ample company return form for year of a … reminder b) orders and bank drafts must be tol free line...
TRANSCRIPT
![Page 1: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/1.jpg)
SAMPLE COMPANY RETURN FORM FOR
YEAR OF ASSESSMENT 2017
IMPORTANT REMINDER
1) Due date to furnish Form e-C and pay the balance of tax payable: Within 7 months from the close of the accounting period
2) This sample form is provided for reference and learning purpose.
3) This sample form CANNOT be used for the purpose of submission to Lembaga Hasil Dalam Negeri Malaysia.
4) In accordance with the provision of the Income Tax Act 1967 (ITA 1967), a company shall:
a) furnish a return on an electronic medium or by way of electronic transmission [subsection 77A(1A)] with effect
from the Year of Assessment 2014;
b) declare its income in the return form based on audited accounts [subsection 77A(4)]; and
c) furnish correct particulars in the return form [paragraph 77A(3)(b) and paragraph 120(1)(h)].
5) A company may be liable to an action under section 112 of ITA 1967 for failure to furnish a return before or on the due date
for submission.
6) An increase in tax of 10% under subsection 103(3) of ITA 1967 shall be imposed for failure to pay the tax or 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) ITA 1967.
7) 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 dan 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 ‘086’ and
instalment no. ‘99’ on the reverse side of the financial instrument. e-Filing (e-C) can be accessed via https://ez.hasil.gov.my .
8) For further information, please contact Hasil Care Line:-
Tol Free Line : 1-800-88-5436 (LHDN) Calls From Overseas : 603-77136666
![Page 2: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/2.jpg)
LEMBAGA HASIL DALAM NEGERI MALAYSIA
SAMPLE OF COMPANY RETURN FORM CP5 [Pin. 2017]
YEAR OF ASSESSMENT
2017
1
PART A: STATUTORY INCOME, TOTAL INCOME AND CHARGEABLE INCOME
[Declare in Ringgit Malaysia(RM) currency]
<>>>?
A1
Business Code Amount (RM)
Business 1
Business 2
Statutory Business Income
Business 3
Business 4
Business 5 + 6 and so forth A5
A4
A3
A2 <>>>?
<>>>?
<>>>?
<>>>?
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
I Name of company
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
V
II
[If there is a change in name, submit the Notice of Registration of New Name)
Reference no. (registration no.)
<?
Country of residence (Use the Country Code)
<>>>>>>>>>>?
IV Resident in Malaysia
<>>>>>>>>?
C VI Income tax no.
IX Basis period <>>>>>>?
Day Month Year
From
III Employer’s no. <>>>>>>>>?
E
VIII Accounting period <>>>>>>?
Day Month Year
Substantial change in shareholding and subsection 44(5A) applies
!
XIII 1 = Yes 2 = No 3 = Not relevant
To <>>>>>>?
Day Month Year
To <>>>>>>?
Day Month Year
XI Record-keeping !
1 = Yes 2 = No
From
Small and medium enterprise
!
XII 1 = Yes 2 = No
!
1 = Claim 2 = Surrender 3 = Not relevant
Claim / Surrender loss under the Group Relief provision
[If claiming, submit C (RK-T); If surrendering, submit Form C (RK-S)]
XIV
VII Date of commencement of operations <>>>>>>?
Day Month Year
XV Claim industrial building allowance under subparagraph 42(1) Schedule 3 (Indicate ‘X’)
!
1 = Yes 2 = No
<>>>>>>>>?
Income Tax No. Statutory Partnership Income
Amount (RM)
Partnership 1
Partnership 2
D
D
D Partnership 3 + 4 and so forth
Aggregate statutory income from businesses ( A1 to A8 )
A9
A8
A7
A6
<>>>>>>>>? <>>>>>>>>?
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , A9
X Status of business !
1 = In operation 2 = Dormant 3 = In the process of winding up
XVI Claim incentive under section 127 (Indicate ‘X’)
!
