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 and note that you have included amounts in some of the boxes, but have also completed the nil declaration box on page 4. We have treated this monthly return as one which reports payments to subcontractors and/or deductions from subcontractors. If you disagree, please call the CIS Helpline to let us know what the correct entry should be. You can also get information about filing your monthly returns online by logging on to our website at www.hmrc.gov.uk/new-cis