BAYARAN POS JELAS POSTAGE PAID PUSAT MEL NASIONAL SHAH ALAM MALAYSIA NO. WP0218 URUSAN SERI PADUKA BAGINDA If undelivered, return to: PUSAT PEMPROSESAN MAKLUMAT LEMBAGA HASIL DALAM NEGERI MALAYSIA MENARA HASIL NO. 3, JALAN 9/10, SEKSYEN 9 KARUNG BERKUNCI 221 43659 BANDAR BARU BANGI SELANGOR FORM C1 2016 IMPORTANT REMINDER 1) Due date to furnish this form and pay the balance of tax payable: Within 7 months from the date following the close of accounting period. a) Penalty under subsection 112(3) of the Income Tax Act 1967 (ITA 1967) shall be imposed for failure to furnish this return form before or on the due date for submission. b) An increase in tax of 10% under subsection 103(3) of ITA 1967 shall be imposed for failure to pay the balance of tax payable before or on the due date for submission. Any balance remaining unpaid upon the expiration of 60 days from the date of such increase, shall be further increased by 5% of the balance unpaid under subsection 103(4) of ITA 1967. 2) Before filling up this form, please refer to the Guide Book which is available at the LHDNM Official Portal, http://www.hasil.gov.my. 3) All relevant items have to be completed in BLOCK LETTERS and use black ink pen. 4) METHOD OF PAYMENT a) Payment can be made at: i) Bank - Information regarding payment via bank is available at the LHDNM Official Portal, http://www.hasil.gov.my ii) LHDNM - ByrHASiL via FPX (Financial Process Exchange) at the LHDNM Official Portal, http://www.hasil.gov.my - ByrHASiL via Visa, Mastercard & American Express Credit Cards at https://byrhasil.hasil.gov.my/creditcard - LHDNM payment counters in Peninsular Malaysia (Kuala Lumpur Payment Centre), Sabah and FT Labuan (LHDNM Kota Kinabalu Branch) dan Sarawak (LHDNM Kuching Branch) or by mail. Cheques, money orders and bank drafts must be crossed and made payable to the Director General of Inland Revenue. When making payment, use the Remittance Slip (CP207) which is available at the LHDNM Official Portal, http://www.hasil.gov.my. If sent by post, payment must be sent separately from the form. Payment by CASH must not be sent by post. iii) Pos Malaysia Berhad - Counter and Pos Online b) Write down the name, address, telephone number, income tax number, year of assessment, payment code and installment on the reverse side of the financial instrument. 5) Pursuant to section 89 of ITA 1967, a change of address must be furnished to LHDNM within 3 months of the change. Notification can be made via e-Kemaskini or by using Form CP600B (Change of Address Notification Form) which can be obtained at the LHDNM Official Portal, http://www.hasil.gov.my. 6) For further information, please contact:- Tol Free Line: 1-800-88-5436 (LHDN) Calls From Overseas: 603-77136666
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BAYARAN POS JELAS POSTAGE PAID
PUSAT MEL NASIONAL SHAH ALAM MALAYSIA
NO. WP0218
URUSAN SERI PADUKA BAGINDA
If undelivered, return to: PUSAT PEMPROSESAN MAKLUMAT LEMBAGA HASIL DALAM NEGERI MALAYSIA MENARA HASIL NO. 3, JALAN 9/10, SEKSYEN 9 KARUNG BERKUNCI 221 43659 BANDAR BARU BANGI SELANGOR
FFOORRMM CC11 22001166 IMPORTANT REMINDER
1) Due date to furnish this form and pay the balance of tax payable: Within 7 months from the date following the close of accounting period. a) Penalty under subsection 112(3) of the Income Tax Act 1967 (ITA 1967) shall be imposed for failure to furnish this return
form before or on the due date for submission. b) An increase in tax of 10% under subsection 103(3) of ITA 1967 shall be imposed for failure to pay the balance of tax payable
before or on the due date for submission. Any balance remaining unpaid upon the expiration of 60 days from the date of such increase, shall be further increased by 5% of the balance unpaid under subsection 103(4) of ITA 1967.
2) Before filling up this form, please refer to the Guide Book which is available at the LHDNM Official Portal, http://www.hasil.gov.my.
