Application form for 30% ruling

Personal details

Name*

Name (according to your passport details)

First name Last name

Gender*

(As stated in your passport)

Male
Female

Date of birth (dd/mm/yyyy)*

Nationality*

Residence address abroad*

Residence address in country directly prior to employment in the Netherlands

Street address + house number City State / Province Postal code Country

Residence address in the Netherlands*

Residence address in the Netherlands

Street address + house number City Postal code

Your Email address*

Phone number (including country code)

Educational title*

Master
Bachelor

Dutch Citizen’s Services Identification Number (BSN).*

Residency in the prior 24 months*

Have you lived in Belgium, Germany, France, Luxembourg or The UK (Kent) two years directly prior to your current employment in the Netherlands?

Yes
No

Address details

List all the addresses you lived at during the period of two years and indicate the period during which you lived there.(use the + symbol on the right to add more addresses)

Period	Street + house number	City	Country

Previous stay in the Netherlands*

Have you ever been present in the Netherlands for more than 6 weeks in a calendar year during the 25 years directly prior to your Dutch employment for reasons of employed presence, holiday, family visits or other personal reasons?

Yes
No

Please indicate the period(s).

From	Until

Previous employment in the Netherlands*

Have you been assigned to/employed by a Dutch employer before (including board membership)?

Yes
No

Please indicate the period(s)

Please indicate the period(s) and make sure they match your curriculum vitae/resume.

From	Until

Previous working days in the Netherlands*

Have you ever worked in the Netherlands before for more than 20 days in a calendar year during the 25 years directly prior to your Dutch employment?

Yes
No

Please indicate the period(s).

From	Until

Questionnaire 30% ruling

Questionnaire 30% ruling

Step 1 of 5

Check entitlement

Data

Personal details

Employment details

Other

Documents to upload

!