ISSUING OFFICE ADDRESS LINE 1-----X ISSUING OFFICE ADDRESS LINE 2-----X ISSUING OFFICE ADDRESS LINE 3-----X ISSUING OFFICE ADDRESS LINE 4-----X ISSUING OFFICE ADDRESS LINE 5-----X ISSUING OFFICE ADDRESS LINE 6-----X POSTCODE X
REPRINT-REFERENCE--X  
999
Unique tax reference (UTR) 
99999 99999
RECIPIENT NAME LINE 1 ------------X 
RECIPIENT NAME LINE 2 ------------X ADDRESS LINE 1 -------------------X ADDRESS LINE 2 -------------------X ADDRESS LINE 3 -------------------X ADDRESS LINE 4 -------------------X ADDRESS LINE 5 -------------------X POSTCODE X
Accounts Office reference
999PA99999999
CIS Helpline
9999 999 9999
Date
99 XXXXXXXXX 9999

## 99/99/9999 Construction Industry Scheme Contractor'S Monthly Return For Period Ending

We have received your Contractor's monthly return for the above period. There are no amounts entered on the monthly return and you have not filled in the nil declaration box on page 4. Although we have treated this as a nil return, please make sure that future returns are filled in correctly.