Return Form of A Non-Resident Individual: (As Per Identification Document)

RETURN FORM OF A NON-RESIDENT INDIVIDUAL
e-M
UNDER SECTION 77 OF THE INCOME TAX ACT 1967

This form is prescribed under section 152 of the Income Tax Act 1967
YEAR OF ASSESSMENT
2014
PARTICULARS OF INDIVIDUAL
Name
YEW SHAN SHEN
(as per Identification document)
Income Tax No.
SG 12169635090
Citizen
SINGAPORE
Indentification No.
820208016014
Date of Birth
08/02/1982
Current Passport No.
E4664331A
Expiry Date of Current Passport
13/06/2019
Sex
FEMALE
Status as at 31-12-2014
SINGLE
Record -keeping
YES
Date of Marriage / Divorce /

Demise
Type of Assessment
SELF(SINGLE / DIVORCE / WIDOW / WIDOWER)

Identification No.
820208016014
Permanent Address in
BLK3 TANJONG PAGAR PLAZA #17-31, SINGAPORE 081003,
Country of Origin of Individual
86000, KLUANG, JOHOR
Telephone No.
077723432
Name of Bank & Account No.
UNITED OVERSEAS BANK (MALAYSIA) BERHAD & 6013002948
Type of Foreign Currency

Requested
e-Mail
sunshine.yew@gmail.com
SWIFT Code
Employer's No.
STATUTORY INCOME AND TOTAL INCOME
Statutory income from businesss
Statutory income from partnerships
Aggregate statutory income from businesses
LESS: Business losses brought forward
TOTAL
Statutory income from employment / director's fees

* If there is a claim for exemption of employment income under:
State: Amount exempted

Statutory income from dividends and rents
0
8,400
Statutory income from discounts, premiums, pensions, annuities, other periodical payments,
other gains or profits and additions pursuant to paragraph 43(1)(c)
AGGREGATE INCOME
LESS : Current year business losses (Restricted to Aggregate income amount)
LESS : Qualifying prospecting expenditure - Schedule 4 and paragraph 44(1)(b)
8,400
0
9,180
LESS : Approved Donations / Gifts / Contributions
TOTAL
TAXABLE PIONEER INCOME

Gross income subject to tax at other rates. Please specify: ( )
TOTAL INCOME (SELF)
Tarikh cetakan : 11-04-2015 TT2014
Muka surat 1/4
Name
YEW SHAN SHEN
SG 12169635090
Income Tax No.

PARTICULARS OF HUSBAND / WIFE
Name of Husband / Wife

(as per Identification document)
Identification No.
Current Passport No.
Expiry Date of Current Passport
Date of Birth
INCOME OF PRECEDING YEARS NOT DECLARED
Type of Income
Year for which paid
Gross Amount
Provident and Pension Fund

Contribution
TAX PAYABLE / REPAYABLE
CHARGEABLE INCOME
COMPUTATION OF TAX CHARGEABLE

Division of Chargeable Income according to the rate applicable
Chargeable Income
Income Tax
Tax Rate (%)

26.00
0.00
0.00
0.00
0.00
TOTAL INCOME TAX
0.00
LESS:
Section 51 Finance
0.00
Act 2007 (dividends)
0.00
Section110
(others)
Section132 and
133
YEAR OF ASSESSMENT 2014 TAX PAYABLE
0.00
0.00
0.00
TAX SUMMARY
Chargeable Income
Total Income Tax
0.00
LESS : Total deduction and relief (Section 132 and 133 tax relief restricted to total)
0.00
YEAR OF ASSESSMENT 2014 TAX PAYABLE
0.00
Instalments/Monthly Tax Deductions Paid for 2014 Income SELF and HUSBAND / WIFE for joint assessment
0.00
Balance Of YA 2014 Tax Payable
0.00
Muka surat 2/4
Name
YEW SHAN SHEN
Income Tax No.
SG 12169635090
FINANCIAL PARTICULARS OF INDIVIDUAL

