Fillable Claim for Fuel Grant in respect An Roinn (Irish Tax & Customs)

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Claim for Fuel Grant in respect An Roinn (Irish Tax & Customs)

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1FORM FG1
An Roinn Airgeadais
Department of Finance
Claim for Fuel Grant in respect
of fuel used in Motor Vehicles
for the Transport of Drivers &
Passengers with Disabilities
RPC013903_EN_WB_L_2
The Fuel Grant for Members of the Drivers and Passengers with Disabilities Scheme was introduced on
1 January 2015 to replace the repayment of excise duty on the fuel element of the previous Scheme.
The rates of payment of the Fuel Grant are set at €0.602 per litre of petrol, €0.495 per litre of diesel
and €0.106 per litre of liqueed petroleum gas (LPG). The fuel grant may be claimed up to an annual
maximum of 2,730 litres in respect of a driver or passenger, and up to 4,100 litres in respect of an
organisation.
The Fuel Grant form is being processed for the Minister for Finance by the Ofce of the Revenue
Commissioners. Payments will be made by Electronic Fund Transfer by the Department of Finance
following the processing of the Fuel Grant form.
How to complete an application online to claim for the Fuel Grant.
- Please go to www.revenue.ie
- Click on
- Select CLAIM FUEL GRANT
- Enter litres used.
Online processing of these forms ensures faster processing and payment.
How to complete this application form to claim for the Fuel Grant.
- Please use BLOCK LETTERS and place an X in the relevant boxes.
- Please answer all questions that apply to you. lf a question does not apply to you please leave the
answer area blank.
- lf you are an organisation you need a tax reference number before you apply.
- lf you are an individual you need a PPSN before you apply.
- Please input the amount of fuel actually used in the transportation of the person with the disability.
More information is available about the Fuel Grant and the Drivers and Passengers with Disabilities
Scheme and can be accessed by downloading the booklet VRT7 from www.revenue.ie or
www.nance.gov.ie or by contacting the Central Repayments Ofce of the Revenue Commissioners
on 01 738 3671.
Please retain your receipts for four years for verication of fuel purchased and mileage used to transport
the person with the disability. Please do not send fuel receipts with claims.
This form should be forwarded to the following address:
FREEPOST
CENTRAL REPAYMENT OFFICE,
FUEL SECTION,
REVENUE COMMISSIONERS,
M:TEK ll BUlLDlNG, ARMAGH ROAD,
MONAGHAN,
H18 YH59.
my
account
An Roinn Airgeadais
Department of Finance
Claim for Fuel Grant in respect
of fuel used in Motor Vehicles
for the Transport of Drivers &
Passengers with Disabilities
2 FORM FG1
SECTION 1 CONTACT DETAILS
IF YOU ARE A DRIVER OR CLAIMING IN RESPECT OF A PASSENGER PLEASE COMPLETE BELOW:
FORENAME:
SURNAME:
PPSN:
TELEPHONE NO.:
ADDRESS:
EIRCODE:
DETAILS OF PERSON WITH A DISABILITY (IF APPLICABLE)
FORENAME:
SURNAME:
PPSN:
3FORM FG1
An Roinn Airgeadais
Department of Finance
Claim for Fuel Grant in respect
of fuel used in Motor Vehicles
for the Transport of Drivers &
Passengers with Disabilities
SECTION 2
IF YOU ARE AN ORGANISATION PLEASE COMPLETE BELOW
ORGANISATION NAME:
TAX REF:
TAX TYPE:
TELEPHONE NO.:
ADDRESS:
EIRCODE:
SECTION 3 VEHICLE AND CLAIM DETAILS
VEHICLE REG. NO.:
FUEL TYPE: DIESEL PETROL LPG
PLEASE ENTER THE TWELVE MONTH PERIOD FOR WHICH YOU ARE CLAIMING THE FUEL GRANT:
FROM: TO:
NO. LITRES USED:
SECTION 4 VEHICLE AND CLAIM DETAILS (IF CHANGED DURING THE CLAIM PERIOD)
VEHICLE REG. NO.:
FUEL TYPE: DIESEL PETROL LPG
PLEASE ENTER THE TWELVE MONTH PERIOD FOR WHICH YOU ARE CLAIMING THE FUEL GRANT:
FROM: TO:
NO. LITRES USED:
D D M M Y Y Y Y D D M M Y Y Y Y
D D M M Y Y Y Y D D M M Y Y Y Y
An Roinn Airgeadais
Department of Finance
Claim for Fuel Grant in respect
of fuel used in Motor Vehicles
for the Transport of Drivers &
Passengers with Disabilities
4 FORM FG1
SECTION 5 BANK DETAILS (GRANTS WILL BE PAID INTO THIS ACCOUNT)
BIC:
IBAN:
Bank details must be completed
DECLARATION
I hereby apply for a Fuel Grant in respect of the number of litres used in connection with the transportation
of the person with the disability. I hereby declare that the amount of fuel used is a true and accurate
calculation, and I consent to the information contained on this form being shared with the Ofce of the
Revenue Commissioners for the purpose of processing the Fuel Grant and to the sharing of my bank
details and contact details with the Department of Finance for the purpose of paying the fuel grant.
DATE:
SIGNATURE (not block letters)
WARNING: If you make or provide information which is false or misleading for the purposes of
receiving the Fuel Grant, you may be prosecuted leading to a ne, a prison term or both.
D D M M 2 0 Y Y
The Revenue Commissioners collect taxes and duties and implement customs controls. Revenue requires
customers to provide certain personal data for these purposes and certain other statutory functions as
assigned by the Oireachtas. Your personal data may be exchanged with other Government Departments
and agencies in certain circumstances where this is provided for by law. Full details of Revenue’s data
protection policy setting out how we will use your personal data as well as information regarding your rights
as a data subject are available on our Privacy page on www.revenue.ie. Details of this policy are also
available in hard copy upon request.
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Claim for Fuel Grant in respect An Roinn (Irish Tax & Customs)

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Completed 29 July 2020

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