E Form 2009 - Hasil

1 1 FOR REFERENCE ONLYCP 8 - Pin. 2009 RETURN form OF EMPLOYERLEMBAGA Hasil DALAM NEGERI MALAYSIAFormEThis form is prescribed under section 152 of the Income Tax Act 1967 Name ofEmployer asRegistered1 Reference IdentityCard ERegistration CompaniesCommission ofMalaysia or others86 Status(use the status code)3 Date received (1)Date received (2)Date received (3) 2009 REMUNERATION FOR YEARUNDER SUBSECTION 83(1) OF THE INCOME TAX ACT 1967 Old IdentityCard Address11e-mailPostcodeTown-State03 = D 05 = J07 = TP09 = TC01 = SG06 = F08 = TA02 = OG04 = C11 = TR10 = CS12 = OthersFOR OFFICE USE2 FOR REFERENCE ONLYNameReference No.

2 EPART A: INFORMATION ON NUMBER OF EMPLOYEES FOR THE YEAR ENDED 31 DECEMBER 2009A2A3 Number of new employeesA4 Number of employees whoceased employmentA1 Number of employeesNumber of employeesunder the STD schemeA5 Number of employeeswho ceased employmentand left MalaysiaA6 Has the cessation beenreported to LHDNM?(If A5 is applicable)1 = Yes2 = Nohereby declare that the information given in this form is true, correct and complete in accordance with the requirements of theIncome Tax Act B:DECLARATIONI,Identity Card No. / Passport No. /Police No. / Army No.** Delete whichever is not relevantSignatureDesignationDate:DayMont hYear--4 FOR REFERENCE ONLYRETURN OF REMUNERATION FROM EMPLOYMENT FOR THE YEAR ENDED 31ST DECEMBER 2009 ANDPARTICULARS OF INCOME TAX DEDUCTION UNDER INCOME TAX RULES(DEDUCTION FROM REMUNERATION) 1994 NameReference No.

3 EBName Of EmployeeReference employer is required to fill in this section if there is any employee whose annual gross remuneration is RM30,000 andabove OR for any employee whose annual gross remuneration is less than RM30,000 but the monthly gross remunerationis RM2,500 and above (inclusive of bonus but excluding remuneration in arrears in respect of preceding years) forwhichever month in the year 2009 . NOTE:AN EMPLOYER CAN PREPARE COPIES AS PER THE FORMAT IN THIS SECTION IF THE SPACE PROVIDED INTHIS form IS EMPLOYER IS ENCOURAGED TO SUBMIT 8D ON DISKETTE/TAPE/COMPACT DISC IN ACCORDANCEWITH THE FORMAT SPECIFIED BY LHDNM.( 8D - Pin.)

4 2009 )5 FOR REFERENCE ONLYNameReference No. EEGDT otal Gross Remuneration(including benefits-in-kindand value of livingaccommodation benefitprovided but excludingremuneration in arrears inrespect of preceding years)Identity Card No. /Passport No. / PoliceNo. / Army Exempt Allowances /Perquisities / Gifts /BenefitsTotal Tax DeductionSTDCP 38 RMRMRMRMTOTALFHRETURN OF REMUNERATION FROM EMPLOYMENT FOR THE YEAR ENDED 31ST DECEMBER 2009 ANDPARTICULARS OF INCOME TAX DEDUCTION UNDER INCOME TAX RULES(DEDUCTION FROM REMUNERATION) 1994( 8D - Pin. 2009 )7 FOR REFERENCE ONLYCName of and Address of form EA MUST BE PREPARED AND PROVIDED TO THE EMPLOYEE FOR INCOME TAX PURPOSEEMPLOYMENT INCOME, BENEFITS AND LIVING ACCOMMODATION (Excluding Tax ExemptAllowances/Perquisites/Gifts/Benef its) RM1.

5 Gross salary, wages or leave pay (including overtime pay)..Fees (including director fees), commissions or tips, perquisites, awards/rewards or other allowances (Details of payment ..)..Income tax borne by the employer in respect of his Value of benefits-in-kind:(a) Motorcars (Actual date )(i) Value of motorcar and ( )(ii) Value of (b) Electricity, water, telephone and other ( c ) Value of household benefits: ( *Delete whichever is not relevant )(i) Semi-furnished with furniture*/air-conditioners*/curtains*/c arpets*, (ii)Fully-furnished with kitchen equipment, crockery, utensils and appliances, (iii) Separate Items:Furniture and and (d) Household servant and (e) Benefit of leave passage for ( f ) Others (for example food and garments).

