E104 form ireland 2026

The document is a request form for Irish social insurance records, specifically for forms E104 and E301. It requires personal information such as name, PPS number, nationality, dates of birth and travel, contact details, and employment history. The document outlines the necessary items needed for the application, including P45 and P60 forms, and notes that delays may occur due to employer inquiries. It also explains the purpose of the E301 and E104 forms in relation to claiming benefits in other countries under EC Regulations.

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Click ‘Get Form’ to open the e104 form in our editor.
Begin by entering your full name in the designated field, ensuring clarity and accuracy.
Input your Personal Public Service Number (PPS No.), which is essential for identification.
Fill in your nationality and date of birth, using the format provided to avoid errors.
Provide the date of intended departure from Ireland and the date of entry into Ireland, ensuring all dates are correct.
Enter your forwarding address and Irish address clearly, along with a contact phone number for follow-up.
List details of your Irish employers, including names, addresses, job titles, and employment periods.
Attach any required documents such as P45 or P60 forms by uploading them directly through our platform for easy submission.

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