Paragraph 127(3)(b) !
Subsection 127(3A) !
Not Relevant
XVII Carry on e-Commerce (If ‘Yes’, complete item P6 on page 11)
!
1 = Yes 2 = No
XVIII Entitled to claim Input Tax from the Royal Malaysian Customs Department
!
1 = Yes 2 = No
XIX Goods & Services Tax registration no.
<>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>? !
1 = Yes 2 = No
![Page 3: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/3.jpg)
2
Name of Company: ....…………………………………………………………………
……………………………..……………………………………………………………... C <>>>>>>>>? A10
A11 TOTAL ( A9 - A10 )
Business losses brought forward (Restricted to A9)
A10
A11
<>_>>_>>_>>?
<>_>>_>>_>>?
, , ,
, , ,
Less:
A12
A13
A18
A19
A20
A21
Other Statutory Income
Dividends
Interest
Other income
Additions pursuant to paragraph 43(1)(c)
Aggregate statutory income from other sources ( A12 to A19 )
AGGREGATE INCOME ( A11 + A20 )
A12
A13
A18
A19
A20
A21
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
A22
A23
Current year business losses (Restricted to A21)
TOTAL ( A21 - A22 )
A22
A23
<>_>>_>>_>>?
, , ,
Less:
, , ,
<>_>>_>>_>>?
<>_>>_>>_>>?
<>_>>_>>_>>?
A24
A25
A26
A27
Other expenses
Prospecting expenditure - Schedule 4 and paragraph 44(1)(b)
Pre-operational business expenditure - Schedule 4B and paragraph 44(1)(b)
Permitted expenses under section 60H
TOTAL [ A23 – ( A24 to A27 ) ] (Enter ‘0’ if value is negative)
A24
A25
A26
A27
<>_>>_>>_>>?
, , ,
, , ,
, , ,
, , ,
Less:
Less:
A28
A28
A <>_>>_>>_>>?
, , ,
Gift of money to the Government/ local authority
Donations / Gifts / Contributions / Zakat
A14
A15
A16
A17
Discounts
Rents
Royalties
Premiums
A14
A15
A16
A17
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
A29 A29 , , ,
Permitted expenses under section 60F
A30AA
Gift of money to approved institutions / organisations / funds
A30B
<>_>>_>>_>>?
, , ,
Gift of money for any sports activity approved by the Minister of Finance
Gift of money or cost of contribution in kind for any project of national interest approved by the Minister of Finance
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
Restricted to 10% of A21
A30
A30C
<>_>>_>>_>>?
, , ,
![Page 4: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/4.jpg)
3
C <>>>>>>>>?
Name of Company: ....…………………………………………………………………
……………………………..……………………………………………………………...
Gift of artefacts, manuscripts or paintings
Gift of money for the provision of library facilities or to libraries
A31
A32
A31
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , , Gift of paintings to the National Art Gallery or any state art gallery
A33 A33
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
<>_>>_>>_>>?
A36
A34 Zakat perniagaan (restricted to 2.5% of aggregate income in A21)
TOTAL INCOME [ A28 – ( A29 to A35 ) ] (Enter ‘0’ if value is negative)
A34
A36
, , ,
, , ,
<>_>>_>>_>>?
A35 Claim for loss under Group Relief provision
A35 , , ,
<>_>>_>>_>>? <>_>>_>>_>>?
CHARGEABLE INCOME ( A36 + A37 )
A39
A38
CHARGEABLE INCOME OF FOREIGN FUND MANAGEMENT (section 60G)
A38
A39
, , ,
, , ,
Apportionment of Chargeable Income
<_>>_>>_>>_>>?
B1 CHARGEABLE INCOME [ from ( A38B + A39 ) ] , , , B1 , Rate (%)
Income Tax
<>_>>_>>_>>_>?
<>_>>_>>_>>_>?
<>_>>_>>_>>_>?
<>_>>_>>_>>_>? <>_>>_>>_>>_>?
