5A
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME :
NOTE: ………,
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
TAXPAYER /AUTHORIZED REPRESENTATIVE
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
2 0
LIST OF BRANCH MAJOR
NO ADDRESS OF MAIN BRANCHES OFFICE TIN LOCATION NUMBER OF MAIN BRANCHES
(1) (2) (3) (4)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
etc.
(………) 24
5A
TAHUN PAJAK
N P W P :
NAMA WAJIB PAJAK :
CATATAN : ………,
APABILA TIDAK MENCUKUPI DAPAT DIGANDAKAN
WAJIB PAJAK / KUASA
dst.
(………) 24
25 22
23 20
21 18
19 16
17 14
15 12
13 10
11 8
9 6
7 4
5 2
3
(1) (2) (3) (4)
1
NO ALAMAT CABANG UTAMA NPWP LOKASI
JUMLAH CABANG PEMBANTU