3) All relevant items have to be completed in BLOCK LETTERS and use black ink pen. 4) METHOD OF PAYMENT
a) Payment can be made at: i) Bank - Information regarding payment via bank is available at the LHDNM Official Portal, http://www.hasil.gov.my ii) LHDNM - ByrHASiL via FPX (Financial Process Exchange) at the LHDNM Official Portal, http://www.hasil.gov.my
- ByrHASiL via Visa, Mastercard & American Express Credit Cards at https://byrhasil.hasil.gov.my/creditcard - LHDNM payment counters in Peninsular Malaysia (Kuala Lumpur Payment Centre), Sabah and FT Labuan
(LHDNM Kota Kinabalu Branch) dan Sarawak (LHDNM Kuching Branch) or by mail. Cheques, money orders and bank drafts must be crossed and made payable to the Director General of Inland Revenue. When making payment, use the Remittance Slip (CP207) which is available at the LHDNM Official Portal, http://www.hasil.gov.my.
If sent by post, payment must be sent separately from the form. Payment by CASH must not be sent by post. iii) Pos Malaysia Berhad - Counter and Pos Online
b) Write down the name, address, telephone number, income tax number, year of assessment, payment code and installment on the reverse side of the financial instrument.
5) Pursuant to section 89 of ITA 1967, a change of address must be furnished to LHDNM within 3 months of the change. Notification can be made via e-Kemaskini or by using Form CP600B (Change of Address Notification Form) which can be obtained at the LHDNM Official Portal, http://www.hasil.gov.my.
6) For further information, please contact:- Tol Free Line: 1-800-88-5436 (LHDN) Calls From Overseas: 603-77136666
1. Form C1 is:
(a) a statement under section 77A Income Tax Act 1967 (ITA 1967); (b) an income tax computation pursuant to subsection 77A(3) of ITA 1967; and (c) a deemed notice of assessment under subsection 90(2) of the same Act.
2. Therefore, you are required to:
(a) complete this return form correctly and clearly. Official Portal of Lembaga Hasil Dalam Negeri Malaysia (LHDNM).
(b) compute your tax based on audited accounts and refer to the guidebook which can be printed from the LHDNM Official Portal. However, working sheets / appendices used for computation need not be furnished with this return form but must be kept for the purpose of examination by LHDNM for a period of seven (7) years after the end of the year in which the return is furnished.
(c) furnish the following appendices which can be printed from the Official Portal if entitled to a tax refund as per item B10 of this return form:-
(i) Appendix B2 pertaining to the claim for section 110 tax deduction (others); and
(ii) Appendix B3 / Appendix B4, if applicable, relating to the foreign tax deducted in the country of origin.
(d) use the enclosed Remittance Slip (CP207) when paying the balance of tax payable (if any) as per item C3 of this return form within the stipulated period.
3. Detach the Remittance Slip (CP207) before you furnish the Form C1. The Form C1 must be completed
and furnished to LHDNM at the above address within the stipulated period. 4. Only original return forms are acceptable. Return forms submitted via fax are not considered as
furnished in accordance with ITA 1967. Thank you.
To
:
GUIDE NOTES ON FORM C1 FOR YEAR OF ASSESSMENT 2016
Director General of Inland Revenue Lembaga Hasil Dalam Negeri Malaysia
Income Tax No.
:
:
Date
PUSAT PEMPROSESAN MAKLUMAT LEMBAGA HASIL DALAM NEGERI MALAYSIA MENARA HASIL NO.3, JALAN 9/10, SEKSYEN 9 KARUNG BERKUNCI 221 43659 BANDAR BARU BANGI SELANGOR
CP5B
Toll Free Line Fax Official Portal
: : : http://www.hasil.gov.my
1-800-88-5436(LHDN) 03-89221801
SERVICE TO THE COUNTRY TOGETHER WE DEVELOP THE NATION
Reference No. (Registration No.) :
<>_>>_>>_>>?
<>_>>_>>_>>?
LEMBAGA HASIL DALAM NEGERI MALAYSIA RETURN FORM OF A CO-OPERATIVE SOCIETY UNDER SECTION 77A INCOME TAX ACT 1967
This form is prescribed under section 152 Income Tax Act 1967 C1 Form
CP5(CS) [Pin. 2016]
YEAR OF ASSESSMENT
2016 <>>>>>>>>>>>>>>>>>>>>>>>>>>? 1
9
4 3
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>? <>>>>>>>>? CS E
Accounting Period 7
8
No. Income Tax No.
Name of Co-Operative Society
Basis Period
<>>>>>>?
