F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line...

18
FORM TA 2012 BAYARAN POS JELAS POSTAGE PAID PEJABAT POS BESAR KUALA LUMPUR MALAYSIA NO. WP0218 URUSAN SERI PADUKA BAGINDA If Undelivered, Return To: LEMBAGA HASIL DALAM NEGERI MALAYSIA PUSAT PEMPROSESAN KARUNG BERKUNCI 11018 50990 KUALA LUMPUR MALAYSIA USE BLACK INK PEN & DO NOT FOLD For Enquiries:- LHDNM Branch Main Line : 1-300-88-3010 Main Line Calls From Overseas : 603-4289-3500 Website : http://www.hasil.gov.my

Transcript of F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line...

Page 1: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

FORM TA 2012

BAYARAN POS JELAS POSTAGE PAID

PEJABAT POS BESAR KUALA LUMPUR

MALAYSIA NO. WP0218

URUSAN SERI PADUKA BAGINDA

If Undelivered, Return To:

LEMBAGA HASIL DALAM NEGERI MALAYSIA

PUSAT PEMPROSESAN

KARUNG BERKUNCI 11018

50990 KUALA LUMPUR

MALAYSIA

USE BLACK INK PEN & DO NOT FOLD

For Enquiries:-

LHDNM Branch

Main Line : 1-300-88-3010

Main Line – Calls From Overseas : 603-4289-3500

Website : http://www.hasil.gov.my

Page 2: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

To

:

GUIDE NOTES ON FORM TA FOR YEAR OF ASSESSMENT 2012

Director General of Inland Revenue Lembaga Hasil Dalam Negeri Malaysia

Reference No. (Registration No.)

Date

:

:

Income Tax No.

:

LEMBAGA HASIL DALAM NEGERI MALAYSIA

PUSAT PEMPROSESAN ARAS 10-18, MENARA C, PERSIARAN MPAJ JALAN PANDAN UTAMA, PANDAN INDAH KARUNG BERKUNCI 11018

50990 KUALA LUMPUR

CP5D

SULIT

Telephone

Fax

Website

:

: : http://www.hasil.gov.my

1-300-88-3010

03-42893400

1. Form TA is:

a statement under section 77A Income Tax Act 1967 (ITA 1967);

an income tax computation pursuant to subsection 77A(3) of ITA 1967; and

a notice of assessment under section 90(2) of the same Act. 2. Therefore, you are required to:

(a) complete this return form correctly and clearly. Please refer to the “Criteria On Incomplete Income Tax Return Form (ITRF)” at the website of Lembaga Hasil Dalam Negeri Malaysia (LHDNM).

(b) compute your tax in accordance with the explanatory notes or guidebook which can be printed from the LHDNM website. However, working sheets used for computation need not be furnished with this return form but must be kept for the purpose of examination by LHDNM for a period of seven (7) years after the end of the year in which the return is furnished.

(c) furnish the following working sheets which can be printed from the website if entitled to a tax refund as per item C8 or CA6 of this return form:-

(i) Working Sheet HK-3 (enclosed) in respect of the claim for tax deduction under section 51 of Finance Act 2007 (dividends);

(ii) Working Sheet HK-6 pertaining to the claim for section 110 tax deduction (others); and

(iii) Working Sheet HK-8 / HK-9, if applicable, relating to the foreign tax deducted in the country of origin.

(d) Use the enclosed Remittance Slip (CP207) when paying the balance of tax payable (if any) as per item D3 of this return form.

3. Detach the Remittance Slip (CP207) before you furnish the Form TA. The Form TA must be

completed, affirmed, duly signed and furnished to LHDNM at the above address within the stipulated period.

4. Only original return forms are acceptable. Return forms submitted via fax are not considered as

furnished in accordance with ITA 1967. Thank you.

“SERVICE TO THE COUNTRY” “TOGETHER WE DEVELOP THE NATION”

Page 3: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

<>>>>>>>>>>>>>>>>>>>>>>>>>?

