1. Authorisation to Act as Agent

I, the undersigned, authorise YourMoneyBack, TAIN 76205U, with an address of Kilberry, Athy, Co. Kildare, to act
as my agent with dealing with all aspects of the filing of my Irish income tax returns.

I confirm that all documentary evidence of entitlement to credit/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 either myself or YourMoneyBack.

I confirm that this authorisation will remain in force until Revenue is formally notified of its cessation by either
myself or YourMoneyBack.

2. Authorisation for Agent to receive funds 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
YourMoneyBack.

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

Bank: Allied Irish Bank                                                     Name: Your Money Back Client Account
IBAN: IE52AIBK93310449681338                                     BIC: AIBKIE2D

I understand that any refund made by the Revenue Commissioners to my agent, YourMoneyBack, 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.
I understand that YourMoneyBack is acting as my agent and is solely responsible to me in respect of any refund
received by them on my behalf. I further understand that my agent YourMoneyBack 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 dealing with them.
I understand and agree that YourMoneyBack will input its own bank account details on the Revenue records 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 YourMoneyBack 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 YourMoneyBack to support any refund, credit claims
or claims for allowances and reliefs made to Revenue on my behalf by YourMoneyBack.

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

I understand that YourMoneyBack 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 YourMoneyBack will be required to
produce same to Revenue upon request.