COMPANY INCOME TAX RETURN
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1 COMPANY INCOME TAX RETURN C COMPANY Name of Company : Postal Address : Taxation Division Derived during the year ended 31st December Nature of Company's Business : Nature of Company's Structure : (Tick the appropriate box) REGISTERED OFFICE Exact Location : TAX IDENTIFICATION NUMBER (T.I.N.) : Public Private or the substituted year ended Resident Non-resident Tick if it is a resident mutual or non-mutual insurance company? Do you have any investments and/or assets overseas? Yes No If yes complete line 99 on page Is the Company engaged in FAVP: Yes No If yes please complete the supplementary form IRS 204A. Is the Company a non-resident company claiming Film Tax Rebate: Yes No If yes please complete the supplementary Tax Rebate IRS 222. Postal Address : AUTHORISED OFFICER Name : Postal Address : Telephone No. : Address: If you would like your refund to be deposited in your bank account please complete the details below NOTE: The bank account nominated must belong to the Company Bank Name : Bank Branch : Account No. : OFFICE USE ONLY Stamp Here DATA ENTRY : ASSESSOR : CHECKER : BATCH NO. : RETURN NO. : FSIC :
2 2 1 NET PROFIT as shown in Profit and Loss Account Add: Items not allowable as deductions (attach details) 2 Depreciation charged in Accounts 3 Capital Expenditure 4 Income Taxes, SRT, CGT, FBT (Section 22(h)) 5 Donations and Subscriptions 6 Legal Expenses 7 Fines and Penalties 8 Unrealized Exchange Loss 9 Impairment Loss 10 Fair Value Losses on Assets and Liabilities 11 Additions to Provisions and Reserves 12 Losses on Disposal of Assets for accounting purposes 13 Gain on Disposal of fixed assets for Tax purposes 14 Preliminary Expenses 15 Audio Visual Production Income (Legal Notice 8) 16 FNPF (50% of 10% Employer Contribution)(Section 23(2)) 17 Debt Forgiveness 18 Forfeited Deposits 19 Other Items Less: Deductions/Concessions Sub Total a20 Depreciation Allowable (Legal Notice 1) 21 Accelerated Depreciation 22 Net Exempt Income (being gross income less expenses incurred) (LN2) 23 Commercial Agriculture & Agro- Processing-Vanua Levu(LN 2 Part 9 (2)) 24 Tax Concession- Small & Micro Enterprises (Legal Notice 2 Part 9 (4)) 25 Bio Fuel Production (10 year tax holiday) (Legal Notice 2 Part 9 (7)) 26 Dividend Deduction (Legal Notice 2 Part 5 (5)) 27 Renewable Energy Projects(5 year tax holiday)(legal Notice 2 Part 9 (8)) 28 Nausori to Ba Tax Free Region Exemption (Legal Notice 2 Part 9 (10)) 29 Hotel Aid Investment Allowance (Legal Notice 3) 30 Medical Investment Incentives (Legal Notice 4) 31 Residential Housing Development Incentive (Legal Notice 6) 32 Maritime Vessel Investment Allowance (Legal Notice 7) 33 Film Making & Audio Visual Production - exempt income(legal Notice 8) 34 F 1 - Contribution to Audio Visual Production(150% of expenditure)(ln8) 35 F 2 - Contribution to Audio Visual Production (125% of expenditure)(ln8) 36 TFF/TFZ/TFR Concession (Legal Notice 10) 37 Decrease in Provisions 38 Amortization of Deferred Grant Revenue 39 Unrealized Exchange Gain 40 Reversal of Impairment loss 41 Share of Gain from Investment in Associates 42 Losses on Disposal of Assets for Tax purposes Office Use Only