CP2B [Pin. 2012] TA

LEMBAGA HASIL DALAM NEGERI MALAYSIA

UNDER SECTION 77A OF THE INCOME TAX ACT 1967

RETURN FORM OF A TRUST BODY

This form is prescribed under section 152 of the Income Tax Act 1967

<>>>>>>>>>>>>>>>>>>>>>>>>>?

<>>>>>>>>?

<>>>>>>?

!

<? <>>>>>>?

<>>>>>>>>>>>>>>>>>>>>>>?

<>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>?

<>>>>>>>>>>>>>>>>>>>>>>?

Name of

Trust Body

<>>>>>>>>>>>>>>>>>>>>>>?

Form

Day Month Year

1 = Yes (Fill in Parts B and C)

2 = No (Fill in Parts BA and CA)

Day Month Year

PART A: PARTICULARS OF TRUST BODY

Resident in Malaysia

<>>>>>>>>>>>>>>>>>>>>>>?

<>>>>>>>>>>>>>?

<>>>?

Town Postcode

State

Opening Date of

Accounts

Tax Exemption

Approval No. (if any)

A2

A4 A3

A1

Correspondence

Address of Trust Body

A8

A9

Income Tax No. TA

Closing Date

of Accounts

Country of

Residence (Use Country Code)

2012 YEAR OF ASSESSMENT

- - -

1

2

-

A6 Employer’s No.

E <>>>>>>>>?

1

!

Compliance with Public Rulings

A5 1 = Yes 2 = No

!

Tax Exemption Approval A7 1 = Yes 2 = No

!

Record-keeping

A5a 1 = Yes 2 = No

Date received – 1 Date received – 2 Date received – 3

FOR OFFICE USE

Tax Repayable (item C8 / CA6 whichever is relevant)

Tax paid in excess (item D4)

There is balance of tax payable (item C7 / CA5 / D3 whichever is relevant)

Not taxable / Nil balance (if C7 / C8 / CA5 / CA6 / D3 / D4 = ‘0’)

Status of Tax (from page 8) (Enter ‘X’ in the relevant box)

[Declare in Ringgit Malaysia currency (RM)]

Page 4: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

<>>>>>>>>>>>>>>>>>>>>>>?

<>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>?

A10 Address of Business

Premise (if relevant)

2

<>>>>>>>>>>>>>>>>>>>>>>?

<>>>>>>>>>>>>>?

<>>>?

Town Postcode

State

<>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>?

<>>>>>>>>>>>>>>>>>>>>>>?

<>>>>>>>>>>>>>>>>>>>>>>?

Address Where Records of Trust Body are Maintained

Other Address (If A11 = 3)

A12

A11 !

<>>>?

Postcode <>>>>>>>>>>>>>?

Town

1 = Address as per A9

2 = Address as per A10

3 = Address other than A9 and A10

State

<>>>>>>>>?

Name Income Tax No.

A13 Particulars of Trustees

Trustee 1

Name

<>>>>>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>>>>>?

A13a

Trustee 2 <>>>>>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>>>>>?

Page 5: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

<>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>?

Name of Bank

<>>>>>>>>>>>?

-

Income Tax No.

Passport No.

Telephone No.

A15

A14

A13e

A13d

A13c

<>>>>>>>>>>? <>>>>>>>>>>?

<>>>>>>>>>>>?

-

<>>>>>>>>>?

<?

Enter type of file: SG / OG / C

Bank Account No.

<>>>>>>>>?

Name Income Tax No.

3

Trustee 1

Trustee 2

Trustee 1

Trustee 2

Trustee 1

Trustee 2

<>>>>>>>>>?

<?

Enter type of file: SG / OG / C

Identity Card / Police / Army No. * ( * Delete whichever is not relevant )

tidak berkenaan

A13b

<>>>>>>>>>>? <>>>>>>>>>>?