Name of Business
Business Code
BALANCE SHEET
TRADING, PROFIT AND LOSS ACCOUNT
FIXED ASSETS
Sales/Turnover
Land and buildings
LESS :
Plant and machinery
Opening stock
Motor vehicles
Purchases and cost of production
Other fixed assets
Closing stock
TOTAL FIXED ASSETS
Cost of sales
0 Investments
GROSS PROFIT / LOSS
0 CURRENT ASSETS
OTHER INCOME
Stock
Other business income
Trade debtors
Dividends
Sundry debtors
Interest and discounts
Cash in hand
Rents, royalties and premiums
Cash at bank
Other income
Other current assets
TOTAL
0 TOTAL CURRENT ASSETS
EXPENSES
TOTAL ASSETS
Loan Interest
LIABILITIES
Salaries and wages
Loans and overdrafts
Rental/Lease
Trade creditors
Contracts and subcontracts
Sundry creditors
Commissions
TOTAL LIABILITIES
Bad debts
OWNER'S EQUITY
Travelling and transport
Capital account
Repairs and maintenance
Current account balance

brought forward
Promotion and advertisement
Current year profit/loss
Other expenses
Net advance/drawing
TOTAL EXPENDITURE
0
0
Current account balance carried

forward
NET PROFIT / LOSS

Non-allowable expenses
PARTICULAR OF BUSINESS INCOME
Losses carried forward

Pioneer loss carried forward
Business capital allowance carried forward
Partnership capital allowance carried forward
Muka surat 3/4
Name
YEW SHAN SHEN
Income Tax No.
SG 12169635090
DECLARATION
I,
YEW SHAN SHEN
Identification No.
820208016014
hereby declare that the information regarding the income and claim for deductions and reliefs given by me in this return form is
true, correct and complete.
IMPORTANT REMINDER
* METHOD OF PAYMENT :
1. Payment can be made as follows :
1.1 Bank
- Information regarding payment via bank is available at the LHDNM Official Portal, http://www.hasil.gov.my
1.2 LHDNM
- ByrHASiL, via FPX (Financial Process Exchange) at the LHDNM Official Portal, http://www.hasil.gov.my
- LHDNM payment counters in Peninsular Malaysia (Kuala Lumpur Payment Centre), Sabah and FT Labuan
(LHDNM Kota Kinabalu Branch) and 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 (CP501) 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.
1.3 Pos Malaysia
Berhad
counter and Pos Online
2. Write down the name, address, telephone number, income tax number, year of assessment , payment code "084" and
installment no. "99" on the reverse side of the financial instrument.
3. Check the receipts / bank payment slips before leaving the payment counter.
Muka surat 4/4

Return Form of A Non-Resident Individual: (As Per Identification Document)

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Return Form of A Non-Resident Individual: (As Per Identification Document)

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RETURN FORM OF A NON-RESIDENT INDIVIDUAL

UNDER SECTION 77 OF THE INCOME TAX ACT 1967

YEW SHAN SHEN

(as per Identification document)

Income Tax No.

Current Passport No.

Expiry Date of Current Passport

Date of Marriage / Divorce /

SELF(SINGLE / DIVORCE / WIDOW / WIDOWER)

BLK3 TANJONG PAGAR PLAZA #17-31, SINGAPORE 081003,

Country of Origin of Individual

86000, KLUANG, JOHOR

Name of Bank & Account No.

UNITED OVERSEAS BANK (MALAYSIA) BERHAD & 6013002948

Type of Foreign Currency

LESS: Business losses brought forward

Statutory income from employment / director's fees

State: Amount exempted

LESS : Approved Donations / Gifts / Contributions

TAXABLE PIONEER INCOME

TOTAL INCOME (SELF)

Tarikh cetakan : 11-04-2015 TT2014

Muka surat 1/4

YEW SHAN SHEN

Income Tax No.

Name of Husband / Wife

Expiry Date of Current Passport

Year for which paid

Provident and Pension Fund

TAX PAYABLE / REPAYABLE

COMPUTATION OF TAX CHARGEABLE

Tax Rate (%)

TOTAL INCOME TAX

Act 2007 (dividends)

YEAR OF ASSESSMENT 2014 TAX PAYABLE

Total Income Tax

YEAR OF ASSESSMENT 2014 TAX PAYABLE

Balance Of YA 2014 Tax Payable

Tarikh cetakan : 11-04-2015 TT2014

Muka surat 2/4

YEW SHAN SHEN

Income Tax No.

FINANCIAL PARTICULARS OF INDIVIDUAL

TRADING, PROFIT AND LOSS ACCOUNT

Land and buildings

Plant and machinery

Purchases and cost of production

Other fixed assets

TOTAL FIXED ASSETS

GROSS PROFIT / LOSS

Other business income

Interest and discounts

Rents, royalties and premiums

Other current assets

0 TOTAL CURRENT ASSETS

Salaries and wages

Loans and overdrafts

Contracts and subcontracts