bilingual TRF 1770S 2016

(1)

GENERAL INSTRUCTIONS FOR THE COMPLETION SPT 1770 S DIGITAL FORM

1. This form is in compliance with the regulations the Director General of Taxes Number PER-34/PJ/2010 about Income Tax Annual Return Form and General Instructions as amended by regulation the Director General of Taxes Number PER-36/PJ/2015. This form is used for completion income tax annual tax return for Taxable Year 2014 and onwards; 2. Print this form in 98% scale (not printed in mode "fit size" or "shrink size"). This

printing results must be signed and must not be folded or crumpled. Use HVS paper size: a. F4/Folio/US Folio/Government Legal (8,5 X 13 inch);

b. Minimum weight 70 gr;

3. To be able to use this form optimally, use the application Adobe Reader version 8 or newer; 4. Complete the Taxable Year, the identity of the Taxpayer and the other mandatory

information properly. Taxpayers can contact the tax office where the Taxpayer is registered to ensure their Taxpayer Indentity Number (TIN) or through applications on the site www.pajak.go.id.

Description of status of married individual are as follows:

a. KK : Tax rights and obligations undertaken by the head of the family; b. HB : Spouse have lived separated based on a court decision;

c. PH : It is requested in writing by both the husband and wife on the basis of an agreement for the separation of property and income; and

d. MT : It is requested by the wife who chooses to meet her tax right and obligation separately.

5. Complete the attachments form first. Summation formulas, reduction, connection with certain parts and others have been available in this form, so that Taxpayers do not need to do a recount;

6. <AUTO> sign shows the calculation results automatically. There are times when automatic

calculation is too late to execute, to make sure it runs well, point the cursor pointer to the field where the calculation formula should be run, block the numbers there, then press DELETE key followed by ENTER. However, Taxpayer is expected to keep doing re-checking the results of calculations on this tax return, especially in the field <AUTO> ;

7. If additional form of 1770S-I and 1770S-II are needed because the information to be loaded is more than one page, that forms now are available in the directory (folder). These files can be reproduced to adjust the needs in a way to copy and replace file name (rename), for example: 1770S-I-1, 1770S-I-2 etc;

8. After all attachments completed, then complete the main form up to the box "Total Net Income after Zakat/ Obligated Charity",

a. in terms of Taxpayer status KK or HB, then fill the box "Personal Exemption" and the next boxes;

b. in terms of Taxpayer status MT or PH, then the box "Personal Exemption" and "Taxable Income" is automatically filled with symbols 0. Next, Taxpayer complete “Workpaper of Income Tax Payable Calculation for Taxpayers with PH and MT Status”. After the workpaper completed, complete the main form on the "Adjustment for Foreign Tax Credits Refunded and had been Credited in The Previous Year Return (Income Tax Article 24)" and the next boxes.

9. The SHOWbutton used to show calculation formulas in completing digital tax return;

10. The RESET button used to clear the data of digital tax return form that have been loaded previously. After completing the tax return and print it, do not forget to save it to another file (Save-as and name different from the original file), then use the RESET button to clear the file;

11. The HIDEbutton used to hide the calculation formula so that it can be printed blank form if you want to complete it manually;

(2)

FOR TAXPAYER WHO HAVE INCOME:

• FROM ONE OR MORE EMPLOYER; ST/ND/RD/TH

AMENDED RETURN

• OTHER DOMESTIC INCOME; AND/OR

• SUBJECTED TO FINAL AND/OR FINALIZED TAX.

• FOLLOW INSTRUCTION IN THE INSTRUCTION BOOK • •MARK " X " IN THE APPROPRIATE BOX

:

TAXPAYER'S NAME :

OCCUPATION : KLU :

PHONE NUMBER : - FAX. NUMBER :

-: KK HB PH MT

SPOUSE'S TIN :

*) The filing columns of Rupiah value must be without decimal value (see example in page 3 of instructions)

1 …….………..

[Total net income from each Form 1721-A1 and/or 1721-A2 attached or other Withholding Tax Receipt]

2 OTHER DOMESTIC NET INCOME ……….

[From Form 1770 S-I Total Part A ]

……….