<>_>>_>>_>>_>?
<>_>>_>>_>>_>?
B2
B3
B4
B7
B8 TOTAL INCOME TAX CHARGED (B2 to B7 )
5
8
10
15
24
<>_>>_>>_>>?
<>_>>_>>_>>?
<>_>>_>>_>>?
<>_>>_>>_>>? <>_>>_>>_>>?
<>_>>_>>_>>?
B8
B5
B6
, , ,
, , ,
, , ,
, , ,
, , ,
, , ,
, , ,
, , ,
, , ,
, , ,
, , ,
, , ,
, , ,
.
.
.
.
.
.
.
TAX PAYABLE
PART B:
<>_>>_>>_>>_>?
18 <>_>>_>>_>>?
B5A , , , , , , .
<_?
.
A32
Less:
B11
B10 Section 110B tax deduction <>_>>_>>_>>_>?
B10 , , , .
<>_>>_>>_>>_>?
B11 , , , .
<>_>>_>>_>>_>?
B13
Section 132 tax relief
B13 , , , .
B9 Tax reduction on income derived from exploration and exploitation of petroleum in a Joint Development Area <>_>>_>>_>>_>?
B9 , , , .
B12 <>_>>_>>_>>_>?
B12
Section 110 tax deduction (others)
, , , . Section 133 tax relief
Restricted to B8
Less: <>_>>_>>_>>?
Exemption in respect of the increase in chargeable income from business
A38A A38A , , ,
<>_>>_>>_>>?
A38B A38B , , , CHARGEABLE INCOME after exemption ( A38 – A38A )
<>_>>_>>_>>?
TAXABLE PIONEER INCOME A37 A37 , , ,
![Page 5: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/5.jpg)
Name of Company: ....…………………………………………………………………
……………………………..……………………………………………………………... C <>>>>>>>>?
B16 TAX REPAYABLE * ( B14 – B8 ) [For a ‘Tax Repayable’ case, fill in items P7 and P8 on page 11]
Or
B14 Total Tax Reduction / Deduction / Relief ( B9 to B13 )
B14 <>_>>_>>_>>_>?
, , , .
<>_>>_>>_>>_>?
B15 TAX PAYABLE * ( B8 – B14 ) B15 , , , .
B16 <>_>>_>>_>>_>?
, , , .
C4 Tax paid in excess ( C2 – C1 )
Or
C4
<>_>>_>>_>>_>?
C1 Tax payable ( from B15 ) , , , C1 .
C2A
C3 Balance of tax payable ( C1 – C2 ) C3 <>_>>_>>_>>_>?
, , , .
<>_>>_>>_>>_>?
, , , .
Less:
PART C: STATUS OF TAX
<>_>>_>>? <>_>>_>>? <>_>>_>>? <>_>>_>>? <>_>>_>>?
<>_>>_>>? <>_>>_>>? <>_>>_>>? <>_>>_>>? <>_>>_>>? <>_>>_>>_>>?
<>?
Amount
, ,
D3
D2
D1
D4
D5
D11
Claim Code Amount
TOTAL CLAIMED
PART D: SPECIAL DEDUCTION, DOUBLE DEDUCTION AND FURTHER DEDUCTION
Claim Code
D8
D7
D6
D9
D10
<>?
, ,
<>? <>?
, ,
<>?
, ,
, ,
<>?
, ,
<>?
, ,
<>?
, ,
<>?
, ,
<>?
, ,
, , , D11
<>_>>_>>_>>_>?
, , , C2 .
PART E: CLAIM FOR SCHEDULE 3 ALLOWANCE
E1
E2
E3
E4
E5
E6
E7
E8
Business 1
Amount Absorbed
E1(a)
E5(a)
E4(a)
E3(a)
E2(a)
Partnership Amount Absorbed
E6(a)
E8(a)
E7(a)
Balance Carried Forward
E1(b)
E5(b)
E4(b)
E3(b)
E2(b)
Balance Carried Forward
E6(b)
E8(b)
E7(b)
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
Business 2
Business 3
Business 4
Business 5 + 6 and so forth
Business
Partnership 1
Partnership 2
Partnership 3 + 4 and so forth
4
Instalments paid pursuant to the provision under section 107C
<>_>>_>>_>>?
