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2016 additional Tax Form

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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,

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

Additional Tax of

Petroleum

Tax

(Under Section 72, 73, 74 and 75 of Chapter XI of

UNTAET Regulation No. 2000/18 as Amended)

Section 73. 1 (a) total amount of the 25%

US$

Section 73.1 (b) total amount of the 100 %

US$

Section 74.

Total amount of the 15%

US$

Section 74 (a) total amount of the 25%

US$

Section 74 (b) total amount of the 100%

US$

Section 75

US$

Grand Total

Contact Person :

Full name : ____________________________ position _______________________ email

__________________________________________(Clear)

Next contact person;

Full name : ___________________________ Position : _______________________

email : ____________________________________________(Clear)

NDPMR Contact E-mails: [email protected] [email protected]; or [email protected] or [email protected]

NDPMR forms: 01-07-215 Last updated 29/12/2015

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Declaration:

I, (full name and designation) ……… , declare on behalf of the Company, that this information is true and correct under ‘Chapter XI of the UNTAET Regulation No. 2000/18 as Amended.

Signature: ______________________________ Date : _____________________

Notes:

1. 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

2. Payment and submitting of additional Tax forms with EFT due on or before as due date mentioned in additional tax notice or on next business day if is a public holiday in Timor-Leste;

NDPMR Contact E-mails: [email protected] [email protected]; or [email protected] or [email protected]

(3)

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

Offences and Penalties of Petroleum Tax

(Under Section 77, 78, 79, 80 and 81 of Chapter

XI of UNTAET Regulation No. 2000/18 as Amended)

Month of ………2016

Section 78 (a) total amount of the 25%

US$

Section 78 (b) total amount of the 100

%

US$

Section 79

Section 79 (a)

US$

Section 80 Section 80 (d)

US$

Section 81 Section 81 (a)

Grand Total

Contact Person :

Full name : ____________________________ position _______________________ email

__________________________________________(Clear)

Next contact person;

Full name : ___________________________ Position : _______________________

email : ____________________________________________(Clear)

Declaration:

NDPMR Contact E-mails: [email protected] [email protected]; or [email protected] or [email protected]

NDPMR forms: 01-07-215 Last updated 29/12/2015

(4)

I, (full name and designation) ……… , declare on behalf of the Company, that this information is true and correct under ‘Chapter XI of the UNTAET Regulation No. 2000/18 as Amended.

Signature: ______________________________ Date : _____________________

Notes:

1. 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

2. Payment and submitting of Offences and penalties of the Petroleum Tax forms with EFT due on or before as due date mentioned in Offences and penalties of the Petroleum Tax notice or on next business day if is a public holiday in Timor-Leste;

NDPMR Contact E-mails: [email protected] [email protected]; or [email protected] or [email protected]

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