Declaration to Revenue - Authorisation Form PAYE A2

1. Authorisation to Act as Agent

I, Ion C ra nga ci (first name, surname)

PPS Number 93 0 5 9 5 5 D A Date of Birth 0 7 1 0 1 995

E-mail address
(of taxpayer) crangaci07@mail.ru (mandatory)

authorise MARIUS BUMBU (name of tax agency)

TAIN 7 6 3 5 9 B

Agent’s UNIT 93A LAGAN ROAD SIGMU

address ND BUSINESS CENTRE GLASNE
to act as my agent in dealing with all aspects of the filing of my Irish income tax return, including the
submission of refund or credit claims, allowances or reliefs.

I confirm that all documentary evidence of entitlement to credits/reliefs claimed and taxable income
sources, will be held for a period of 6 years beginning at the end of the year of assessment to which the
Return of Income and/or claim relates by (select preferred option) MARIUS BUMBU (insert
name of tax agency) OR myself ✔ . (mandatory)

I confirm that this authorisation will remain in force until Revenue is formally notified of its cessation by
MARIUS BUMBU
either myself or __________________________ (insert name of tax agency).

2. Authorisation for Agent to Receive Refunds on Behalf of Client

I authorise the transfer of any refund or repayment of PAYE/Income Levy/Universal Social Charge due to
me by the Revenue Commissioners by electronic funds transfer to the following bank account which is held
by __________________________
MARIUS BUMBU (insert name of tax agency).

Note: It is not possible to make a refund directly to a foreign back account that is not a member of the
Single Euro Payments Area (SEPA).

International Bank Account Number (IBAN) (Maximum 34 characters)

I E 7 2 A I B K 9 3 2 1 0 8 3 3 4 0 4 0 5 9

Bank Identifier Code (BIC) (Maximum 11 characters)

A I B K I E 2 D

Name of Account Holder M A R I U S B U M B U

RPC006362_EN_WB_L_1
I understand that any refund made by the Revenue Commissioners to my agent,
____________________(insert
MARIUS BUMBU name of tax agency), on my behalf is refunded in a similar manner
as if same were being refunded directly to me and that once the refund is transferred into the bank
account nominated by me I have no further call upon the Revenue Commissioners in respect of same.
MARIUS BUMBU (insert name of tax agency) is acting as my agent and is solely
I understand that _________________
responsible to me in respect of any refund received by them on my behalf. I further understand that my
MARIUS BUMBU
agent __________________________(insert name of tax agency) is an independent entity and that the
Revenue Commissioners make no endorsement of my agent or any such agency and cannot accept any
responsibility whatsoever for problems encountered by me in dealing with them.

MARIUS BUMBU
I understand and agree that __________________________ (insert name of tax agency) will input its own
bank account details on the Revenue record for the duration of this mandate and will remove these details
on the cessation of the mandate.

I confirm that I am aware of, and agree to, the payment of the fees charged by ______________________
MARIUS BUMBU
(insert name of tax agency) in respect of the services carried out on my behalf and that this fee will be
deducted from any amount refunded by Revenue and that the balance of this amount will be paid to me.

3. Terms and Conditions of Authorisation

I understand that Tax law provides for both civil penalties and criminal sanctions for the failure to make
a return, the making of a false return, facilitating the making of a false return, or claiming tax credits,
allowances or reliefs which are not due.

I confirm that I will provide the necessary documentation to ______________________________

MARIUS BUMBU (insert
name of tax agency) to support any refund, credit claims or claims for allowances and reliefs made to
Revenue on my behalf by __________________________
MARIUS BUMBU (insert name of tax agency).

I confirm that I will provide details of all my sources of income to __________________________

MARIUS BUMBU (insert
name of tax agency).

I understand that the person selected in Section 1 above is required to retain all documentation relating
to any refund or credit or allowance or relief claimed by the agent on my behalf for a period of 6 years
beginning at the end of the year of assessment to which the Return of Income and/or claim relates and that
MARIUS BUMBU
__________________________ (insert name of tax agency) will be required to produce same to Revenue
upon request.

Signed (Client) Date 0 1 0 9 2 021

Signed (Agent) Date 0 1 0 9 2 021

 AGENT LI N K NOTI FICATION , ii,,"
e-'-'
Revenue {i.
Client Name: Ion Crangaci Cdin agus Custaim na hEireann
lrish Tax and Custons
(Block Capitals)

Tax Reference Number: 9 3 0 5 9 5 5 D A

Agent TAIN: 7 6 3 5 9 B

I confirm that with effect from 01 09 2021 MARIUS BUMBU is to act as my agent in
respect of the following taxes :

TAX Please Tick as

aoprooriate

lncome Tax (inc. PAYE)

Corporation Tax

Value Added Tax (VAT)

Employer's PAYE/PRSI

Capital Gains Tax (CGT)

Relevant Contracts fax (RCT)

Environment Levy (E Levy)

Dividend Withholding Tax (DWT)

Other: Please Specify:

I understand ond accept, on my own decision, to let MARIUS BUMBU to oct as Tox Agent with full authorization in my
beholf on my ROS occount ond records.

I understond thot this does not preclude me from my responsibility to mointain appropriote/odequote books and
records and to produce such documentation as/when requested by the Office of the Revenue Commissioners.

This arrangement will remain in place until changed by either the ogent or client ond the chonge is notified to the Office
of the Revenue Commissioners.

Signed: 0 1I 0 9
Date: 2021
l.

----l
aiu,0 0- Date:0 1/ 0 9 2021

Agent Contact Details:

Name: MARIUS BUMEU Tel/Emoil : O894624363 I marius },umbu@ emall.@m