, , , C2B Instalments paid pursuant to the provision under
paragraph 107A(1)(a)
<>_>>_>>_>>?
, , ,
![Page 6: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/6.jpg)
Name of Company: ....…………………………………………………………………
……………………………..……………………………………………………………...
5
C <>>>>>>>>?
Total capital allowance on assets acquired in the basis period
E10 E10 <>_>>_>>_>>?
, , , Tota l capi ta l a l lowance brought forward but disregarded due to substantial change in shareholding E11 E11 <>_>>_>>_>>?
, , ,
CLAIM FOR LOSSES
PART F:
F1
Type of Loss
<_>>_>>_>>?
, , ,
Balance Carried Forward
F1(b) F1(a) <_>>_>>_>>?
, ,
Amount Disregarded
F2
F5
F4
F3
Pioneer losses
Losses from approved service projects
Business losses from Operational Headquarters / Foreign Fund Management
Section 54A
shipping losses
Business / partnership losses
F2(a)
F3(a)
F4(a)
F5(a)
<_>>_>>_>>?
, , ,
<_>>_>>_>>?
, , ,
<_>>_>>_>>?
, , ,
F2(b)
F3(b)
F4(b)
F5(b) <_>>_>>_>>?
, , ,
<_>>_>>_>>?
, , ,
<_>>_>>_>>?
, , ,
<_>>_>>_>>?
, , ,
<_>>_>>_>>?
, , ,
Balance Carried Forward
Amount Surrendered
Amount Absorbed
<_>>_>>_>>?
, , ,
Balance Carried Forward
F1A(b) F1A(a) <_>>_>>_>>?
, , , F1A Losses surrendered under Group Relief provision
E9 E9(a) E9(b) <>_>>_>>_>>?
, , , <>_>>_>>_>>?
, , Total accelerated capital allowance
INCENTIVE CLAIM
PART G:
Amount Absorbed Jenis Insentif Balance Carried Forward
, , , G1 Investment Tax Allowance
G1(a) G1(b) <>_>>_>>_>>?
, , , <>_>>_>>_>>? G2 Industrial
Adjustment Allowance
G2(a) G2(b) <>_>>_>>_>>?
, , , <>_>>_>>_>>?
, , ,
G3 Infrastructure Allowance
G3(a) G3(b) <>_>>_>>_>>?
, , , <>_>>_>>_>>?
, , ,
G4 Schedule 7A Allowance
G4(a) G4(b) <>_>>_>>_>>?
, , , <>_>>_>>_>>?
, , ,
G6 Increased Exports Allowance
G6(a) G6(b) , , , <>_>>_>>_>>?
, , ,
G6A Allowance for Increased Agriculture Exports
G6A(a) G6A(b) <>_>>_>>_>>?
, , , <>_>>_>>_>>?
, , ,
G6B Increased Exports Allowance for Malaysian International Trading Company
G6B(a) G6B(b) <>_>>_>>_>>?
, , , <>_>>_>>_>>?
, , ,
G5 Schedule 7B
Allowance G5(a) G5(b) <>_>>_>>_>>?
, , , <>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
G6C Value of Increased Export of Services
G6C(a) G6C(b) <>_>>_>>_>>?
, , , <>_>>_>>_>>?
, , ,
G6D Special Incentive for Exports
G6D(a) G6D(b) <>_>>_>>_>>?
, , , <>_>>_>>_>>?
, , ,
G6E Allowance for BioNexus status company
G6E(a) G6E(b) <>_>>_>>_>>?
, , , <>_>>_>>_>>?
, , ,
![Page 7: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/7.jpg)
Name of Company: ....…………………………………………………………………
……………………………..……………………………………………………………...