[Complete it from separate attachment, if any foreign income, see instruction book]

4 TOTAL NET INCOME (1+2+3) ………

………

7 PERSONAL EXEMPTIONS TK / K / K / I /

8 TAXABLE INCOME (6-7) ………. 8

………

[From Form 1770 S-I Total Part C column (7)]

13 a. TAX DUE AFTER CREDIT _……….. b. TAX OVERLY WITHHELD

14 a. MONTHLY INSTALLMENT OF INCOME TAX ARTICLE 25

15 TOTAL TAX CREDIT (14a + 14b)

16 a. UNDERPAID TAX (INCOME TAX ARTICLE 29) b. OVERPAID TAX (INCOME TAX ARTICLE 28 A)

17 REQUEST: Overpaid amount stated in 16.b would be :

a. REFUNDED c. REFUNDED WITH SKPPKP ARTICLE 17 C (COMPLIANCE TAXPAYER)

b. d. REFUNDED WITH SKPPKP ARTICLE 17 D (TAXPAYER

0

0 5. ZAKAT/COMPULSORY RELIGIOUS DONATION 3 OFFSHORE NET INCOME

TOTAL NET INCOME AFTER ZAKAT/COMPULSORY RELIGIOUS DONATION (4-5)

9 INCOME TAX PAYABLE (TAX RATE ON ARTICLE 17 X LINE 8)

11 TOTAL INCOME TAX PAYABLE (9+10)

(3)

••

•

TIN :

TAXPAYER'S NAME :

PART A : OTHER DOMESTIC NET INCOME

(NOT INCLUDING INCOME SUBJECT TO FINAL INCOME TAX AND/OR FINAL IN NATURE)

(1)

PART B : NON TAXABLE INCOME

(1)

PART C : LIST OF INCOME TAX WITHHELD BY OTHER PARTIES, PAID/WITHHELD IN FOREIGN COUNTRIES AND BORNE BY THE GOVERNMENT

(1)

5. etc

Copy Total Part C to Form 1770 S Part D Line 12

Catatan :

*) - DTP : BORNE BY THE GOVERNMENT

- Fill column (6) with following options: 21/22/23/24/26/DTP (Example: 21, 22, 23, 24, 26, DTP)

- If there is a Tax Credit of Income Tax Article 24, the column should be filled with maximum creditable amount according to separate attachment (Follow the Instruction related to Part C of Attachment I and Annual Tax Return line 3)

Page from pages Attachment-I

IF NEEDED, ADDITIONAL PAGES MAY BE ADDED

TPC TOTAL PART C

1.

2.

3.

4.

(3) TPA

6. 3.

4. 1.

5. 2.

NO 1.

RENT ROYALTIES

AWARDS AND PRIZES

5.

6.

TYPES OF INCOME GAIN FROM THE SALE/TRANSFER OF PROPERTY

OTHER INCOMES 2.

3.

4.

NO.

1770 S - I

MINISTRY OF FINANCE

(7) (6)

(2) (3) (4) (5)

TOTAL PART B

DATE TPB SCHOLARSHIP

NUMBER

Copy Total Part A to Form 1770 S Part A line 2 TOTAL PART A

INTEREST

INHERITANCE

FO

RM

(3) TOTAL NET INCOME

(Rupiah)

TA

XA

B

LE

Y

EA

R

OF THE REPUBLIC OF INDONESIA

2 0

NO. TYPES OF INCOME

DIRECTORATE GENERAL OF TAXES

ATTACHMENT - I

ANNUAL INDIVIDUAL INCOME TAX RETURN

OTHER DOMESTIC NET INCOMES NON TAXABLE INCOME

LIST OF INCOME TAX WITHHELD BY OTHER PARTIES, PAID/WITHHELD IN FOREIGN AND BORNED BY THE GOVERNMENT

(2)

DISTRIBUTION OF PROFIT RECEIVED BY A MEMBER OF A LIMITED PARTNERSHIP WHOSE CAPITAL DOES NOT CONSIST OF SHARES, PARTNERSHIP, ASSOCIATION, FIRM AND KONGSI

NAME OF WITHHOLDING AGENT TIN OF WITHHOLDING AGENT WITHHOLDING TAX RECEIPT INCOME TAX ARTICLE TYPES OF TAX : 21/22/23/24/26/DTP *)

TOTAL OF INCOME TAX WITHHELD

(Rupiah) (2)

(Rupiah)

GROSS INCOME

OTHER NON TAXABLE INCOME

0

AIDS/DONATIONS/GIFTS

(4)

• INCOME SUBJECT TO FINAL TAX AND/OR FINALIZED TAX • ASSETS AT YEAR-END

• LIABILITIES AT YEAR- END

• LIST OF MEMBER OF FAMILY'S DEPENDENT

TIN :

TAXPAYER'S NAME :

PART A : INCOME SUBJECT TO FINAL TAX AND/OR FINALIZED TAX

(1)

: ASSETS AT YEAR-END NO.

