Tax File No. Sultanate of Oman Ministry of Finance Secretariat General for Taxation

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For official use No: Date: Tax File No. Sultanate of Oman Ministry of Finance Secretariat General for Taxation Income Tax Form No (14) Final Return of Income of Omani Company for tax year.. (Accounting Period from / / to / / ) (As per Article 140 of Income Tax Law) Part One: Details of the Omani company 1- Name of the company:.. 2- Address of the company - P.O. Box :.......... - City/Wilayat :.......... - Postal Code :... - Phone No. :.... - Fax No. :.... - E-Mail Address :. - Website :...... 3- Legal Status of the Company (General partnership, limited partnership, joint-venture/ Joint Stock Company (Public, Closed), Limited Liability Company):..... 4- Activity carried on by the company Main activity :........ Other activities :.... 5- Details of Commercial Registration - Governorate :...... - Commercial registration no.:. - Registration date :.....

6- Details of the principal officer - Name :...... - Position :... - Address :.... - ID Card no. /Resident Card no. /Passport no. :... - Phone no. (Office / Mobile) :... 7- Previous exemption from income Tax (if any) - Date of commencement of exemption :........ - Date of expiry of exemption :...... - Reason for exemption :...... 8- No of employees in the company - Omani employees :... - Non- Omani employees :... 9- Other details:.....

Part Two: Determination of taxable income and due tax (Amounts in OMR) Appendix No. Statement Sub-total Total 1 Net profit or loss (as per Profit/Loss account) Add: (items of earned income, and expenses not deductible) A 2 -Income earned by the company not recorded in accounts. B 3 - Profits or gains from disposal of assets not recorded in accounts except securities listed in Muscat Securities Market C 4 - Balancing charge D 5 - Expenses not wholly incurred to realize gross income of the company. E 6 - Expenses not deductible as per Law and Regulation. 7 - Expenses incurred to realize tax exempted income. F 8 - Provisions as per accounts, except provisions stipulated in Article 65/1 of the Law in the case of Insurance Companies and Article 66 in the case of Banks. 9 - Expenses payable for preparation of income tax return or tax consultancy fees. 10 - Income tax or additional tax or administrative penalties as per Law. G 11 - Loss resulting from disposal of securities listed in Muscat Securities Market as per accounts. 12 - Unrealized loss recorded in accounts. 13 - Loss resulting from disposal of fixed assets as per accounts. H 14 - Capital expenses not deductible as per Law. 15 - Remuneration of chairmen and members of board of directors of joint stock companies and salaries and wages of partners in return for management of the company as per accounts. 16 - Donations as per accounts. 17 - Bad debts as per accounts. 18 - Depreciation of fixed assets as per accounts. 19 - Interest on loans due from company (except banks and insurance companies) as per accounts. 20 Total amounts added as per items (2) to (19) 21 Net profit or loss after addition of amounts as per items (2) to (19)

(Continue) Determination of taxable income and due tax (Amounts in OMR) Appendix No. Statement Sub-total Total Deduct: (Items of income exempted from tax and deductible expenses) I 22 -Dividends realized by the company from shares it owned in the capital of any other Omani company. J 23 - Profits or gains from disposal of securities listed in Muscat Securities Market. K 24 - Loss arising from disposal of assets- which are not recorded in the accounts -except securities listed in Muscat Securities Market. 25 - Income earned from tax- exempted activities. L 26 - Income not earned by the company recorded in accounts. 27 - Profits derived from disposal of fixed assets as per accounts. M 28 - Balancing allowance. N 29 - Donations deductible as per Law and Regulation. O 30 - Debts considered as bad as per Law and Regulation. P 31 - Depreciation of capital assets as per Law. Q 32 - Interest on loans due from company (except banks and insurance companies) as per Law and Regulation. R 33 - Other deductions allowable as per Law and Regulation. 34 -Total deductions as per items (22) to (33) 35 S 36 -Net profit or loss after deducting amounts as per items (22) to (33) (item 21 minus item 34) Deduct: - Remuneration of chairman and members of board of directors of joint stock companies, and salaries and wages of partners in return for management as per Law and Regulation. 37 -Net profit or loss after deducting salaries and similar wages (item 35 minus item 36). T 38 - Loss brought forward from previous years as per Law. 39 -Taxable income or loss (item 37 minus item 38). 40 - Tax due U 41 Deduct: Tax paid as per provisional return V 42 Deduct: Excess tax paid as per final assessment for previous years. 43 Tax payable (or excess tax paid).

Part three: Accounts, appendices and details required to be attached to the return: 1. Accounts pertaining to the Omani Company prepared for the tax year for which the return is submitted- or the accounting period (s) ending in that year- audited by an accounts' auditor legally licensed to practice the audit profession in Oman. 2. Appendices from (A) to ( ) referred to in Part Two. 3. Details of the following: a. Banks- whether main centers or branches- with which the company transacts. b. Amounts paid by the company to major transacting suppliers or sub- contractors. c. Details of the company's transactions with related parties. d. Premises rented by the company to carry on activity, nature and the rent sum specified for each, the name and address of the owner and the date of registration of lease contracts thereto according to the Royal Decree No 6/89. e. Details of remittance of withholding tax in case the company pays amounts specified in Article 52 of the Income Tax Law to a foreign person or credits to its account, as given in Form No (18) attached to the Regulation of the Income Tax Law.

Part Four: I,.... in my capacity as a principal officer of the company:.... hereby declare that what have been included in the final return submitted by the company for tax year.... (Accounting period from / / to / / ) along with the attached accounts, appendices and details are true and correct according to facts. Name of the principal officer at the company:..... Designation :.... Signature :.. Date :..... Stamp :.. Income Tax Form No (14)

Sultanate of Oman Ministry of Finance Secretariat General for Taxation UReceipt of delivery of final return The Administrative and Financial Affairs Department at the Secretariat General for Taxation hereby acknowledges receipt of the final return submitted by the company: for tax year.. according to Income Tax Form No (14) on / /20 along with the following accounts, appendices and details attached to the return. 1.. 2.. 3.. 4.. 5.. 6.. 7.. Name of the recipient of return:. Position :. Signature :. Stamp of the Secretariat General for Taxation