Trustee 1

Trustee 2

Page 6: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

<>_>>_>>_>>?

<>>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>>>?

<>>>?

B1

B2

B3

<>>>>>>>>? <>>>>>>>>? <>>>>>>>>?

<>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

B7

B8

B9

Statutory Business Income Business Code Amount

Business 1

Business 2

Business 3 + 4 and so forth (if any)

Income Tax No. Statutory Partnership Income

B4

B5

B6

B7

B8

B9

Partnership 1

Partnership 2

Partnership 3 + 4 and so forth (if any)

Aggregate statutory income from businesses ( B1 to B6 )

LESS: Business losses brought forward (Restricted to B7)

TOTAL ( B7 – B8 )

NOTE: If A1 = 1, fill in Parts B and C for a Trust Body RESIDENT in Malaysia. (Parts BA and CA need not be filled)

PART B: STATUTORY INCOME AND TOTAL INCOME

B10 B10

B11

B12

B13

B14

B15

B16

<>_>>_>>_>>?

B11

B12

B13

B14

B15

B16

Dividends

OTHER STATUTORY INCOME

Interest and discounts

Rents, royalties and premiums

Annuities and other periodical payments

Other gains or profits

Additions pursuant to paragraph 43(1)(c)

Aggregate of other statutory income ( B10 to B15 )

D

D

D

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

4

<>>>>>>>>?

Name Income Tax No.

B17

B18

B19

B17

B18

B19

AGGREGATE INCOME ( B9 + B16 )

LESS: Current year business losses (Restricted to B17)

TOTAL ( B17 – B18 )

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

, , ,

, , ,

, , ,

<>_>>_>>_>>?

B20 Prospecting expenditure - Schedule 4 and paragraph 44(1)(b)

LESS: Other Expenditure

B20 , , ,

Page 7: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

5

<>>>>>>>>?

Name Income Tax No.

B21 TOTAL ( B19 – B20 ) (Enter ‘0’ if value is negative) B21 <>_>>_>>_>>?

, , ,

B22

B23

B24

B26

B27

LESS:

B28 B28

B24

B26

B27

Gift of artefacts, manuscripts or paintings

Gift of money for the provision of library facilities or to libraries

Gift of paintings to the National Art Gallery or any state art gallery

Gift of money to the Government / local authority

TOTAL ( B21 – B22 )

Annuities payable / Periodical payments <>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

LESS: Donations / Gifts / Contributions / Zakat

Gift of money to approved institutions or organizations

Gift of money or cost of contribution in kind for any

approved sports activity or sports body Restricted to 7% of B17

<>_>>_>>_>>?

, , ,

B25A

<>_>>_>>_>>?

, , , Gift of money or cost of contribution in kind for any

project of national interest approved by the Minister

of Finance

Menteri Kewangan <>_>>_>>_>>?

, , ,

B29

B30

B32

TOTAL INCOME [ B23 – ( B24 to B29 ) ] (Enter ‘0’ if value is negative)

CHARGEABLE INCOME ( B30 – B31 )

Zakat perniagaan (restricted to 2.5% of aggregate income in B17)

B31

B32

B29

B30

Distribution to resident beneficiaries

<>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>?

<>_>>_>>_>>?

, , ,

, , ,

, , ,

, , ,

LESS:

B31

B25B

B25C

B25

->>_>>_>>_>?

->>_>>_>>_>?

C1

C7

Tax deduction under section 51 of Finance Act 2007 (dividends)

C5

C6

C1

C2

C3

C4

->>_>>_>>_>?

->>_>>_>>_>?

, , ,

, , , .

.

TAX AT RATE OF 25% ( B32 x 25% )

LESS:

Section 110 tax deduction (others)

OR

C7

Section 132 tax relief

Section 133 tax relief

Total deduction or relief ( C2 to C5 )

TAX PAYABLE * ( C1 – C6 )

C2

C3

C4

C5

C6

C8

->>_>>_>>_>?

