2015 Monthly NonResident Employee WithholdingTax Form

(1)

DIRECÇÃO GERAL RECEITAS

DIRECÇÃO NACIONAL DE RECEITA PETROLIFERAS E MINERAIS

Building#5 (Ground Floor), Palacio do Governo RDTL, Avenida do

Presidente de Nicolau Lobato

P

.O Box-18, Dili , Timor-Leste, Phone- +(670) 333 9542

Web: www.mof.gov.tl/Taxation/Petroleum Tax/Tax forms

TIMOR-LESTE

NON-RESIDENT EMPLOYEE

MONTHLY

PETROLEUM TAX

WITHHOLDING FORM

(Income Tax Withheld from Timor-Leste Non-resident Employees)

For the Month of

: ……… 2015

Taxpayer Name

: ………

TIN

: ………..

Petroleum Withholding Tax – Non-resident employee tax

Type of Income

(

Provide detail list of all non-resident

employees )

A

Please providing the list of employee you employed and gross income they earned from different areas

Total employee : ………..

Total Gross Income : ……….

Will your Company not withheld any

wages tax the Following period? (if any);

If yes, state the reason ……….

………..……….

and confirm with Timor-Leste Tax Authority, with official documents

* Tax Rates are Numbered as 1,2,3&4 based on Different Tax Regimes as follows:

1 - Bayu Undan 2 - Greater Sunrise & EKKN 3 -JPDA but not Annex F 4- 100% Timor-Leste Territory

Contact Person :

Full name : ________ position _

email __________________________________________(Clear)

Next contact person;

NDPMR Contact E-mails: hsarmento@mof.gov.tl oraramos@mof.gov.tl; or adacosta@mof.gov.tl or jmonteiro@mof.gov.tl

PTD Form No: 02-01-01 Last updated 29/12/2014

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Full name : _____ Position : _

email : ____________________________________________(Clear)

Employer’s Declaration:

I, (full name and designation)_________________________________________________,

declare on behalf of the company, that the particulars set out in this statement are true and

correct.

Signature:________________________________________Date:

Notes:

1. The withholding tax rates are mentioned after considering the effect of framework percentage (90% & 10%) under the Timor Sea Treaty. So, further reduction will not apply in computing the Timor-Leste withholding tax;

2. Payment and lodgment of form due on or before 15th_{day of the following month or on next business day} if 15th_{is a public holiday in Timor-Leste;}

3. Calculation sheet of the Non-resident employees tax must be attached with the tax form for the month;

4. Withholding tax deducted from wages/salaries of non-resident employees are final tax liabilities for all tax regimes;

5. For Timor-Leste resident employees please use Resident Employee Monthly Withholding Tax Form;

6.

Please attach copy of EFT bank transfer instruction form in support of electronic

payment of above taxes to the TL Petroleum Fund bank account which details are as

follows:

Name and Address of the Bank- The Federal Reserve Bank of New York, 33 Liberty Street, New York, NY 10045; SWIFT CODE- FRNYUS33

Beneficiary Name – ‘Banking and Payments Authority of East Timor- Petroleum Fund Account’ Account Number- 021080973

7.

Payment and lodgment of forms due on or before the 15

th

_{of the following month or on}

next business day if 15

th

_{is a public holiday in Timor-Leste;}

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Annex List of employee

Name of Company

: ……….

TIN

: ………..

Tax jurisdiction on JPDA/TLEA

:

: Tick X 2.

1. 2.

List of Employments

No Name

Nationality Passport

number

Gross Income (Taxable wages/ salaries and similar remuneration derived in respect of employment exercised in the petroleum operations in JPDA or in Timor-Leste)

Net Tax will be paid to Timor-Leste

PTD Form No: 02-01-01 Last updated 29/12/2014

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Total

US$ :

………

2015 Monthly NonResident Employee WithholdingTax Form

Building#5 (Ground Floor), Palacio do Governo RDTL, Avenida do

Presidente de Nicolau Lobato

P

.O Box-18, Dili , Timor-Leste, Phone- +(670) 333 9542

Web: www.mof.gov.tl/Taxation/Petroleum Tax/Tax forms

TIMOR-LESTE

NON-RESIDENT EMPLOYEE

MONTHLY

PETROLEUM TAX

WITHHOLDING FORM

(Income Tax Withheld from Timor-Leste Non-resident Employees)

For the Month of

: ……… 2015

Taxpayer Name

: ………

TIN

: ………..

Petroleum Withholding Tax – Non-resident employee tax

Type of Income

(

A

Please providing the list of employee you employed and gross income they earned from different areas

Total employee : ………..

Total Gross Income : ……….

Will your Company not withheld any

wages tax the Following period? (if any);

If yes, state the reason ……….

………..……….

* Tax Rates are Numbered as 1,2,3&4 based on Different Tax Regimes as follows:

Contact Person :

Full name : ____________________________ position _____________________

email __________________________________________(Clear)

Next contact person;

Full name : ___________________________ Position : _______________________

email : ____________________________________________(Clear)

Employer’s Declaration:

I, (full name and designation)_________________________________________________,

declare on behalf of the company, that the particulars set out in this statement are true and

correct.

Signature:________________________________________________Date:________

Please attach copy of EFT bank transfer instruction form in support of electronic

payment of above taxes to the TL Petroleum Fund bank account which details are as

follows:

Payment and lodgment of forms due on or before the 15

of the following month or on

next business day if 15

is a public holiday in Timor-Leste;

Annex List of employee

Name of Company

: ……….

TIN

: ………..

Tax jurisdiction on JPDA/TLEA

:

: Tick X 2.

1. 2.

List of Employments

No Name

Total

US$ :

…………

Note “ 1. Please provide list of employees and include tax calculations depend on operations area

2. Please add other page if necessary”

Monthly Payroll ………./2015

I (full name) ………. Position ……….. declare this

list right and total gross income and tax withheld true, correct, and complete.

Full name : ________ position _

Full name : _____ Position : _

Signature:________________________________________Date:

_{of the following month or on}

_{is a public holiday in Timor-Leste;}

_…………