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                                       CORRECTIVE AFFIDAVIT (Form CA26)
                                     CAPITAL ACQUISITIONS TAX CONSOLIDATION ACT, 2003
                                (to be used where the deceased died on or after 5th December, 2001)
                                      Please complete this form in BLOCK CAPITALS using BLUE INK
                            When completed, this form in duplicate and all other relevant documentation
                           (i.e. Original Grant of Representation, Administration Bond (if necessary) should
                                       be submitted to the Probate Office/District Probate Registry.
                                    All consideration to be stated in whole Euro only and do not enter cent.
       Courts Service
                                                          All fields are mandatory
Details of the Person/Solicitor to be contacted in the event of Enquiry regarding this Affidavit

Forename

Surname

Address




Telephone No.                                                                             DX Number (if applicable)

Contact e-mail

Agent's
Reference                                                                                                TAIN                         -
Information relating to the deceased

                                                                                                        D D         M M       Y   Y   Y   Y
PPS No. of
Deceased
                                                                                        Date of Death
                                                                                                                /         /
Forename of
deceased
Surname of
deceased

Address




                                                                                                        D D         M M       Y   Y   Y   Y
Place of issue
of Grant
                                                                                        Date of Grant
                                                                                                               /          /
Details of the applicants
I/We, the Applicant(s)
Forename of
1st Applicant
Surname of
1st Applicant

Address




Occupation

Relationship to deceased


       CA26                                                       Page 1                                              1073115457
Details of the applicants
Forename of
2nd Applicant
Surname of
2nd Applicant
Address




Occupation

Relationship to deceased

Forename of
3rd Applicant
Surname of
3rd Applicant
Address




Occupation

Relationship to deceased

Sworn declaration
     I/We make oath and say as follows;-
1.   It appears that the Inland Revenue Affidavit already delivered in this deceased's estate requires correction as shown
     herein.
2.   The contents of this Affidavit are true and correct to the best of my/our knowledge, information and belief, and this
     Affidavit has been completed in accordance with the provisions of the Capital Acquisitions Tax Consolidation Act, 2003.
SWORN by
Surname of 1st Applicant                                                                                        Signature of Applicant/Deponent


Forename of 1st Applicant

At

On the                           day of

Before me, a Commissioner for Oaths/Practising Solicitor/Court Clerk
and
(Tick relevant box and Delete as appropriate)
(i) the Deponent (Applicant) is personally known to me
or
(ii) the Deponent (Applicant) has been identified to me by
     who is personally known to me

Identifier's Signature
I certify that I know the Deponent/Applicant
or
(iii) the identity of the Deponent has been established by reference to a relevant document containing a photograph

Document Type:                                                                     Issue No:


Signature Commissioner for Oaths/Practising Solicitor/Court Clerk


     WARNING: IF THE APPLICANT(S) SWEAR TO THIS AFFIDAVIT WITHOUT PERSONALLY VERIFYING THAT THE STATEMENTS IN IT ARE
     TRUE, THEY MAY MAKE THEMSELVES LIABLE TO PENALTIES.


         CA26                                                          Page 2                                                5858115452
Sworn declaration (cont.)

Surname of 2nd Applicant                                                                                        Signature of Applicant/Deponent


Forename of 2nd Applicant

At

On the                           day of

Before me, a Commissioner for Oaths/Practising Solicitor/Court Clerk
and
(Tick relevant box and Delete as appropriate)
(i) the Deponent (Applicant) is personally known to me
or
(ii) the Deponent (Applicant) has been identified to me by
     who is personally known to me

Identifier's Signature
I certify that I know the Deponent/Applicant
or
(iii) the identity of the Deponent has been established by reference to a relevant document containing a photograph

Document Type:                                                                     Issue No:


Signature Commissioner for Oaths/Practising Solicitor/Court Clerk




Surname of 3rd Applicant                                                                                        Signature of Applicant/Deponent


Forename of 3rd Applicant



At

On the                           day of

Before me, a Commissioner for Oaths/Practising Solicitor/Court Clerk
and
(Tick relevant box and Delete as appropriate)
(i) the Deponent (Applicant) is personally known to me
or
(ii) the Deponent (Applicant) has been identified to me by
     who is personally known to me

Identifier's Signature
I certify that I know the Deponent/Applicant
or
(iii) the identity of the Deponent has been established by reference to a relevant document containing a photograph

Document Type:                                                                     Issue No:


Signature Commissioner for Oaths/Practising Solicitor/Court Clerk




     WARNING: IF THE APPLICANT(S) SWEAR TO THIS AFFIDAVIT WITHOUT PERSONALLY VERIFYING THAT THE STATEMENTS IN IT ARE
     TRUE, THEY MAY MAKE THEMSELVES LIABLE TO PENALTIES.


         CA26                                                          Page 3                                                4005115455
                              All considerations to be stated in whole EURO only. Do not enter Cent
N.B. Items not needing correction should not be inserted.
PERSONAL PROPERTY AND REAL PROPERTY SITUATE IN THE STATE
Items of property in the Inland Revenue Affidavit or the last Corrective Affidavit, needing correction, and omitted property
and deductions (if any).
Description of Assets Value as last previously                          Increase/Decrease                          Value as now corrected
                      shown
                          Millions           Thousands       Hundreds    Millions       Thousands       Hundreds    Millions       Thousands       Hundreds

                                         ,               ,                          ,               ,                          ,               ,
                                         ,               ,                          ,               ,                          ,               ,
                                         ,               ,                          ,               ,                          ,               ,
                                         ,               ,                          ,               ,                          ,               ,
Description of Debts

                                         ,               ,                          ,               ,                          ,               ,
                                         ,               ,                          ,               ,                          ,               ,
                                         ,               ,                          ,               ,                          ,               ,
                                         ,               ,                          ,               ,                          ,               ,
SUMMARY OF INCREASE/DECREASE IN VALUE OF IRISH ESTATE
                         Value as last previously                       Increase/Decrease                          Value as now corrected
                         shown
Gross Irish Estate
                                         ,               ,                          ,               ,                          ,               ,
Irish Debts
                                         ,               ,                          ,               ,                          ,               ,
Net Irish Estate                         ,               ,                          ,               ,                          ,               ,
PERSONAL PROPERTY AND REAL PROPERTY OUTSIDE THE STATE
Items of property in the Inland Revenue Affidavit or the last Corrective Affidavit, needing correction, and omitted property
and deduction (if any).
Description of Assets Value as last previously                          Increase/Decrease                          Value as now corrected
                      shown

                                         ,               ,                          ,               ,                          ,               ,
                                         ,               ,                          ,               ,                          ,               ,
Description of Debts


                                         ,               ,                          ,               ,                          ,               ,
                                         ,               ,                          ,               ,                          ,               ,
CERTIFICATE OF PROBATE REGISTRAR

Fees on additional assets paid and further security given

Signature                                                                                                          Registrar
 D   D        M M       Y Y   Y      Y

         /          /
         CA26                                                             Page 4                                                    8827115451

				
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