->>_>>_>>_>?

->>_>>_>>_>?

, , , .

, , , .

, , , .

, , , .

, , , .

->>_>>_>>_>?

, , , .

PART C: TAX PAYABLE / REPAYABLE

B22

B23

C8

<>_>>_>>_>>?

, , ,

TAX REPAYABLE * ( C6 – C1 ) [For a ‘Tax Repayable’ case, fill in items A14 and A15 on page 3]

Restricted to C1

Page 8: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

NOTE: If A1 = 2, fill in Parts BA and CA for a Trust Body NOT RESIDENT in Malaysia.

(Parts B and C need not be filled)

PART BA: STATUTORY INCOME AND TOTAL INCOME

Amount

<>_>>_>>_>>?

BA7

BA8

BA9

BA10

BA11

BA12

BA13

BA14

BA15

BA16

BA17

BA18

BA19

BA17

BA18

BA19

BA13

BA14

BA15

BA16

BA8

BA9

BA10

BA11

BA12

BA4

BA5

BA6

BA7

BA1

BA3

Business 1

Business 2

Business 3 + 4 and so forth (if any)

Partnership 1

Partnership 2

Partnership 3 + 4 and so forth (if any)

LESS: Business losses brought forward

(Restricted to BA7)

Dividends

TOTAL ( BA7 – BA8 )

Rents and premiums

Annuities and other periodical payments

Other gains or profits

Additions pursuant to paragraph 43(1)(c)

Discounts

Aggregate of other statutory income ( BA10 to BA15 )

AGGREGATE INCOME ( BA9 + BA16 )

LESS: Current year business losses

(Restricted to BA17)

TOTAL ( BA17 – BA18 )

Aggregate statutory income from businesses

( BA1 to BA6 )

<>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

BA2

6

<>>>?

<>>>?

<>>>?

<>>>>>>>>? <>>>>>>>>? <>>>>>>>>?

Statutory Business Income Business Code

Income Tax No. Statutory Partnership Business

Other Statutory Income

D

D

D

<>>>>>>>>?

Name Income Tax No.

Page 9: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

BA24

BA25

BA26

BA27

BA28

BA29

BA31a

BA31b

BA31c

BA31d

BA28

BA24

BA25C

BA26

BA27

BA29

BA25B

BA31

BA31a

TOTAL INCOME / CHARGEABLE INCOME

( BA30 to BA31d )

Gross income subject to tax at other rates

Royalties

Interest

Special classes of income under section 4A

Other income (please specify………………………......…….)

Zakat perniagaan

(restricted to 2.5% of aggregate income in BA17)

Gift of money for the provision of library facilities or to libraries

Gift of artefacts, manuscripts or paintings

Gift of paintings to the National Art Gallery or any state art gallery

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>?

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , , BA32

BA31b

BA31c

BA31d

BA32

7

<>>>>>>>>?

Name Income Tax No.

BA30 BA30 TOTAL [ BA23 – ( BA24 to BA29 ) ] (Enter ‘0’ if value is negative) <>_>>_>>_>>?

, , ,

LESS: Donations / Gifts / Contributions / Zakat

BA21

BA20 BA20

BA21

LESS : Other Expenditure

Prospecting expenditure - Schedule 4 and paragraph 44(1)(b)

TOTAL ( BA19 – BA20 ) (Enter ‘0’ if value is negative)

<>_>>_>>_>>? <>_>>_>>_>>?

, , ,

, , ,

<>_>>_>>_>>?

BA22

BA23

BA22

BA23

LESS:

TOTAL ( BA21 – BA22 )

Annuities payable / Periodical payments

<>_>>_>>_>>?

, , ,

, , ,

Gift of money to the Government / local authority Gift of money to approved institutions or organizations

Gift of money or cost of contribution in kind for any

approved sports activity or sports body Restricted to

7% of BA17

<>_>>_>>_>>?