6
C <>>>>>>>>?
G10 TOTAL TRANSFERRED TO EXEMPT ACCOUNT [ G1(a) to G6E(a) ]
G10
G7 Schedule 4 expenditure G7 <>_>>_>>_>>?
, , ,
G8 G8 <>_>>_>>_>>?
, , ,
G9 TOTAL CLAIMED [ A24, A25 and G1(a) to G6E(a) ] G9 <>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
Schedule 4B expenditure
<>_>>_>>_>>?
Amount
H11
Income Code Amount
TOTAL TRANSFERRED TO EXEMPT ACCOUNT
PART H: INCOME TRANSFERRED TO EXEMPT ACCOUNT
, , , H11
Income Code
<>?
H3
H2
H1
H4
H5
H8
H7
H6
H9
H10
<>? <>? <>? <>?
<>? <>? <>? <>? <>?
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
<>_>>_>>_>>?
, , ,
I2
I1
, , ,
PART I: EXEMPT ACCOUNT
I1
I2
Credit in account
Tax exempt dividend paid
Amount
<>_>>_>>_>>?
I3 , , , I3 Balance carried forward !
(Enter ‘X’ if value is negative)
PART J: INCOME OF PRECEDING YEAR NOT DECLARED
PART K: DISPOSAL OF ASSET UNDER THE REAL PROPERTY GAINS TAX ACT 1976
K1 Disposal of asset under the Real Property Gains Tax Act 1976 (If ‘Yes’, also complete item K2)
K2 Disposal declared to LHDNM
<>_>>_>>_>>?
, , , J1 <>>?
Amount Year of Assessment Type of Income
!
1 = Yes 2 = No
!
1 = Yes 2 = No
![Page 8: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/8.jpg)
Name of Company: ....…………………………………………………………………
……………………………..……………………………………………………………...
7
C <>>>>>>>>?
Business Income:
Business code
Sales / Turnover
L1
L2
L1
L2 <>_>>_>>_>>?
, , ,
<>>>?
L3
L4
L5
L6
L7
L8
Less:
Opening stock
Purchases
Cost of production
Closing stock
Cost of sales
GROSS PROFIT / LOSS ( L2 – L7 )
(Enter ‘X’ if value is negative)
L3
L4
L5
L6
L8
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , !
FINANCIAL PARTICULARS OF COMPANY ( MAIN BUSINESS ) PART L:
L10
L11
L12
Other business income
Other income
Non-taxable profits
L10
L11
L12
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
L9 Foreign currency exchange gain
L9 <>_>>_>>_>>?
, , ,
L19 Cost of Employee Stock Options
L19 <>_>>_>>_>>?
, , ,
L20
L21
L22
Royalties
Rental / Lease
Maintenance and repairs
L20
L21
L22
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
L16
L18
Contract payments
Salaries and wages
L16
L18
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
L13
L14
Expenditure:
Interest
Professional, technical, management and legal fees
L13
L14
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
L15 Technical fee payments to non-resident recipients
L15 <>_>>_>>_>>?
, , ,
Type of business activity
L1A <>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
L17 Directors’ fee
L17 <>_>>_>>_>>?
, , ,
(Enter ‘X’ if value is negative)
L7 !
![Page 9: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/9.jpg)
Name of Company: ....…………………………………………………………………
……………………………..……………………………………………………………...
8
C <>>>>>>>>?
TOTAL FIXED ASSETS
Other fixed assets
L34
L35
L34
L35
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
L36 Total cost of fixed assets acquired in the basis period
L36 <>_>>_>>_>>?
, , ,
L24
L25
Promotion and advertisement
Travelling and accommodation
L24
L25
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
L23 Research and development
L23 <>_>>_>>_>>?
, , ,
L26 Foreign currency exchange loss
L26 <>_>>_>>_>>?
, , ,
L30 Non-allowable expenses
L30 <>_>>_>>_>>?