3 3 43 Gain on Disposal of Assets for accounting purposes 44 Fuel Concession 45 Investment Allowances 46 Employee Share Scheme (Section 16) 47 Cash Donations to Approved Organisations/Charities (Section 24 (1) & (2)) Donation to Sports fund (Section 24 (3)) Donation to Fiji Heritage Foundation (Section 24 (4)) 50 Donation-Poverty Relief Fund for Education (Section 24(5)) Donation of Computers to Schools (Section 24 (6) & (7)) Disaster Rehabilitation Fund (Section 24 (8)) Donation to Farmers Emergency Fund Acc (Section 24 (11)) Listing on Stock Exchange 150% Deduction (Section 25 (2)) 55 Vanua Levu Incentive- 40% Deduction on capital expenditure(section 25 (4)&(5) % Deduction - Rural Banking Programming (Section 25 (6)) 57 Commercial Agriculture & Agro-Processing (Section 25 (7)) 58 Export Profit (Section 25 (8)) 59 ICT Development - 150% Deductions (Section 25 (12)) 60 ICT Training Institutions 150% Deductions (Section 25 (13)) 61 Uniform made in Fiji 50% Deductions (Section 25 (14)) 62 Cyclone Reserve Fund (Section 28) 63 Amortization of Business Intangibles (Section 35) 64 ETS (Section 143 (3)) 150% Deductions for Professional Qualification Fees 65 ETS 200% Deductions for First Full Time Employees, Student Employees 66 ETS 300% Deduction for employment of Disabled People 67 Electric Vehicle Charging Station 68 Other Items (attach details) Sub Total 69 Taxable Business Income/Loss for Current Year 70 Losses brought forward from prior years 71 CHARGEABLE INCOME/LOSS 72 Film Tax Rebate 73 Opening Stock 74 plus: Purchases 75 less: Closing Stock INFORMATION REQUIRED OFFICE USE ONLY Total Sales less: Cost of Goods Sold Gross Trading Income plus: Interest Income plus: Dividend Income plus: Other Income = COST OF GOODS SOLD = GROSS TRADING INCOME = TOTAL GROSS INCOME 82
4 Total Expenses Interest Expenses Net Income Total Assets INFORMATION REQUIRED continued 87 Total Liabilities ICT Incentives Current Year Previous Year No. of Employees Total Sales Office use Only 92 Gross Wages and Salaries paid for the year DETAILS OF DIRECTOR S/MANAGEMENT FEES PAID Name of Director T.I.N. of Director Director's/Mgt Fees Total : 94 Continue on a separate sheet if necessary Total Fees: 93 DETAILS OF DIVIDEND PAID (Include Directors Advance/Deemed Dividend) Name of Recipient T.I.N. of Recipient Gross Dividends Total : 96 Continue on a separate sheet if necessary Total Dividends: 95 INTEREST INCOME Name of Financial Institution Gross Interest Total : 98 Continue on a separate sheet if necessary Total Interest Income: 97
5 5 OVERSEAS INCOME INFORMATION REQUIRED continued Office use Only Name of Company W/ Gross Income Total W/ 100 Total Gross Income: 99 DETAILS OF CONTRACTUAL PAYMENTS RECEIVED Name of Contractor T.I.N. of Contractor Gross Payment Total : 102 Total Payments: NOTE: Continue on a separate sheet if necessary SHARE OF JOINT VENTURE/TRUST/PARTNERSHIP INCOME RECEIVED Name of Joint Venture/Trust/Partnership T.I.N. Income NOTE: Continue on a separate sheet if necessary Total Income: DETAILS OF MANAGEMENT FEES RECEIVED Name of Paying Company T.I.N. Gross Payment Total : 105 Total Payments 104
6 6 INFORMATION REQUIRED continued DIRECTOR'S FEES RECEIVED Name of Director T.I.N. Gross Payment Office use Only Total : 107 Total Payments: 106 DECLARATION BY AUTHORISED OFFICER I, declare that this tax return is true and complete. Signature: Date: IT IS A SERIOUS OFFENCE TO MAKE A FALSE INCOME TAX RETURN DECLARATION BY TAX AGENT I, declare that this tax return has been prepared in accordance with information supplied by the taxpayer. Signature: Date: Tax Agent's No.: NOTE: All attachments to this return must be signed by the person authorised to make the return.
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