, , ,

<>_>>_>>_>>?

, , ,

Gift of money or cost of contribution in kind for any

project of national interest approved by the Minister

of Finance

<>_>>_>>_>>?

, , ,

BA25A

Page 10: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

->>_>>_>>_>?

<_?

25

5

8

10

12

15

CA1

CA1a

CA1b

CA1c

CA1d

CA1e

CA1f

CA1g

Gross income subject to tax at other rates

COMPUTATION OF TAX CHARGEABLE

Chargeable Income Rate (%) Tax Chargeable

Division of chargeable income according to the rate applicable

<>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>?

->>_>>_>>_>? ->>_>>_>>_>? ->>_>>_>>_>? ->>_>>_>>_>? ->>_>>_>>_>? ->>_>>_>>_>?

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

.

.

.

.

.

.

. .

PART CA: TAX PAYABLE / REPAYABLE

TAX AT RATE OF 25% ( BA30 x 25% )

8

<>>>>>>>>?

Name Income Tax No.

->>_>>_>>_>? CA3

CA4

CA5

CA6

CA2

CA5

TOTAL TAX CHARGEABLE ( CA1a to CA1g )

Tax deduction under section 51 of Finance Act 2007 (dividends)

OR

LESS:

CA4

CA3

CA2

Section 110 tax deduction (others)

TAX REPAYABLE * ( CA3 + CA4 – CA2 ) [For a ‘Tax Repayable’ case, fill in items A14 and A15 on page 3]

TAX PAYABLE * ( CA2 – CA3 – CA4 )

->>_>>_>>_>? ->>_>>_>>_>? ->>_>>_>>_>?

, , ,

, , ,

, , ,

, ,

.

.

.

.

->>_>>_>>_>?

, , , . CA6

,

D4

D3

PART D: STATUS OF TAX FOR YEAR OF ASSESSMENT 2012

D1

Tax paid in excess * ( D2 – D1 )

D2

D3

->>_>>_>>_>?

->>_>>_>>_>?

, , ,

, , ,

.

.

OR

LESS: Instalments paid

Balance of tax payable * ( D1 – D2 )

Tax payable ( from C7 or CA5 )

D2

D1

->>_>>_>>_>?

, , , .

->>_>>_>>_>?

, , , .

D4

Please enter the tax position ( C7 / C8 /CA5 / CA6 / D3 / D4 whichever is applicable ) under

the item ‘Status of Tax’ on page 1. *

Page 11: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

PART E: INCOME OF PRECEDING YEARS NOT DECLARED

Year For

Which Paid Type of Income Gross Amount

<>>?

E3

E2

E1 <>_>>_>>_>>? <>_>>_>>_>>?

<>>? <>>?

, , ,

, , ,

<>_>>_>>_>>?

, , ,

9

<>>>>>>>>?

Name Income Tax No.

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

Business 3 + 4 and

so forth (if any)

Partnership 1

CAPITAL ALLOWANCES

Business 2

Business 1

Allowance Absorbed G2

G2a

G2b

G2c

G2d

G2e

G2f

Balance Carried Forward

Partnership 2

Partnership 3 + 4 and

so forth (if any)

<>_>>_>>_>>? <>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>?

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

<>_>>_>>_>>?

, , ,

<>_>>_>>_>>?

, , ,

<>_>>_>>_>>?

, , ,

<>_>>_>>_>>?

, , ,

<>_>>_>>_>>?

<>_>>_>>_>>?

G3a

G3b

G3

G3c

G3d

Total gross amount paid

107A

PARTICULARS OF WITHHOLDING TAXES

109

109A

109B

Total tax withheld and remitted to LHDNM

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

, , , , , ,

, , ,

, , ,

, , ,

, , ,

Gross payments to non-residents in the basis period subject to withholding tax under sections 107A, 109, 109A, 109B and 109F.

<>_>>_>>_>>?

, , , <>_>>_>>_>>?