(1)

5. etc

PART C : LIABILITIES AT YEAR- END

(1)

5 dst

PART D : LIST OF MEMBER OF FAMILY'S DEPENDENT NO.

(1) 1 2

3 4

5

Page from pages Attachment-II

TOTAL

4 3

IF NEEDED, ADDITIONAL PAGES MAY BE ADDED

OCCUPATION (5) NAME

(2)

IDENTITY NUMBER (NIK) (3)

RELATIONSHIP IN FAMILY (4)

2.

YEAR OF

ACQUISITION DESCRIPTION

(6) (5)

1.

13. WIFE INCOME FROM ONE EMPLOYER INCOME FROM DERIVATIVE TRANSACTION

NO.

2.

5. 3.

4.

11.

TRANSFERS OF RIGHTS ON LAND AND BUILDING 6.

7.

9. 8.

12.

TA

XA

B

LE

Y

EA

R

(4) INCOME TAX PAYABLE

(Rupiah)

CODE TYPE OF ASSETS

(2) (3)

LOTTERY PRIZES

COST OF ACQUISITION (Rupiah)

3.

4.

FO

R

M

OF THE REPUBLIC OF INDONESIA

TYPES OF INCOME

ANNUAL INDIVIDUAL INCOME TAX RETURN

DIRECTORATE GENERAL OF TAXES

ATTACHMENT - II

(2) (3)

1.

(Rupiah)

2 0

TOTAL PART A TPA

(4)

NO. CODE

(3) (2)

14.

PART B

10.

DIVIDEND

LEASE/RENT VALUE ON LAND OR BUILDING

TPB

LENDER ADDRESS YEAR LENDING

TOTAL PART B

NAME OF LENDER

JUMLAH BAGIAN C

(4) (5) (6)

JBC 2

1

1770 S - II

MINISTRY OF FINANCE

TAX BASE/GROSS INCOME

INTEREST FROM DEPOSIT, SAVINGS, DISCOUNT ON BANK INDONESIA CERTIFICATES, STATE SECURITIES

INTEREST/DISCOUNT OF BOND

PROPERTY RECEIVED FROM BUILD OPERATE TRANSFER SCHEME

0

SALES OF SHARES TRADED IN THE STOCK EXCHANGE

SEVERANCE PAYMENTS, RETIREMENT ALLOWANCES AND PENSIONS PAID IN LUMP SUM

HONORARIA DERIVED FROM STATE AND/OR LOCAL BUDGET

SAVING INTEREST PAID BY COOPERATIVE TO ITS INDIVIDUAL MEMBER

(5)

No. 's Net Income

(1) (3)

A

1 DOMESTIC NET INCOME FROM BUSINESS ACTIVITIES AND/OR INDEPENDENT PERSONAL SERVICE [From Form 1770 Part A line 1]

2 DOMESTIC NET INCOME IN RESPECT OF EMPLOYMENT

[From Form 1770 Part A Line 2 or Form 1770 S Part A Line 1]

3 OTHER DOMESTIC NET INCOME

[From Form 1770 Part A line 3 or Form 1770 S Part A line 2]

4 FOREIGN NET INCOME

5 ZAKAT/OBLIGATED CHARITY

6 TOTAL ( 1 + 2 + 3 + 4 - 5 )

7 LOSS CARRY FORWARD

[Only for Individual Taxpayer who applying bookkeeping system. From Form 1770 Part A line 8]

8 TOTAL NET INCOME ( 6 - 7 )

No

(1)

B C D E

1 5% x 2 15% x 3 25% x 4 30% x

F

G

Name : TIN : Signature

(2) (4)