, , ,
L27
L28
L29
Other expenditure
TOTAL EXPENDITURE
NET PROFIT / LOSS
(Enter ‘X’ if value is negativef)
L27
L28
L29
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , , !
Motor vehicles
Fixed Assets:
Plant and machinery
Land and buildings
L31 L31 <>_>>_>>_>>?
, , ,
L32
L33
L32
L33
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
L41
L42
L43
L44
L45
Loans to directors
Cash in hand and cash at bank
Other current assets
TOTAL CURRENT ASSETS
TOTAL ASSETS ( L35 + L37 + L44 )
L41
L43
L44
L45
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
(Enter ‘X’ if value is negative)
L42 !
L38
L39
Current Assets:
Trade debtors
Sundry debtors
L38
L39
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
L37 Investments
L37 <>_>>_>>_>>?
, , ,
L40 Stock
L40 <>_>>_>>_>>?
, , ,
L26A Input tax not claimable from the Royal Malaysian Customs Department
L26A <>_>>_>>_>>?
, , ,
![Page 10: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/10.jpg)
Name of Company: ....…………………………………………………………………
……………………………..……………………………………………………………...
9
C <>>>>>>>>?
L46
L47
L48
Current Liabilities:
LIABILITIES AND OWNERS’ EQUITY
Loans and overdrafts
Trade creditors
Sundry creditors
L46
L47
L48
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
L54
L55
L56
L57
L58
Shareholders’ Equity:
Paid-up capital
Profit and loss appropriation account
(Enter ‘X’ if value is negative)
Reserve account
Total Equity
TOTAL LIABILITIES AND EQUITY
(Enter ‘X’ if value is negative)
(Enter ‘X’ if value is negative)
L54
L55
L56
L57
L58
!
!
!
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
L52 Long-term liabilities
L52 <>_>>_>>_>>?
, , ,
L53 TOTAL LIABILITIES
L53 <>_>>_>>_>>?
, , ,
L49
L50
L51
Loans from directors
Other current liabilities
TOTAL CURRENT LIABILITIES
L49
L50
L51
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
Section
107A
109
109A
109B
M1
M2
M3
M4
Total gross amount paid Total tax withheld and remitted to LHDNM
Total net amount paid
PART M: PARTICULARS OF WITHHOLDING TAXES
Payments made in the basis period which are subject to the withholding tax provision under sections 107A, 109, 109A, 109B, 109E, 109F and 109G.
109E M5
109F M6
109G M7
![Page 11: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/11.jpg)
Name of Company: ....…………………………………………………………………
……………………………..……………………………………………………………...
10
C <>>>>>>>>?
N9
N10
N11
N12
N9
N10
N11
Loans from related companies in Malaysia
Loans from related companies outside Malaysia
Other income from related companies in Malaysia
Other income from related companies outside Malaysia
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , , N12
N1
N2
N3
N4
N5
N2
N3
N4
N5
Total sales to related companies in Malaysia
Total sales to related companies outside Malaysia
Total purchases from related companies in Malaysia
Total purchases from related companies outside Malaysia
Total of other expenses to related companies in Malaysia
PART N: TRANSACTION BETWEEN RELATED COMPANIES
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
Amount
N6 N6 Total of other expenses to related companies outside Malaysia <>_>>_>>_>>?
, , ,
N7
N8
N7
N8
Loans to related companies in Malaysia
Loans to related companies outside Malaysia
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
N1
PART P: PARTICULARS OF COMPANY
P2 Registered address
P1 Status of company (Enter ‘X’ in the relevant box)
State
Town Postcode <>>>?
<>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>?
!
!
!
!
!
!
! !
!
!
!
!
Public Venture Capital
International Procurement Centre
Charitable Organisation
Operational Headquarters
Foreign Fund Management
MSC BioNexus
Investment Holding
Closed-end Fund
Real Property
Institution
!
!
!