, , ,

Section

G3e 109F <>_>>_>>_>>?

<>_>>_>>_>>?

, , , , , ,

PART G: PARTICULARS OF BUSINESS INCOME

G1

G1b

G1c

<>_>>_>>_>>? <>_>>_>>_>>?

, , ,

, , ,

LOSSES

Balance from previous year’s losses

Losses carried forward [ G1a(ii) + G1b ]

G1b

G1c

<>_>>_>>_>>?

, , , Balance from current year losses G1a

Balance Carried Forward

G1a

PART F: DISPOSAL OF ASSET UNDER THE REAL PROPERTY GAINS TAX ACT 1976

F1 ! !

! !

Any disposal of asset? Yes

Yes

No

No

(Indicate ‘X’ in the relevant box)

F2 Has the disposal been declared to LHDNM? (If F1 = ‘Yes’)

Page 12: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

<>? ->>_>>_>>?

<>?

->>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

H2

H4

J3

PART H: SPECIAL DEDUCTION, FURTHER DEDUCTION AND DOUBLE DEDUCTION

Claim Code Amount Amount

PART J: INCENTIVE CLAIM

H1

H3

TOTAL CLAIMED H5

Type of Incentive Amount Absorbed

J1

J3 Schedule 4 Expenditure

Schedule 7A Allowance

J2 Increased Exports Allowance for Qualifying Services

Balance Carried Forward

H5

<>?

Claim Code

->>_>>_>>?

<>? ->>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>?

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

10

<>>>>>>>>?

Name Income Tax No.

PART K: FINANCIAL PARTICULARS OF TRUST BODY

TRADING, PROFIT AND LOSS ACCOUNT

<>_>>_>>_>>?

<>>>?

!

K1

K2

K3

K4

K5

K7

K8

K9

K11

K10

K6

K12

K13

K1

K2

K3

K4

K5

K6

K7

K8

K9

K10

K11

K12

K13

GROSS PROFIT / LOSS ( K2 – K6 )

OTHER INCOME:

TOTAL ( K8 to K12 )

LESS:

Other businesses

Dividends

Interest and discounts

Other income

Rents, royalties and premiums

(Enter ‘X’ if value is negative)

Closing stock

Opening stock

Business code

Sales or turnover

Purchases and cost of production

Cost of sales ( K3 + K4 – K5 )

<>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>?

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

Page 13: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

!

K14

K15

K16

K17

K18

K19

K20

K21

K22

K23

K24

K25

K26

K27

K28

K29

K14

K15

K16

K17

K18

K19

K20

K21

K22

K23

K24

K25

K26

K27

K28

K29

EXPENSES:

TOTAL EXPENDITURE ( K14 to K21 )

NET PROFIT / LOSS

BALANCE SHEET

FIXED ASSETS:

TOTAL FIXED ASSETS ( K25 to K28 )

(Enter ‘X’ if value is negative)

Non-allowable expenses

Land and buildings

Motor vehicles

Other fixed assets

Other expenses

Annuities

Bad debts

Commissions

Contracts and subcontracts

Salaries and wages

Rental / Lease

Loan interest

Plant and machinery

<>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>?

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

11

<>>>>>>>>?

Name Income Tax No.

K30 K30 Investments <>_>>_>>_>>?

, , ,

K31

K32

Stock

K31

Trade debtors

K32

K33 Sundry debtors

CURRENT ASSETS:

K33

<>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>?

, , ,

, , ,

, , ,

K36

Cash in hand

Cash at bank

K34

K35

K34

K36 Other current assets

<>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>?

, , ,

, , ,

, , ,

K35

(Enter ‘X’ if value is negative) !