WORKPAPER OF INCOME TAX PAYABLE CALCULATION

Description 's Net Income

FOR MARRIED INDIVIDUAL WHO HAVE TAX LIABILITY STATUS MARRIED WITH AN AGREEMENT FOR THE SEPARATION OF PROPERTY AND INCOME (PH) OR THE WIFE CHOOSE TO MEET HER TAX RIGHT AND OBLIGATION SEPARATELY (MT)

NET INCOME

Description Value

(2) (3)

TOTAL HUSBAND AND WIFE'S NET INCOME [ A.8.(3) + A.8.(4) ]

PERSONAL EXEMPTIONS

TAXABLE INCOME [ B - C ]

INCOME TAX PAYABLE (COMBINED)

TOTAL INCOME TAX PAYABLE (COMBINED)

PORTION INCOME TAX PAYABLE FOR [ (A.8.(3) / B) x E ] [Copy to 's Tax Return Part C Line 12 Form 1770 or Part C Line 9 Form 1770 S]

PORTION INCOME TAX PAYABLE FOR [ (A.8.(4) / B) x E ] [Copy to 's Tax Return Part C Line 12 Form 1770 or Part C Line 9 Form 1770 S]

Husband Wife

0

0 ₀

0

Husband

0

Wife

0

Husband

(6)

(7)

BAGI WAJIB PAJAK YANG MEMPUNYAI PENGHASILAN :

• DARI SATU ATAU LEBIH PEMBERI KERJA; SPT PEMBETULAN KE -

• DALAM NEGERI LAINNYA; DAN/ATAU

• YANG DIKENAKAN PPh FINAL DAN/ATAU BERSIFAT FINAL.

• SEBELUM MENGISI BACA DAHULU PETUNJUK PENGISIAN • •BERI TANDA "X" PADA (KOTAK PILIHAN) YANG SESUAI

NPWP : NAMA WAJIB PAJAK :

PEKERJAAN : KLU :

NO. TELEPON : - NO. FAKS :

-: KK HB PH MT

NPWP ISTERI / SUAMI :

*) Pengisian kolom-kolom yang berisi nilai rupiah harus tanpa nilai desimal (contoh penulisan lihat petunjuk pengisian halaman 3)

1 …….………..

[Diisi akumulasi jumlah penghasilan neto pada setiap Formulir 1721-A1 dan/atau 1721-A2 yang dilampirkan atau Bukti Potong Lain]

2 PENGHASILAN NETO DALAM NEGERI LAINNYA ……….

[Diisi sesuai dengan Formulir 1770 S-I Jumlah Bagian A ]

3 PENGHASILAN NETO LUAR NEGERI ……….

[Apabila memiliki penghasilan dari luar negeri agar diisi dari Lampiran Tersendiri, lihat petunjuk pengisian]

4 JUMLAH PENGHASILAN NETO (1+2+3) ………

5 ZAKAT/SUMBANGAN KEAGAMAAN YANG SIFATNYA WAJIB ………

6 ………

7 PENGHASILAN TIDAK KENA PAJAK TK / K / K / I /

8 PENGHASILAN KENA PAJAK (6-7) ………. 8

9 PPh TERUTANG (TARIF PASAL 17 UU PPh x ANGKA 8) ………

10 PENGEMBALIAN / PENGURANGAN PPh PASAL 24 YANG TELAH DIKREDITKAN ………

11 JUMLAH PPh TERUTANG (9+10) ………

12

NEGERI DAN/ATAU TERUTANG DI LUAR NEGERI [Diisi dari Formulir 1770 S-I Jumlah Bagian C Kolom (7)] 13 a. PPh YANG HARUS DIBAYAR SENDIRI _………..

b. PPh YANG LEBIH DIPOTONG/DIPUNGUT

14 a. PPh PASAL 25 ………

b. STP PPh Pasal 25 (Hanya Pokok Pajak) ………

15 JUMLAH KREDIT PAJAK (14a + 14b)

16 a. PPh YANG KURANG DIBAYAR (PPh PASAL 29) b. PPh YANG LEBIH DIBAYAR (PPh PASAL 28 A) 17 PERMOHONAN : PPh Lebih Bayar pada 16b mohon :

a. DIRESTITUSIKAN c. DIKEMBALIKAN DENGAN SKPPKP PASAL 17C (WP dengan Kriteria Tertentu)

b. d. DIKEMBALIKAN DENGAN SKKPP PASAL 17D (WP yang Memenuhi Persyaratan Tertentu)

