SPT Dollar dan Rupiah beserta Lampirannya
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Transcript of SPT Dollar dan Rupiah beserta Lampirannya
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MINISTRY OF FINANCE OF REPUBLIK OF INDONESIA DIRECTORATE GENERAL OF TAXES
INSTRUCTION FOR THE COMPLETION OF INCOME TAX RETURN FOR CORPORATE
GENERAL INSTRUCTION
In accordance with the Law Number 6 of 1983 concerning General Provisions and Tax Procedures as lastly amended by Law Number 16 of 2009, Taxpayers should pay attention to several things below: 1. Any Taxpayer should be required to complete and file its Annual Tax Return truly, completely, and
clearly and also sign it.
2. The Tax Return shall be signed by the Taxpayer or his/her authorized proxy/representative.
3. The Tax Return shall be assumed not filed if it is not signed or it is not fully provided with details
and/or documents as regulated by Minister of Finance Decree No. 534/KMK.04/2000, Minister of Finance Regulation No. 181/PMK.03/2007 and Director General of Taxes Decree No. KEP-214/PJ./2001.
4. Any Taxpayer shall collect his/her own annual tax return to tax office (KPP)/ taxation and
consultation office (KP2KP) or can be downloaded through website www.pajak.go.id and file it not later than 4 (four) months after the end of taxable year .
5. The tax return may be directly delivered in to the tax office where the tax payer is registered or
other places regulated by the Director General of Taxes which is : Tax corner, Tax mobile and specific appointed tax return receiving places (Drop Box) or send it by registered mail through post office or some other ways as regulated by Minister of Finance Decree No. 181/PMK.03/2007 as amended by Minister of Finance b Regulation Number 152/PMK.03/2009
6. Any underpayment shall be paid in full before the tax return filed. Failure to make full payment within such a period shall result in an administrative sanction in the form of a monthly interest of 2 % (two percent) from the due date of payment to the date on which the full payment is made. Any portion of a month shall be considered as a full month.
7. The Taxpayer shall be required to make tax payments to the State Treasury through a Post Office or banks designated by the Minister of Finance.
8. The Director General of Taxes may – at the request of a Taxpayer – approve a tax to make an instalment or a deferral of tax payment, including any underpaid tax in the annual tax return (income tax article 29) for a period not exceeding a 12 (twelve) month period. Under Director General of Taxes Decree No. PER-38/PJ/2008, the request shall be submitted in writing to the head of a tax office in which the Taxpayer is registered, at the latest 9 (nine) working days before payment due date, using a designated form attached in attachment Form- I on that decree.
9. The Director General of Taxes may – at the request of a Taxpayer – extend the filing period of an annual tax return for no later than 2 (two) months. The request shall be made in writing, accompanied with a statement of one-tax-year's interim tax due and its proof of payment.
10. Failure to file the Annual Tax Return within the specified period or an extended period shall result in an administrative fine of Rp 1,000,000 (one million rupiah).
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11. Book of accounts in English language and United State Dollar currency is able to be applied by Taxpayer after getting permission from Ministry of Finance. Taxpayer who allowed to have a book of accounts in English language and United State Dollar Currency shall apply the Corporate Annual Income Tax Return and its attachments in Bahasa (except an attachment in the form of financial statement) and in dollar united state currency. This agreement arranged in Ministry of Finance Regulation Number 196/PMK.03/2007.
12. Anyone who – by reason of negligence or deliberately – fails to file an Annual Tax Return, or files one incorrectly, or not completed, or furnishes false information which may causes to the Government, shall be subject to administrative sanctions and / or criminal sanctions in accordance with the provisions of the applicable legislation.
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INSTRUCTIONS FOR THE COMPLETION
Income Tax Annual Return year of 2009 is using a form which is able to read by scanning machine, therefore, Taxpayers need to comply with the following conditions:
1. If the Taxpayer makes the Annual Tax Return forms itself, not to forget to make (black square) on every corner as border so that the document can be scanned.
2. Use the paper size F4/Folio (8.5 x 13 inch) with minimum weight of 70 gram.
3. Paper should not be fold or rumpled.
4. Identity column : for Taxpayers using typing machine, when filing unstructured column (such as Taxpayer’s name, Type of Business and Origin Country of Head Office (for PEE)), letter boxes can be ignored as long as the writing does not over the right border. For structured filling (such as Taxpayer’s Identification Number, Phone Number), each number should be written in a letter box.
Example of Filling:
TIN :
Taxpayer’s Name : PT. MAJU MAKMUR SENTOSA JAYA
Types of Business : WOOD FURNITURE INDUSTRY
Telephone No. :
Notes: for those using computer or hand writing, all filling should be in letter boxes.
