5 April 2002)
Children's Tax Credit
The date of birth of a child living with you who was born on or after 6 April 1986							16.14
Tick 16.15 if the child was your own child or one you looked after at your own expense							16.15
Tick 16.16 if the child lived with you throughout the year to 5 April 2003							16.16
If the child lived with you for only part of the year, your share in £s that you have agreed with any other claimants that you may claim for this child							16.17	£
				16.18		Your partner's surname	16.19		Your partner's National Insurance number
Tick 16.20 if you had the higher income in the year to 5 April 2003							16.20
Tick 16.21 if your partner had the higher income in that year							16.21
Tick 16.22 if either of you were chargeable to tax above the basic rate limit in the year to 5 April 2003							16.22
I had the higher income and I am claiming all of our entitlement to CTC							16.23
We are both making separate claims for half of our entitlement to CTC							16.24
We elected before 6 April 2002 or during the year to 5 April 2003, for the partner with the lower income to claim all of our entitlement to CTC							16.25
If you separated from, or started living with, your partner in the year to 5 April 2003, enter the amount of CTC you are claiming							16.26	£
Transfer of surplus allowances
Tick 16.27 if you want your spouse to have your unused allowances							16.27
Tick 16.28 if you want to have your spouse's unused allowances							16.28
Tick 16.29 if you want to have your partner's unused CTC							16.29
Tick 16.30 if your surplus CTC should be transferred to your partner							16.30
The amount of the surplus allowance you can have:
	16.31	£	Blind person's surplus allowance	16.32	£	Married couple's surplus allowance	16.33	£	Surplus CTC
Other Information for the Year Ended 5 April 2003
Q17 I am liable to make Student Loan Repayments for 2002/2003 on an Income Contingent Student Loan.
Q18 I want to calculate my tax and, if appropriate, any Student Loan Repayment.
	18.1	£	Unpaid tax for earlier years included in your tax code for 2002-03	18.2	£	Tax due for 2002-03 included in your tax code for a later year	18.2A	£	Student Loan Repayment due
Total tax, Class 4 NIC and Student Loan Repayment due for 2002-03 before you made any payments on account							18.3	£
	18.4	£	Tax due for earlier years	18.5	£	Tax overpaid for earlier years	18.7	£	Your first payment on account for 2003-04
Tick 18.6 if you are claiming to reduce your 2003-04 payments on account							18.6
Any 2003-04 tax you are reclaiming now							18.8	£
Q19 I want to claim a repayment if I have paid too much tax.
Repayment direct into a bank or building society account
Should the repayment be sent:
to your bank or building society account?							19.1
to your nominee's bank or building society account?							19.2
Name of bank or building society				19.3
				19.4		Branch sort code	19.5		Account number
				19.6		Name of account holder	19.7		Building society ref.
Repayment by cheque
Should the cheque be sent:
to you, at the address on the front page?							19.8A
to your nominee?							19.8B
My nominee is my agent							19.9A
Agent's reference for you (if your agent is your nominee)							19.9
I authorise				19.10		Name of your nominee/agent
- Nominee/agent address				19.11
						to receive on my behalf the amount due
Q20 I have already had 2002-03 tax refunded or set off by my Inland Revenue office or the Benefits Agency (in Northern Ireland, the Social Security Agency).
- If yes, enter the amount of the refund in 20.1							20.1	£
Q21 My name or address on the front of the Tax Return is wrong.
Q22    Please give other personal details
	22.1 Your daytime telephone number 22.2 Your agent's telephone number 22.3 and their name and address 22.4 Your first two forenames 22.5 Say if you are single, married, widowed, divorced or separated 22.6 Your date of birth 22.7 Your National Insurance number
Q23    Please tick 23.1 to 23.4 if they apply. Provide any additional information in box 23.5 below
Tick 23.1 if you do not want any tax you owe for 2002-03 collected through your tax code							23.1
Tick 23.2 if this Tax Return contains figures that are provisional because you do not yet have final figures							23.2
Tick 23.3 if you are claiming relief now for 2003-04 trading, or certain capital, losses							23.3
Tick 23.4 if you are claiming to have post-cessation or other business receipts taxed as income of an earlier year							23.4
23.5 Additional Information
23.5 Additional Information Continued
Q24    Declaration
	24.1	The information I have given in this Tax Return is correct and complete to the best of my knowledge and belief. I understand that if false information is given or any income or chargeable gains are concealed, financial penalties may be charged and/or prosecution may follow.