18 ANGSURAN PPh PASAL 25 TAHUN PAJAK BERIKUTNYA SEBESAR 18 DIHITUNG BERDASARKAN :

a. 1/12 x JUMLAH PADA ANGKA 13

b. PENGHITUNGAN DALAM LAMPIRAN TERSENDIRI

a. Fotokopi Formulir 1721-A1 atau 1721-A2 atau Bukti Potong PPh Pasal 21 d. b. Surat Setoran Pajak Lembar Ke-3 PPh Pasal 29 e. c. Surat Kuasa Khusus (Bila dikuasakan)

WAJIB PAJAK KUASA TANGGAL

NAMA LENGKAP :

N P W P :

F.1.1.32.18 D . K R ED IT P A JA K 1 3 4

JUMLAH PENGHASILAN NETO SETELAH PENGURANGAN ZAKAT /SUMBANGAN KEAGAMAAN YANG SIFATNYA WAJIB (4-5)

2 5 6 B .PEN GH A SI LA N K EN A PA JA K ……… 13 [Bagi Wajib Pajak dengan status PH atau MT diisi dari Lampiran Perhitungan PPh Terutang sebagaimana dimaksud dalam bagian G: Lampiran huruf d]

14a 14b

2 0

SPT TAHUNAN C . P Ph T ER U TA N G FO RMUL IR

KEMENTERIAN KEUANGAN RI

PAJAK PENGHASILAN WAJIB PAJAK ORANG PRIBADI

ISI DENGAN HURUF CETAK /DIKETIK DENGAN TINTA HITAM PERHATIAN

1770 S

TANDA TANGAN A . P EN G H A SI LA N N ET O IDE NT IT AS 15 12 DIPERHITUNGKAN DENGAN UTANG PAJAK STATUS KEWAJIBAN PERPAJAKAN SUAMI-ISTERI (13-15) ……….. TGL LUNAS

PPh YANG DIBAYAR SENDIRI

10

DIREKTORAT JENDERAL PAJAK

Permohonan perubahan data disampaikan terpisah dari pelaporan SPT Tahunan PPh Orang Pribadi ini, dengan menggunakan Formulir Perubahan Data Wajib Pajak dan dilengkapi dokumen yang disyaratkan.

11 PENGHASILAN NETO DALAM NEGERI SEHUBUNGAN DENGAN PEKERJAAN

(11-12)

PPh YANG DIPOTONG/DIPUNGUT PIHAK LAIN/DITANGGUNG PEMERINTAH DAN/ATAU KREDIT PAJAK LUAR

TAH UN P AJAK 16 RUPIAH *) 9 7 TGL BLN THN BLN TGL THN Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan peraturan perundang-undangan yang berlaku, saya menyatakan bahwa yang telah beritahukan diatas beserta lampiran-lampirannya adalah benar, lengkap dan jelas.

F. A N G SU R A N PPh PA SA L 25 T A H U N PA JA K B ER IK U TN YA G. L A M PI R A N PERNYATAAN E. PPh K U R A N G/ LEB IH B A YA R

Perhitungan PPh Terutang bagi Wajib Pajak dengan status perpajakan PH atau MT

(8)

••

•

N P W P :

NAMA WAJIB PAJAK :

BAGIAN A : PENGHASILAN NETO DALAM NEGERI LAINNYA

(TIDAK TERMASUK PENGHASILAN DIKENAKAN PPh FINAL DAN/ATAU BERSIFAT FINAL)

(1)

angka (2)

BAGIAN B : PENGHASILAN YANG TIDAK TERMASUK OBJEK PAJAK

(1)

BAGIAN LABA ANGGOTA PERSEROAN KOMANDITER TIDAK ATAS SAHAM, PERSEKUTUAN, PERKUMPULAN, FIRMA, KONGSI

BAGIAN C : DAFTAR PEMOTONGAN/PEMUNGUTAN PPh OLEH PIHAK LAIN DAN PPh YANG DITANGGUNG PEMERINTAH

(1)

5. dst

Pindahkan Jumlah Bagian C ke Formulir

Catatan : Induk 1770 S Bagian D angka 12

*) - DTP : Ditanggung Pemerintah

- Kolom (6) diisi dengan pilihan PPh Pasal 21/22/23/24/26/DTP (Contoh : ditulis 21, 22, 23, 24, 26, DTP)

- Jika terdapat kredit pajak PPh Pasal 24, maka jumlah yang diisi adalah maksimum yang dapat dikreditkan sesuai lampiran tersendiri (lihat petunjuk pengisian tentang Lampiran I Bagian C dan Induk SPT angka 3)

Halaman ke- dari halaman Lampiran-I

JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI

JBC JUMLAH BAGIAN C

1.