<>>>>>>?Record-keeping 1 = Yes
2 = No
Status of Tax ( f rom page 4 ) (Enter in the re levant box)
Tax repayable (Item B10)
Tax paid in excess (Item C4)
There is balance of tax payable (Item B9/C3 whichever is relevant)
<>_>>_>>_>>? , , , K16A Input tax not claimable from the Royal Malaysian Customs Department K16A
7
CS <>>>>>>>>?
<>_>>_>>_>>? , , , K24 Other fixed assets K24
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<>_>>_>>_>>?
<>_>>_>>_>>? , , ,
, , ,
, , ,
, , ,
K27
K28
K29
, , ,
K30
K31
K32
K33
Current Assets:
Stock
Trade debtors
Sundry debtors
Cash at bank
Other current assets
TOTAL ASSET (K25 + K26 + K33)
TOTAL CURRENT ASSET (K27 to K32)
Cash in hand
K34
K27
K28
K29
K30
K31
K32
K33
K34
!
K35 Trade creditors
Sundry creditors
Liabilities:
K36
K35
K36
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<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
K25
K26
TOTAL FIXED ASSET (K21 to K24)
Investments:
Investments
K25
K26
Funds K39
TOTAL LIABILITY AND FUNDS (K38 + K39) K40
period K41
Amount transferred during the basis period to the Statutory Reserve Fund pursuant to subsection 65A(a) K42
Amount pursuant to subsection 65A(b) K43
K39
K40
K41
K42
K43
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
K37
K38
Other liabilities
TOTAL LIABILITY (K35 to K37)
K37
K38
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , , K23 Land and buildings K23
Name of Co-operative Society
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
K21
K22
Fixed Assets:
Motor vehicles
Plant and machinery
K21
K22
<>_>>_>>? <>_>>_>>?
8
CS <>>>>>>>>?
Section
107A
109
109A
109B
L1
L2
L3
L4
M1
M2 Correspondence Address
Total Gross Amount Paid Total Tax Withheld And
Remitted To LHDNM Total Net Amount Paid
PART M: PARTICULARS OF CO-OPERATIVE SOCIETY
Registered Address
PART L: PARTICULARS OF WITHHOLDING TAX Gross payments to non-residents subject to withholding tax provision under section 107A, 109, 109A, 109B and 109F.
State
Town Postcode
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>? <>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
, ,
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, ,
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State
Town Postcode
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>? <>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
109F L5 <>_>>_>>? , , <>_>>_>>? , , <>_>>_>>? , ,
M4 Date Registered <>>>>>>? Day Month Year
M3 Address of Business Premise
State
Town Postcode
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>? <>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
Name of Co-operative Society
9
CS <>>>>>>>>?
M8
M9
M10
M11
<>>>>>>>>>>>>>>>>>>>>>>>>?
!
Name of Bank
Bank Account Number
Address where co-operative
If item 9 does not apply, state the address where the co-
Telephone No.
1 = Address as per M1 2 = Address as per M2 3 = Address as per M3
<>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
M7
e-Mail M12
State
Town Postcode
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>? <>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>? Address
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>? Website / Blog address M6
M13a
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
Particulars of Co- M13
Name
Chairman
Treasurer
Secretary
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
Notes : Enter the name of the bank and bank account number for the purpose of electronic income tax refund
Name of Co-operative Society
<>>>>>>>>>>>>>>>>>>>>>>>>? M5 Place of Registration
<>>>>>>>>>>>>>>>>>>>>>>>>?
10
CS <>>>>>>>>?
Chairman
M13b Identification No.
Treasurer
Secretary
Chairman
Treasurer
Secretary
Chairman
Treasurer
Secretary
Chairman
Treasurer
Secretary
M13h Amount of Allowance
<>_>>_>>? , ,
<>_>>_>>? , ,
<>_>>_>>? , ,
Passport No. M13c
<>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>>>>>?
, ,
M13f Salary / Commission / Bonus
<>_>>_>>?
<>_>>_>>? , ,
<>_>>_>>? , ,
M13d Income Tax No.
<>>>>>>>>>?
<>>>>>>>>>?
<>>>>>>>>>?
<?
<?
<?
Type of file: SG/OG
Type of file: SG/OG
Type of file: SG/OG
Telephone No.
<>>>>>>>>>>>?
<>>>>>>>>>>>?
<>>>>>>>>>>>?
M13e
<_>?
<_>?
<_>?
.
.
