S.L. 123.79 Art. 10Diplomatic Missions.

(Revoked by Legal Notice 399 of 2011).

SCHEDULE A Amended L.N. (Regulation 5) INCOME TAX ACT (CAP. 123)

Application under the Residents Scheme Regulations Applicant’s Details:

Surname: Forename(s):

Maiden Surname: Nationality:

Date of Birth: Passport/Legally valid document number:

Place of Birth: Place and Date of Issue:

Father’s Name: Mother’s Name and Maiden

Marital Status: Maltese Income Tax Registration (if applicable):

Tax Identification No. in Residence country

Postal Address of Applicant: Representative’s Local Address (if applicable): .......................................................... ............................................................ .......................................................... ............................................................ .......................................................... ............................................................

Personal: Tel. No.: .............. Fax. No.: ............. E-mail: Representative Tel. No.: .............. Fax. No.: ............. E-mail: (if applicable) Details (if applicant is married)

Forename(s):

Surname: Nationality:

Birth: Passport/Legally valid identification document number: Birth: Place and Date of Issue:

Name: Mother’s Name and Maiden Surname:

Status: Maltese Income Tax Registration No. (if applicable):

dependants:

daughters under 21, parents or grandparents financially dependant on

Surname Forename Relationship Nationality Date of Birth to applicant

Documentary Evidence to be produced with this application

Checklist of Documents Attached Bankers’ Certificate or equivalent Conduct Certificate/s Marriage Certificate/s or Full Birth Certificate/s Lease Agreement or Deed of Purchase of Immovable Property Malta (where applicable) Declaration (if dependants on application include parents grandparents) Three (3) recent passport size photographs of each person mentioned on application

Declaration

I declare that: • all the information given in this application is true, complete • I am aware that the Commissioner for Revenue has the right, by law, to verify the information given on this form • I bind myself to inform immediately the Commissioner for Revenue change in circumstances by means of a new application.

Signature of applicant ..........................................................................................

Full Name and Surname: ...................................................................................... (In Block Letters)

Date ............../.........../............. SCHEDULE B

(Regulation 7)

INCOME TAX ACT

(CAP. 123) Notice of Residence to the Commissioner under the Residents Scheme Regulations

Number .........................................

Certificate No. ................................... Date ............./............../................. ............................................................. do hereby declare that I arrived and took in Malta on ............./.........../............. . My present address in Malta is ................................................................................................................................. .................................................................................................................................

accept all the conditions attached to the Residence Certificate Permit the Residents Scheme Regulations.

..................................................................................... reference/Legally Valid Identification Document No. ..................] ...............................................................................................................

tax representative.

..............................................................

full: .......................................................... ............/....................../................. SCHEDULE A Added L.N. (Regulation 2)

Localities for the purposes of the definition of "south of Malta" Birżebbuġia Cospicua

Fgura Għaxaq Gudja

Kalkara Kirkop Luqa

Marsascala Marsaxlokk Mqabba

Paola Qrendi Safi

Santa Luċija Senglea Siġġiewi

Tarxien Vittoriosa Xgħajra

Żabbar Żejtun Żurrieq