2.

3.

4.

(3)

BANTUAN/SUMBANGAN/HIBAH

JBA

6. 3.

4. 1.

5. 2.

NO

KLAIM ASURANSI KESEHATAN, KECELAKAAN, JIWA, DWIGUNA, BEASISWA

PEMUNGUT PAJAK 1.

SEWA ROYALTI

PENGHARGAAN DAN HADIAH

5.

6.

JENIS PENGHASILAN KEUNTUNGAN DARI PENJUALAN/PENGALIHAN HARTA

PENGHASILAN LAINNYA 2.

3.

4.

NO.

TANGGAL PEMUNGUTAN

JBB BEASISWA

NOMOR PENGHASILAN LAINNYA YANG TIDAK TERMASUK OBJEK PAJAK

BUKTI PEMOTONGAN/ PEMUNGUT PAJAK

(7) (6)

DIPOTONG / DIPUNGUT PPh PASAL 21/

(2) (3) (4) (5)

22/23/24/26/DTP*

JENIS PAJAK : JUMLAH PPh YANG

JUMLAH BAGIAN B

NPWP PEMOTONG/ NAMA PEMOTONG/

FORM

U

LIR

(3)

JUMLAH PENGHASILAN

(Rupiah)

TAH

UN

P

AJAK

1770 S - I

KEMENTERIAN KEUANGAN RI

2 0

NO. JENIS PENGHASILAN

DIREKTORAT JENDERAL PAJAK

LAMPIRAN - I

SPT TAHUNAN PPh WAJIB PAJAK ORANG PRIBADI

PENGHASILAN NETO DALAM NEGERI LAINNYA PENGHASILAN YANG TIDAK TERMASUK OBJEK PAJAK

DAFTAR PEMOTONGAN/PEMUNGUTAN PPh OLEH PIHAK LAIN DAN PPh YANG DITANGGUNG PEMERINTAH

(2)

WARISAN

(Rupiah)

JUMLAH PENGHASILAN

Pindahkan Jumlah Bagian A ke Formulir Induk 1770 S Bagian A

JUMLAH BAGIAN A BUNGA

0

(9)

• PENGHASILAN YANG DIKENAKAN PPh FINAL DAN/ATAU BERSIFAT FINAL • HARTA PADA AKHIR TAHUN

• KEWAJIBAN/UTANG PADA AKHIR TAHUN • DAFTAR SUSUNAN ANGGOTA KELUARGA

N P W P :

NAMA WAJIB PAJAK :

BAGIAN A : PENGHASILAN YANG DIKENAKAN PPh FINAL DAN/ATAU BERSIFAT FINAL

(1)

BUNGA DEPOSITO, TABUNGAN, DISKONTO SBI, SURAT BERHARGA NEGARA

PESANGON, TUNJANGAN HARI TUA DAN TEBUSAN PENSIUN YANG DIBAYARKAN SEKALIGUS

BANGUNAN YANG DITERIMA DALAM RANGKA BANGUN GUNA SERAH

BUNGA SIMPANAN YANG DIBAYARKAN OLEH KOPERASI KEPADA ANGGOTA KOPERASI

PENGHASILAN LAIN YANG DIKENAKAN PAJAK FINAL DAN/ATAU BERSIFAT FINAL

: HARTA PADA AKHIR TAHUN

NO.

(1)

5. dst

BAGIAN C : KEWAJIBAN/UTANG PADA AKHIR TAHUN

(1)

5 dst

BAGIAN D : DAFTAR SUSUNAN ANGGOTA KELUARGA NO.

(1) 1 2

3 4 5

Halaman ke- dari halaman Lampiran-II

4 3

JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI

PEKERJAAN (5) NAMA

(2)

NIK (3)

HUBUNGAN KELUARGA (4)

6. 7.

9. 8.

12.

JUMLAH BAGIAN B

NAMA PEMBERI PINJAMAN 2.