Equity Holding (%) M13g
<>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>>>>>?
.
Name
Identification / Passport No.
Income Tax No.
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>?
Particulars of co-b
M14
M14a
M14b
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>? <? Type of file:
SG/OG
Name
Identification / Passport No.
Income Tax No.
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>>>>? <? Type of file:
SG/OG
Name of Co-operative Society
DECLARATION 11
CS <>>>>>>>>? Name of Co-operative Society
M14c
M14d
M15e
Name <>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>>>>? <? SG/OG
Name <>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>>>>? <? SG/OG
Name <>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>>>>? <? SG/OG
Identification / Passport No.
Income Tax No. Type of file:
Identification / Passport No.
Income Tax No. Type of file:
Identification / Passport No.
Income Tax No. Type of file:
DECLARATION
I
Identification / Passport No.* (* Delete whichever is not relevant)
hereby declare that this return form contains information that is true, correct and complete pertaining to the income tax of the above co-operative as required under the Income Tax Act 1967.
<>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
Signature Date
Designation
Day Month Year <>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
12
CS <>>>>>>>>?
Approval No. <>>>>>>>>>>>>>?
Signature Date
Day Month Year <>>>>>>?
PARTICULARS OF THE FIRM AND SIGNATURE OF THE PERSON WHO COMPLETE THIS FORM
a
b
Name of Firm
Address of Firm
<>>>>>>>>>>>>>>>>>>>>>>>>?
Postcode
State
Town
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>? <>>>?
c
d
e
Telephone No.
e-Mail <>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>?
Name of Co-operative Society
RM
REMITTANCE SLIP DIRECTOR GENERAL OF INLAND REVENUE To :
Enclosed herewith is the cheque/money order/postal order/bank draft for payment of income tax.
INCOME TAX NO. INSTALLMENT YEAR OF ASSESSMENT
Amount of Payment
CP207 [Pin. 1/2016]
Name and Postal !!!!!!!!!!!! , , , .
PAYMENT CODE
086 99 2016
Reference No. (Registration No.)
Cheque No. and Others
Telephone No.
Date :
Name of Bank
1. Payment can be made as follows: 1.1 Bank - Counters of CIMB Bank Berhad (CIMB), Public Bank Berhad (PBB), Malayan Banking Berhad (Maybank), Affin Bank Berhad
(ABB), RHB Bank Berhad (RHB), Bank Simpanan Nasional (BSN) and Bank Rakyat by using the bank payment slip. - PBB, Maybank, Hong Leong Bank, Citibank, RHB & Alliance Bank Malaysia Berhad internet banking and Maybank phone
banking. - Auto Teller Machine (ATM) PBB dan Maybank. 1.2 LHDNM - ByrHASiL through FPX (Financial Process Exchange) at LHDNM Official Portal, http://www.hasil.gov.my - ByrHASiL via Visa, Mastercard & American Express Credit Cards at LHDNM Official Portal, https://byrhasil.gov.my/creditcard - LHDNM payment counters or by mail:
Cheques, money orders and bank drafts must be crossed and made payable to Director General of Inland Revenue. Use the Remittance Slip (CP 207) when making payment
1.3 Pos Malaysia Berhad - Counter and Pos Online
MALAYSIAN INCOME TAX Remittance Slip
2. Write down the name, address, telephone number, income tax number, year of assessment dan payment code on the reverse side of financial instument.
3. Check the receipts/ bank payment slips before leaving the payment counter.
Lembaga Hasil Dalam Negeri Malaysia Pusat Bayaran, Tingkat 15, Blok 8A Kompleks Bangunan Kerajaan, Jalan Tuanku Abdul Halim Karung Berkunci 11061 50990 Kuala Lumpur
Postal Address Kaunter Bayaran PENINSULAR MALAYSIA
SABAH & WP LABUAN
SARAWAK
Lembaga Hasil Dalam Negeri Malaysia Cawangan Kota Kinabalu Wisma Hasil Jalan Tunku Abdul Rahman 88600 Kota Kinabalu Lembaga Hasil Dalam Negeri Malaysia Cawangan Kuching Aras 17, Wisma Hasil No. 1, Jalan Padungan 93100 Kuching
Tingkat Bawah, Blok 8A Kompleks Bangunan Kerajaan Jalan Tuanku Abdul Halim Kuala Lumpur
Tingkat Bawah Wisma Hasil Jalan Tunku Abdul Rahman Kota Kinabalu