6 3. Value of living accommodation provided ( )..4. Refund from unapproved Pension/Provident Fund, Scheme Or Compensation for loss of AND OTHERS1. Annuities or other Periodical TO APPROVED PENSION/PROVIDENT FUND, SCHEME OR SOCIETYName of Provident Fund ..Amount of contribution (state the employee's share of contribution only) RM .. ( 8A - Pin. 2009 )DEMALAYSIAINCOME TAXSTATEMENT OF REMUNERATION FROM EMPLOYMENTFOR THE YEAR ENDED 31 DECEMBER ..APARTICULARS OF EMPLOYEE1. Full Name of Employee/Pensioner ( ) ..2. Job New Identity Card No.. Identity Card EPF If the period of employment is less than a year, please state:(a) Date of (b) Date of DEDUCTION1.

7 Current Year's Schedular Tax Deductions (STD) remitted to CP 38 Deductions for Zakat remitted to the collection authority of Malaysian OF PAYMENT IN ARREARS AND OTHER PAYMENTS IN RESPECT OF PRECEDING YEARS (PRIOR TO CURRENTYEAR)Year for which PaidType of IncomeTotal Payment (RM)EPF Contribution (RM)Schedular Tax Deductions (STD) (RM)..FSerial 's No. E ..Employee's Reference SECTOR Employee'sStatement of RemunerationTOTAL TAX EXEMPT ALLOWANCES / PERQUISITES / GIFTS / REFERENCE ONLY( 8C - Pin. 2009 )ECEMPLOYMENT INCOME AND BENEFITS (Excluding Tax Exempt Allowances/Perquisites/Gifts/Benefits) (a) Salary, including Leave Pay, Bonuses and (b) Gratuity for the period from.

8 To .. (State the ).. of Leave Passage for Travel (if relevant)..TAXABLE INCOME ( B1 + B2 + B3 )Date ..BDCONTRIBUTION TO EMPLOYEES PROVIDENT FUND (state the employee's share of contribution only)..APARTICULARS OF EMPLOYEE1. Full Name of Employee/Pensioner ( )..2. Job New Identity Card No .. Identity Card EPF If the period of employment is less than a year, please state:(a) Date of (b) Date of DEDUCTION1. Current Year's Schedular Tax Deductions (STD) remitted to CP 38 Deductions for Zakat remitted to the collection authority of Malaysian OF PAYMENT IN ARREARS AND OTHER PAYMENTS IN RESPECT OF PRECEDING YEARS (PRIOR TO CURRENTYEAR)Year for which PaidType of IncomeTotal Payment (RM)EPF Contribution (RM)Schedular Tax Deductions (STD) (RM).

9 CEmployee's Reference 's No. E ..PUBLIC SECTOR Employee'sStatement of RemunerationTHIS form EC MUST BE PREPARED AND PROVIDED TO THE EMPLOYEE FOR INCOME TAX PURPOSEMALAYSIAINCOME TAXSTATEMENT OF REMUNERATION FROM EMPLOYMENTFOR THE YEAR ENDED 31 DECEMBER ..LIST OF TAX EXEMPT ALLOWANCES / PERQUISITES / GIFTS / BENEFITS WITH RESPECTIVE AMOUNTType of Allowances/Perquisites/Gifts/BenefitsExe mpted Amount (RM)Type of Allowances/Perquisites/Gifts/BenefitsExe mpted Amount (RM)1..3..2..FEName of and Address of REFERENCE ONLYP etrol card, petrol allowance or travel allowance or any of its combination for travelling between the homeand place of work (up to year of assessment 2010 only).

10 Petrol card, petrol allowance, travelling allowance or toll payment or any of its combination for officialduties. If the amount received exceeds RM6,000 a year, the employee can make a further deduction inrespect of the amount spent for official duties. Records pertaining to the claim for official duties and theexempted amount must be kept for a period of 7 years for audit care allowance in respect of children up to 12 years of business products of the employer provided free of charge or at a partly discounted price tothe employee, his spouse and unmarried children. The value of the goods is based on the sales received by the employee from a company within the same group of companies as his employerare not exempted from of fixed line telephone, mobile phone, pager or Personal Digital Assistant (PDA) registered in thename of the employee or employer including cost of registration and bills for subscription of broadband, fixed line telephone, mobile phone, pager and PDA registeredin the name of the employee or employer including cost of registration and of new personal computer (one unit).