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Non-Resident Form V2A Dividend Withholding Tax DWT as provided for by Chapter 8A Part 6 of the Taxes Consolidation Act 1997 - the Act EXEMPTION FROM DWT FOR A Qualifying Non-Resident Individual IN RESPECT OF RELEVANT DISTRIBUTIONS Please refer to Notes on Page 2 for guidance on completing this form This exemption declaration form is valid from the date of issue of the certificate to the 31st day of December in the fifth year following the year i.

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