DIRECÇÃO GERAL RECEITAS
DIRECÇÃO NACIONAL DE RECEITAS PETROLIFERAS E MINERAIS
Building#5 (Ground Floor), Palacio do Governo RDTL, Avenida do Presidente de Nicolau Lobato
Payment if there has been a shortfall is due by 31 March 2016
Total Gross wages paid Line Amount US$
Total gross amount of wages paid during 2015 tax year (please separate attached summary of monthly paid to employees from Jan to Dec 2015)
05
Wages Tax reconciliation :
Total amount wages tax payment made to Timor Leste Tax authority in respect of the 2015 tax year
(please separate attached summary of monthly wages tax paid from Jan to Dec 2015)
10
Total of wages tax deducted from your employees wages in respect of 2015 tax year.
20
Difference, (if line 20 exceed at line 10), underpaid
Declaration:
Under penalties of perjury, I (full name) ……….…, (designation) ……… ……..declare that I have examined this form, including
accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete.
Signature: ______________________________
Date : _____ /_______________/2016
Notes:
1. Any annual wages Income Tax payment shortfall is to be computed on the basis of Annual Wages Income Tax should be paid before lodgment of the annual returns within 25th of the third month following the end of the Tax Year;
2. 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
NDPMR Contact E-mails: [email protected] or [email protected] or [email protected] or [email protected]
PTD Form No: 02-01-01 Last updated 29/12/2015
“ S e j a u m b o m c i d a d ã o , s e j a u m n o v o h é r o i p a r a a
n o s s a N a ç a o ”
“ S e j a u m b o m c i d a d ã o , s e j a u m n o v o h é r o i p a r a a
Summary List of Employees, Gross Income and Tax paid to Timor Leste Tax Authority
Name of Company : ……….
TIN : ………..
Tax Year : 2015
2006 Tax year
Total Number of Employees Work at; Total Gross Income earned from your company at:
Tax Paid to Timor-Leste Tax Authority JPDA Annex F (BU & GS) JPDA Non Annex F &
TLEA JPDA annex F JPDA no Annex F & TLEA
Resident ResidentNon Resident Non Resident Resident Employee of JPDA Annex F Nonresident Employee of JPDA Annex F
Resident Employee of JPDA Non annex F & TLEA
Nonresident Employee of JPDA Non Annex F & TLEA
1 2 3 4 5 6 7 8 9 10
January February March April May June July August September October November December
Total US$ ……….. US$ ……….. US$ ……….. US$ : ………… US$ : …………
I (full name) ………. Position ……….. declare this list is right and total gross income and tax withheld true, correct, and complete. Date, ……….2016
Note “ Please provide list of the employees and gross Income earned include tax calculations based the area operations in the table above.
NDPMR Contact E-mails: [email protected] or [email protected] or [email protected] or [email protected]
PTD Form No: 02-01-01 Last updated 29/12/2015
Annex 1.1
