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Part VIII
Annual Statement of Collection or Deduction of Income Tax (Other than from Salary)
(See rule 44)
Particulars of withholding agent/payer/collector:
Name           NTN    
Address                
Statement for the year ending 30th June,  
S. No. Name, address and NTN of the person from whom tax collected or deducted Nature of payment etc. Section under which tax collected or deducted Value / amount on which tax collectible or deductible during the year. Amount of tax collected or deducted during the year.  Rate of tax collected or deducted. Amount of tax deposited.
  (As detailed on back of this form)   (Rupees) (Percentage) (Rupees)
Where NTN is not available indicate NIC or Consumer or Telephone or Registration No. etc.   (Rupees)      
           
           
(1)   (2)   (3) (4) (5) (6) (7) (8)
1.                  
                   
    NTN/NIC/Etc.              
2.                  
                   
    NTN/NIC/Etc.              
3.                  
                   
    NTN/NIC/Etc.              
4.                  
                   
    NTN/NIC/Etc.              
5.                  
                   
    NTN/NIC/Etc.              
6.                  
                   
    NTN/NIC/Etc.              
Verification Total (Rupees)  
I, ____________________________________ (Name), holder of NIC No. ________________________, in my capacity as__________________________ (Designation) and person responsible for collecting / deducting the tax , do hereby solemnly declare that to the best of my knowledge the information given in this statement is correct, complete and in accordance with the Income Tax Ordinance, 2001 and the Income Tax Rules, 2002. Tax deposited as per 1st quarter statement  
Tax deposited as per 2nd quarter statement  
Tax deposited as per 3rd quarter statement  
Tax deposited as per 4th quarter statement
Dated:_________________ (dd/mm/yyyy) Signature     Total (Rupees)  
Please see filling instructions at back page.
Filling Instructions
1. Use additional sheet(s) wherever necessary
2. State amount excluding tax relating to earlier year deposited during the year and including tax deposited in following year relating to current year in column 8.
3. This statement should be filled in the order of each person from whom tax has been collected or deducted and mentioning against it the details relating to tax collected or deducted under various section as illustrated below:
S. No. Name, address and NTN of the person from whom tax collected or deducted Nature of payment etc. Section under which tax collected or deducted Value / amount on which tax collectible or deductible during the year Amount of tax collected or deducted during the year  Rate of tax collected or deducted * Amount of tax deposited
  (As detailed on back of this form) (Rupees) (Rupees) (Percentage) (Rupees)
Where NTN is not available indicate NIC or Consumer or Telephone or Registration No. etc.          
           
1. XYZ & Co, 24, North, Jinnah Avenue, Islamabad Sale of goods 153(1)                 275,865                     9,655 3.50%                     9,655
18-01-1234567 Services 153(1)                   12,650                        633 5.00%                        633
Commission 233                   35,000                     3,500 10.00%                     3,500
2. ABC, H.No. 20, Street No. 10, Sector VI, Rawalpindi Dividend 150                     1,250                        125 10.00%                        125
02-01-2345678 Profit on debt 151                     6,230                        623 10.00%                        623
Rent 155                 320,000                   16,000 5.00%                   16,000
4. Description of sections is as under:
Section On account of Section On account of
148 Import of goods 153(3)(e) Payments to a non-resident person on account of contract for advertisement services rendered by TV Satellite Channels 
150 Dividend paid:
151(1)(a) Profit on debt paid or credited to a resident person on schemes of National Savings
154(1) Realization of proceeds of exports of goods
151(1)(b) Profit on debt paid or credited to a resident person on an account or deposit with a banking company or a financial institution 154(2) Realization of foreign indenting commission
154(3) Realization of proceeds of sale of goods to an exporter under an inland back-to-back letter of credit etc.
151(1)(c) Profit on debt paid or credited to a resident person on securities of Federal or Provencal Government or a local authority
154(3A) Export of goods by an industrial undertaking located in an export processing zone
151(1)(d) Profit on debt paid or credited to a resident person on any bond, certificate, debenture, security or any other instrument by a banking company, financial institution,  company incorporated under the Companies Ordinance,1984, a body corporate formed by or under any law in force in Pakistan or a finance society
154(3B) Payment against sale of goods by an indirect exporter to a direct exporter or an export house registered under DTRE Rules, 2001
155 Payment of rent of immovable property
152(1) Payment to a non-resident person on account of royalty or  fee for technical services 156 Payment of prize on a prize bond or winnings from a raffle, lottery, cross-word puzzle or quiz; and prize offered by companies for promotion of sale
152(2) Payment to a non-resident person on any other account including profit on debt but excluding those covered under section 153(3)
156A Payment of commission on petroleum products of petrol pump operators
153(1)(a) Payments to a resident person on account of sale of goods
153(1)(b) Payments to a resident person on account of services rendered 233 Payment of brokerage or commission including indenting, advertising, yarn, insurance or travel agent
153(1)(c) Payments to a resident person on account of execution of a contract, other than contract for sale  of goods or services rendered 233A(1)(a) and 233A(1)(b) On value of shared purchased or sold by a member of a stock exchange in lieu of its commission income
233A(1)(c)  On value of shared traded by a person (sold) through a member of a stock exchange
153(3)(a), 153(3)(b), 153(3)(c) and 153(3)(d) Payment to a non-resident on account of turnkey contract, contract or sub-contract for the design, construction or supply of plant and equipment under a hydel power project or transmission line project or any other power project or any other contract for construction or services rendered
233A(1)(d)  On financing of carry over trade (Badla) in shares business
234 Alongwith motor vehicle tax of motor vehicles
235 Alongwith electricity consumption bills
236 Telephone users including mobile phones & pre-paid cards
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