Regional Distribution Centre
Others (Specify: )
Malaysian International Trade
![Page 12: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/12.jpg)
Name of Company: ....…………………………………………………………………
……………………………..……………………………………………………………...
11
C <>>>>>>>>?
PART P:
P4
P8
Address of business premise
<>>>>>>>>>>>>>>>>>>>>>>?
P7 <>>>>>>>>>>>>>>>>>>>>>>?
Name of bank *
Bank account no. *
<>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>?
<>>>?
<>>>>>>>>>>>>>>?
Town
<>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>?
Town
<>>>>>>>>>>>>>>>>>>>>>>? <>>>?
<>>>>>>>>>>>>>>?
P3 Correspondence address
P9 !
!
!
Address where company’s records are kept (Enter ‘X’ in the relevant box)
Address as per P2 Address as per P3 Address as per P4
State
Postcode
P6 <>>>>>>>>>>>>>>>>>>>>>>?
Website / Blog address
P5 Telephone no. of business premise <>>>>>>>>>>?
* Note: Enter the name of the bank and bank account no. for the purpose of electronic income tax refund
Postcode
<>>>>>>>>>>>>>>>>>>>>>>?
State
<>>>>>>>>>>>>>>>>>>>>>>?
P10 Other address if P9 does not apply
Postcode
<>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>?
<>>>?
<>>>>>>>>>>>>>>?
State
Town
![Page 13: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/13.jpg)
<>>>>>>?
Name of Company: ....…………………………………………………………………
……………………………..……………………………………………………………...
12
P14 Directors’ income tax no.
Director I
Director II
Director III
SG / OG
SG / OG
SG / OG
<?
<?
<?
<>>>>>>>>>?
<>>>>>>>>>?
<>>>>>>>>>?
C <>>>>>>>>?
P17 Directors’ salary / bonus
Director I
Director II
Director III
P16 Directors’ equity shareholding (%)
<>_>?
.
<>_>?
.
<>_>?
.
<>_>>_>>?
, ,
<>_>>_>>?
, ,
<>_>>_>>?
, ,
P18 Directors’ fee / commission / allowance
<>_>>_>>?
, ,
<>_>>_>>?
, ,
<>_>>_>>?
, ,
P12 Directors’ identification / passport no.
Director I
Director II
Director III
<>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>>>>>?
P13 Directors’ date of birth
P11
Director I
Director II
Director III
Directors’ Name
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
P19 Total loan to Directors
Director I
Director II
Director III
<>_>>_>>?
, ,
<>_>>_>>?
, ,
<>_>>_>>?
, ,
P20 Total loan from Directors
<>_>>_>>?
, ,
<>_>>_>>?
, ,
<>_>>_>>?
, ,
P15 Directors’ telephone no.
<>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>?
<>>>>>>?
Day Month Year
Day Month Year
Day Month Year
![Page 14: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/14.jpg)
Name of Company: ....…………………………………………………………………
……………………………..……………………………………………………………...
13
C <>>>>>>>>?
PARTICULARS OF FIVE MAJOR SHAREHOLDERS OF THE COMPANY
PART Q:
Q1
Q2
Q3
Q5
Q4
Identification / Passport / Registration No.
Name
<>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
Identification / Passport / Registration No.
Name
<>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
Identification / Passport / Registration No.
Name
<>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
Identification / Passport / Registration No.
Name
<>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
Identification / Passport / Registration No.
Name
<>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
Controlled company
!
1 = Yes 2 = No
<>>>>>>?
<>>>>>>?
<>>>>>>?
<>>>>>>?
<>>>>>>?
Day Month Year
Direct shareholding (%)
Country of origin (Use the Country Code) <>_>?
<?
. Shareholder’s date of birth
Day Month Year
Direct shareholding (%)
Country of origin (Use the Country Code) <>_>?
<?
. Shareholder’s date of birth
Day Month Year
Direct shareholding (%)
Country of origin (Use the Country Code) <>_>?
<?
. Shareholder’s date of birth
Day Month Year
Direct shareholding (%)
Country of origin (Use the Country Code) <>_>?