TAHUN

PEROLEHAN KETERANGAN

(6) (5)

1.

JUMLAH PEMBERI PINJAMAN

13. PENGHASILAN ISTERI DARI SATU PEMBERI KERJA PENGHASILAN DARI TRANSAKSI DERIVATIF

NO.

2.

5. 3. 4.

11.

PENGALIHAN HAK ATAS TANAH DAN/ATAU BANGUNAN

2 0

JUMLAH BAGIAN A JBA

(4)

(Rupiah)

KODE

HARTA NAMA HARTA

(2) (3)

HADIAH UNDIAN

TA

H

U

N

P

A

JA

K

(4) PPh TERUTANG

HONORARIUM ATAS BEBAN APBN/APBD

HARGA PEROLEHAN

(Rupiah)

3.

4.

FO

R

M

U

LI

R

KEMENTERIAN KEUANGAN RI

SUMBER/JENIS PENGHASILAN

SPT TAHUNAN PPh WAJIB PAJAK ORANG PRIBADI

DIREKTORAT JENDERAL PAJAK

1770 S - II

LAMPIRAN - II

PENJUALAN SAHAM DI BURSA EFEK

(2) (3)

DASAR PENGENAAN PAJAK/ PENGHASILAN BRUTO

1.

(Rupiah)

BUNGA/DISKONTO OBLIGASI

NO. _UTANGKODE

(3) (2)

14.

BAGIAN B

10.

DIVIDEN

SEWA ATAS TANAH DAN/ATAU BANGUNAN

JBB

PEMINJAMAN TAHUN ALAMAT

JUMLAH BAGIAN C

(4) (5) (6)

JBC 2

1

0

(10)

No. Penghasilan Neto

(1) (3)

A

1 PENGHASILAN NETO DALAM NEGERI DARI USAHA DAN/ATAU PEKERJAAN BEBAS

[Diisi dari Formulir 1770 Bagian A angka 1]

2 PENGHASILAN NETO DALAM NEGERI SEHUBUNGAN DENGAN PEKERJAAN

[Diisi dari Formulir 1770 Bagian A angka 2 atau Formulir 1770 S Bagian A angka 1]

3 PENGHASILAN NETO DALAM NEGERI LAINNYA

4 PENGHASILAN NETO LUAR NEGERI

5 ZAKAT / SUMBANGAN KEAGAMAAN YANG BERSIFAT WAJIB

6 JUMLAH ( 1 + 2 + 3 + 4 - 5 )

7 KOMPENSASI KERUGIAN

[Khusus Bagi WP OP yang menyelenggarakan pembukuan. Diisi dari Formulir 1770 Bagian A angka 8]

8 JUMLAH PENGHASILAN NETO ( 6 - 7 )

No

(1)

B C D E

1 5% x 2 15% x 3 25% x 4 30% x

F G

Nama : NPWP : Tanda Tangan

JUMLAH PAJAK PENGHASILAN TERUTANG (GABUNGAN) PPh TERUTANG YANG DITANGGUNG [ (A.8.(3) / B) x E ]

[Pindahkan nilai pada bagian ini ke SPT bagian C angka 12 Formulir 1770 atau ke bagian C angka 9 Formulir 1770 S]

PPh TERUTANG YANG DITANGGUNG [ (A.8.(4) / B) x E ]

[Pindahkan nilai pada bagian ini ke SPT bagian C angka 12 Formulir 1770 atau ke bagian C angka 9 Formulir 1770 S]

,

(2) (3)

JUMLAH PENGHASILAN NETO SUAMI DAN ISTERI [ A.8.(3) + A.8.(4) ]

PENGHASILAN TIDAK KENA PAJAK PENGHASILAN KENA PAJAK [ B - C ]

PAJAK PENGHASILAN TERUTANG (GABUNGAN)

Uraian Nilai

PENGHASILAN NETO

(2) (4)

LEMBAR PENGHITUNGAN PAJAK PENGHASILAN TERUTANG

BAGI WAJIB PAJAK YANG KAWIN DENGAN STATUS PERPAJAKAN SUAMI-ISTERI PISAH HARTA DAN PENGHASILAN (PH) ATAU ISTERI YANG MENGHENDAKI UNTUK MENJALANKAN HAK DAN KEWAJIBAN PERPAJAKANNYA SENDIRI (MT)