Page 14: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

K41

K42

L2

L5

L4

TOTAL ASSETS ( K29 + K30 + K37 )

Current year profit / loss

Drawings

Interest

Business and partnership

PART L: PARTICULARS OF EXEMPT INCOME

K37

K38

K40

TOTAL CURRENT ASSETS ( K31 to K36 )

K43

LIABILITIES:

Loans and overdrafts

Trade creditors

CAPITAL AND FUNDS:

Balance carried forward

Special fund

L3 L3

Other income

Rents

L1

L2

L1

K45

K46

Balance brought forward

K39

TOTAL LIABILITIES ( J39 to J41 )

Sundry creditors

K37

K41

K38

K40

K39

K42

K43

K45

K46

(Enter ‘X’ if value is negative)

(Enter ‘X’ if value is negative)

(Enter ‘X’ if value is negative)

Dividends

K47

K48

!

!

!

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>?

<>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>? <>_>>_>>_>>?

K48

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

, , ,

<>_>>_>>_>>?

Advance K44 <>_>>_>>_>>?

K44 , , ,

12

L4

L5

K47

TOTAL CAPITAL AND FUNDS ( K47 + K48 )

K49 <>_>>_>>_>>?

K49 , , ,

<>>>>>>>>?

Name Income Tax No.

Page 15: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

a

State

Address of Firm

Name of Firm

c

d

f

Telephone No.

Handphone No.

e-Mail

e

Tax Agent’s Approval No.

b

PARTICULARS OF THE FIRM AND SIGNATURE OF THE PERSON WHO COMPLETES THIS RETURN FORM

Postcode Town

Identity Card / Police / Army / Passport No. * ( * Delete whichever is not relevant )

I

TRUSTEE’S DECLARATION

<>>>>>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>?

<>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>?

<>>>>>>>>>>>>>>>>>>>>>>?

<>>>?

<>>>>>>>>>>>>>?

<>>>>>>>>>>>>>?

Signature Date

13

hereby declare that this return form contains information that is true, complete and correct pertaining to the income tax of the above trust body for the Year of Assessment 2012 as required under the Income Tax Act 1967.

Signature

Date

Designation <>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>?

<>>>>>>>>>>>>>>>>>>>>>>?

<>>>>>>>>>>>? <>>>>>>>>>>>?

Day Month Year <>>>>>>?

<>>>>>>>>?

Name Income Tax No.

Day Month Year <>>>>>>?

Page 16: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

Name and income tax number of the trust body are clearly indicated at the top of every page of this return form and relevant working sheets.

14

<>>>>>>>>?

Name Income Tax No.

Please read the following reminder before signing this return form

REMINDER

Please ensure that this return form is completed and in order . Carefully check all information given before it is furnished to Lembaga Hasil Dalam Negeri Malaysia. Check to ensure that the following have been done (Enter ‘ ’ in the relevant box):

Tax computation have been done on the working sheets provided and the amounts accurately transferred to the Form TA.

All working sheets, records and documents are properly kept for examination by LHDNM.

All information have been clearly filled in the spaces provided.

If there is any balance of tax payable, payment must be made according to the following:

Payment can be made as follows: (a) Bank - counters of CIMB Bank Berhad (CIMB), Public Bank Berhad (PBB), Malayan

Banking Berhad (Maybank) and Affin Bank Berhad (ABB) by using the bank payment slip.

- PBB, Maybank, Hong Leong Bank & Citibank internet banking and Maybank phone banking.

- Auto Teller Machine (ATM) of PBB and Maybank. (b) LHDNM - e-Payment through FPX (Financial Process Exchange) at LHDNM website,

http://www.hasil.gov.my . - payment counters of LHDNM or by mail:

Cheques, money orders and bank drafts must be crossed and made payable to the Director General of Inland Revenue. Use the Remittance Slip (CP207) when making payment.

Write down the name, address, telephone number, income tax number, year of assessment and payment code on the reverse side of the financial instrument.

Payment by CHEQUE / MONEY ORDER / POSTAL ORDER / BANK DRAFT must be separately remitted to LHDNM at the following address.

CASH payment must not be sent by mail.