Bank/Building Society etc   Account number   Amount after tax   Tax deducted   Gross before tax   1   £   £   £   2   £   £   £   3   £   £   £   4   £   £   £   5   £   £   £   6   £   £   £   7   £   £   £   8   £   £   £   9   £   £   £   10   £   £   £   Totals   10.2  £   10.3  £   10.4  £

The total amounts have been rounded to your benefit.

Details of employer
	Employer's PAYE reference	1.1
	Employer's name	1.2
	Date employment started (only if between 6 April 2002 and 5 April 2003)						1.3
	Date employment finished (only if between 6 April 2002 and 5 April 2003)						1.4
	Employer's address	1.5
	Tick 1.6 if you were a director of the company	1.6				And, if so, was it a close company	1.7
Income from employment

Money
Payments from P60 (or P45)							1.8	£	Before tax
Payments not on P60 etc.			- tips				1.9	£
			- other payments (excluding expenses entered below and lump sums and compensation payments or benefits entered overleaf)				1.10	£
UK tax deducted from payments in boxes 1.8 to 1.10							1.11	£	Tax deducted
Benefits and expenses
Assets transferred/ payments made for you			1.12	£	Amount	Vouchers, credit cards and tokens	1.13	£	Amount
Living accommodation			1.14	£	Amount	Mileage allowance	1.15	£	Amount
Company cars			1.16	£	Amount	Fuel for company cars	1.17	£	Amount
Vans			1.18	£	Amount	Interest-free and low-interest loans	1.19	£	Amount
box 1.20 not used
Private medical or dental insurance			1.21	£	Amount	Other benefits	1.22	£	Amount
Expenses payments received and balancing charges			1.23	£	Amount
Lump sums and compensation payments or benefits including such payments and benefits from a former employer
Reliefs
£30,000 exemption			1.24	£		Foreign service and disability	1.25	£
Retirement and death lump sums			1.26	£
Taxable lump sums
From box B of Help Sheet IR204			1.27	£		From box K of Help Sheet IR204	1.28	£
From box L of Help Sheet IR204			1.29	£		Tax deducted from payments in boxes 1.27 to 1.29	1.30	£
Foreign earnings not taxable in the UK in the year ended 5 April 2003							1.31	£
Expenses you incurred in doing your job
Travel and subsistence costs			1.32	£		Fixed deductions for expenses	1.33	£
Professional fees and subscriptions			1.34	£		Other expenses and capital allowances	1.35	£
Tick 1.36 if the figure in box 1.32 includes travel between your home and a permanent workplace							1.36
Foreign Earnings Deduction (seafarers only)							1.37	£
Foreign tax for which tax credit relief not claimed							1.38	£
Student Loans
Student Loans repaid by deduction by employer							1.39	£
Tick box 1.39A if your income is under Repayment of Teachers' Loans Scheme							1.39A
1.40 Additional Information

Tax Calculation for the year ended 5 April 2003

Income Employments and Directorships (PAYE) minus expenses         £  4,400.00 UK Interest (before tax)         £  277.00 UK Dividends & tax credits         £  13.00 Total Income         £  4,690.00  Minus deductions and allowances Personal Allowance         £  4,615.00 Total Deductions and Allowances         £  4,615.00 Taxable Income         £  75.00  How SA Online has calculated your Income Tax Savings (other than Dividend income) etc. £  62.00   @ 10% = £  6.20 Dividend Income etc. £  13.00   @ 10% = £  1.30 Taxable Income £  75.00         Income Tax         £  7.50 Income Tax due after Allowances and Reliefs (A)         £  7.50 minus Non-Payable Tax Credits on Dividends             1.30 plus Class 4 National Insurance Contributions         £  0.00 Income Tax and Class 4 National Insurance Contributions         £  6.20 minus Tax Deducted at Source from             Employments and Directorships (PAYE) £  764.00         UK Interest £  56.00         Total tax deducted at source         £  820.00 Income Tax overpaid         £  813.80 Estimated overpayment at 31 January 2004             2002-03 balancing credit         £  -813.80 First Payment on Account for 2003-2004         £  0.00 Total Overpaid         £  -813.80 (The 'Total Due' does not take account of any payments already made to cover this liability, unless you have entered details of payments made in box 18.8A. The 'Total Due' also does not include any other liabilities that may be outstanding).