<?
. Shareholder’s date of birth
Day Month Year
Direct shareholding (%)
Country of origin (Use the Country Code) <>_>?
<?
. Shareholder’s date of birth
![Page 15: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/15.jpg)
PARTICULARS OF LABUAN ENTITY / ENTITIES
No. Name
( R6a )
Registration No.
( R6b )
Income Tax No.
( R6c )
i. LE
ii. LE
iii. LE
iv. LE
v. LE
vi. LE
vii. LE
viii. LE
ix. LE
x. LE
Name of Company: ....…………………………………………………………………
……………………………..……………………………………………………………...
14
C <>>>>>>>>?
OTHER PARTICULARS PART R:
R1 (Enter ‘X’ in the relevant box)
!
!
Yes No R2a Advance Ruling
R2c Material difference in arrangement (To be completed if R2a = ‘Yes’)
!
!
Yes No
R2b Compliance with Advance Ruling (To be completed if R2a = ‘Yes’)
Foreign equity in comparison with paid-up capital:
Advance Ruling: (Enter ‘X’ in the relevant box) R2
!
!
Yes No
!
!
Yes No R3a Advance Pricing Arrangement
R3c Material difference in arrangement (To be completed if R3a = ‘Yes’)
!
!
Yes No
R3b Compliance with Advance Pricing Arrangement (To be completed if R3a = ‘Yes’)
Advance Pricing Arrangement: (Enter ‘X’ in the relevant box) R3
!
!
Yes No
Transfer pricing documentation prepared (Enter ‘X’ in the relevant box) R4 !
!
Yes No
R5a Name of ultimate holding company
Particulars of holding company R5
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<?
Country code
R5b Name of immediate holding company
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<?
Country code
R6 Has subsidiary company or related company in Labuan F.T. (If ‘Yes’, enter the particulars of the Labuan entity / entities in the following schedule) !
!
Yes No
!
!
> 70% - 100% > 50% - 70% > 20% - 50% NIL !
!
!
< 20%
![Page 16: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/16.jpg)
<>>>>>>?
Name of Company:…………………………………………………………………….
……………………………..……………………………………………………………...
15
C <>>>>>>>>?
PARTICULARS OF THE FIRM AND SIGNATURE OF THE PERSON WHO COMPLETES THIS RETURN FORM
PART T:
T1 Name of firm <>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>?
T3
T4
Telephone No.
Tax agent’s approval no. <>>>>>>>>>>>>>?
T6
T5
Business registration no.
<>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>?
T2 Address of firm
Postcode
State
<>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>? <>>>?
<>>>>>>>>>>>>>>?
Town
<>>>>>>>>>>>>>>>>>>>>>>?
Signature Date
<>>>>>>>>>>>?
PARTICULARS OF AUDITOR
PART S:
S1 Name of firm <>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>?
S3 Telephone No.
S2 Address of firm
Postcode
State
<>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>? <>>>?
<>>>>>>>>>>>>>>?
Town
<>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>?
Day Month Year
![Page 17: AMPLE COMPANY RETURN FORM FOR YEAR OF A … REMINDER b) orders and bank drafts must be Tol Free Line SAMPLE COMPANY RETURN FORM FOR YEAR OF ASSESSMENT 2017 1) Due date to furnish Form](https://reader036.vdocuments.net/reader036/viewer/2022070609/5ae551077f8b9acc268be05e/html5/thumbnails/17.jpg)
Name of Company: ....…………………………………………………………………
……………………………..……………………………………………………………...
16
C <>>>>>>>>? DECLARATION
I
Identification / Passport No. *
hereby declare that this return form has been prepared based on audited accounts and contains information that is true, correct and complete pertaining to the income tax of this company as required under the Income Tax Act 1967.
( * Delete whichever is not relevant )
<>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>>>>>?
Signature Date
Designation <>>>>>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>>>>>?
Day Month Year <>>>>>>?