(c) Pos Malaysia Berhad

- counter and Pos Online

PENINSULAR MALAYSIA

SABAH & FT LABUAN

SARAWAK

Lembaga Hasil Dalam Negeri Malaysia Cawangan Pungutan, Tingkat 15, Blok 8A Kompleks Bangunan Kerajaan, Jalan Duta Karung Berkunci 11061 50990 Kuala Lumpur

Postal Address

Lembaga Hasil Dalam Negeri Malaysia Cawangan Kota Kinabalu Wisma Hasil Jalan Tunku Abdul Rahman 88600 Kota Kinabalu Lembaga Hasil Dalam Negeri Malaysia Cawangan Kuching Aras 17, Wisma Hasil No. 1, Jalan Padungan 93100 Kuching

Payment Counter

Tingkat Bawah, Blok 8A Kompleks Bangunan Kerajaan Jalan Duta Kuala Lumpur

Tingkat Bawah Wisma Hasil Jalan Tunku Abdul Rahman Kota Kinabalu

Aras 1, Wisma Hasil No. 1, Jalan Padungan Kuching

Page 17: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

RM

REMITTANCE SLIP DIRECTOR GENERAL OF INLAND REVENUE To:

Enclosed herewith is the cheque/money order/postal order/bank draft for payment of income tax.

INCOME TAX NO. INSTALMENT NO. YEAR OF ASSESSMENT

Amount of Payment

Reference No. (Registration No.)Cheque No. and Others

Telephone No.

Date :

CP207 [Pin. 1/2012]

Name and Postal Address !!!!!!!!!!!!, , , .

PAYMENT CODE

Name of Bank

086 99 2012

Page 18: F TA 2012 - Hasillampiran2.hasil.gov.my/pdf/pdfborang/Form_TA2012_2.pdf · kuala lumpur main line web form ta 2012 bayaran pos jelas postage paid pejabat pos besar malaysia no. wp0218

MALAYSIAN INCOME TAX Remittance Slip

2. Write down the name, address, telephone number, income tax number, year of assessment and payment code on the reverse side of the financial instrument. 3. Check the receipts/bank payment slips before leaving the payment counter.

1. Payment can be made as follows: 1.1 Bank - Counters of CIMB Bank Berhad (CIMB), Public Bank Berhad (PBB), Malayan Banking Berhad (Maybank) and Affin Bank

Berhad (ABB) by using the bank payment slip. - PBB, Maybank, Hong Leong Bank & Citibank internet banking and Maybank phone banking. - Auto Teller Machine (ATM) of PBB and Maybank. 1.2 LHDNM - e-Payment through FPX (Financial Process Exchange) at LHDNM website, http://www.hasil.gov.my - Payment counters of LHDNM or by mail: Cheques, money orders and bank drafts must be crossed and made payable to the Director General of Inland Revenue. Use

the Remittance Slip (CP207) when making payment. 1.3 Pos Malaysia Berhad - counter and Pos Online

Lembaga Hasil Dalam Negeri Malaysia Cawangan Pungutan, Tingkat 15, Blok 8A Kompleks Bangunan Kerajaan, Jalan Duta Karung Berkunci 11061 50990 Kuala Lumpur

Postal Address Payment Counter

PENINSULAR MALAYSIA

SABAH & FT LABUAN

SARAWAK

Lembaga Hasil Dalam Negeri Malaysia Cawangan Kota Kinabalu Wisma Hasil Jalan Tunku Abdul Rahman 88600 Kota Kinabalu

Lembaga Hasil Dalam Negeri Malaysia Cawangan Kuching Aras 17, Wisma Hasil No. 1, Jalan Padungan 93100 Kuching

Tingkat Bawah, Blok 8A Kompleks Bangunan Kerajaan Jalan Duta Kuala Lumpur

Tingkat Bawah Wisma Hasil Jalan Tunku Abdul Rahman Kota Kinabalu

Aras 1, Wisma Hasil No. 1, Jalan Padungan Kuching