Paragraph 10 I1

the name and address of the policy holder;

any unique identifying designation given to the policy or contract in connection with which the relevant event has occurred;

the date and nature of the relevant event;

the amount of the gain;

the number of years relevant for computing the appropriate fraction of the gain for the purposes of section F1536, apart from section 536(7), of ITTOIA 2005;

whether the policy holder is to be treated as having paid income tax at the basic F2... rate on the amount of the gain in accordance with F3530, apart from section 528, of ITTOIA 2005.