5. In filling monetary values in rupiah or United State Dollar currency, the number should be written without decimal places. Example:
a. In writing ten million rupiah is: 10.000.000 (NOT 10.000.000,00)
b. In writing a hundred twenty five rupiah fifty cent is 125 (NOT 125,50)
0 7 2 3 4 5 6 7 8 0 1 2 0 0 0
0 7 2 1 1 2 3 4 5 6 7 8
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Item 1 : DOMESTIC NET COMMERCIAL INCOME
Domestic commercial net income is the net income according to Indonesian accounting principles, namely all incomes received and obtained from business activities and from non-business activities in Indonesia including income imposed by Finalized Tax and non taxable object, deducted with expenditures/costs to obtain, bill, and maintain income in accordance with the Indonesian accounting system and method which is followed consistently as reflected in the commercial financial statement, before adjusted according to Income Tax Law and its implementing regulations.
a. GROSS INCOME
Fill with the gross amount of business activities in Indonesia, after less of sales return and discount, for trade and industrial company in the taxable year concerned.
b. COST OF SALES
Fill with cost of sales from Taxpayer’s business activity. If according to accounting system and method followed by particular Taxpayers (e.g. banks, pension fund, mutual fund, social organizations, associations etc.) there is no costs separation or classification for cost of sales, then all costs are reported into point c: others expenses.
c. OTHER OPERATING EXPENSES
Fill with expenses which are not included in cost of sales.
d. NET INCOME FROM BUSINESS (1a – 1b – 1c)
Net income is calculated from sales deducted by cost of sales and others expenses.
e. INCOME FROM NON BUSINESS ACTIVITIES
Fill with gross amount of income received and or obtained from non business activities as stated in point a, for example: income from capital investment in Indonesia, gain from sales/transfers/leases of assets, and other incomes which are not included in income from business activities or not related with business activities.
f. EXPENSES FROM NON BUSINESS ACTIVITIES
Fill with direct expenses relevant to the income from non business activities as stated in point e.
g. NET INCOME FROM NON BUSINESS ACTIVITIES (1e-1f)
Fill with amount from point e deducted by point f.
h. Total (1d + 1g)
Sufficiently clear
Item 2 : FOREIGN COMMERCIAL NET INCOME
Fill with the net income received or obtained from overseas as stated in special form 7A/7B column (5) ‘Net Amount’.
Item 3 : TOTAL NET COMMERCIAL INCOME (1h + 2)
Fill with net commercial income from domestic and overseas.
ATTACHMENT – I (FORM 1771 – I AND FORM 1771 – I / $)
CALCULATION OF FISCAL NET INCOME
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Item 4 : INCOME SUBJECT TO FINALIZED INCOME TAX AND NON TAXABLE INCOME
In order to calculate the net amount of taxable income according to general provisions, income from Indonesia which is imposed by Finalized Tax and non taxable objects must be deducted so as the net taxable income (number 8) will be zero/nil. Fill with the commercial net income from income which is imposed by Finalized Tax and commercial net income from non taxable objects that has already been recorded in number 1 form 1771-I; in case of experiencing commercial loss , fill with the amount of commercial loss.
Item 5 : POSITIVE ADJUSTMENTS
Positive adjusment for tax purpose is the adjustment of commercial net income (excluding income which is imposed by Finalized Tax and non taxable objects) in order to calculate Income Tax according to Income Tax Law and its implementing regulations, which increases the income and or reduces commercial costs stated in number 1.
a. Adjustments based on Article 9 paragraph (1) subparagraph b of Income Tax Law, corporate expenditures to buy/fix private houses or cars, private/family travel expenditures, private/family insurance premium expenditures, and other expenditures for stockholders, partners, or members, must be excluded from corporate expenses.
b. Adjustments based on Article 9 Paragraph (1) Subparagraph c of Income Tax Law, the formation and maintenance of reserved fund must be excluded from corporate expenses. However for certain businesses that economically requires to form reserved fund to cover expenses and loss in the future, it is still allowed to consider it as expenses, but limited to:
1. Allowance for Doubtful Accounts for bank industry and other entity which is transferring a
credit , leasing with option right, multifinance and factoring companies;
2. reserve for insurance, include reserve for social aids generated by Badan Penyelenggara Jaminan Sosial (Committee of social Security)
3. reserve of security for LPS
4. reserve of reclamation cost for mining sectors
5. reserve of replanting cost for forestry sector
6. reserve of shut-down and maintenance cost of the banishment of industrial waste for industrial-waste processing sector
See : * Minister of Finance Regulation Number 81 / PMK.03 / 2009 .
c. Pursuant to Article 4 Paragraph (3) Subparagraph d of Income Tax Law, consideration or remuneration in the form of benefit in-kinds in relation with employment or services is not
See : * Minister of Finance Regulation Number 83/PMK.03 /2009;
d. Adjustment pursuant to Article 9 Paragraph (1) Subparagraph f of Income Tax Law, payment of salary, honorarium, and other rewards referring to passed to service or work given to stockholders or other related parties as stated in Article 18 Paragraph (4) of Income Tax Law, can be burdened as expense of a company as long as its amount does not exceed fairness. Fairness is measured based on common standards for the same qualification of work which is done by non related parties. The difference exceeding fairness may be considered as distribution of profit.
e. Pursuant to Article 4 Paragraph (3) Subparagraph a of Income Tax Law, aid or donation and grant received by religious bodies, education institutions, social bodies, or small enterprises including cooperation as regulated by the Minister of Finance, are not considered income as long as there is no relationship based on business, employment, ownership, or control among related parties. Therefore according to the taxability and deductibility principle, adjustment according to
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Article 9 Paragraph (1) Subparagraph g of Income Tax Law, the aid or donation and grant given by Taxpayers can not be burdened as expenses.
See : Minister of Finance Decree Number 604/KMK.04/1994.
Tithe or Zakat paid by corporate Taxpayer owned by moslem can be deducted from gross income to calculate Taxable Income under these conditions:
The taxable income entitled to be tithed has already been reported in the Annual Tax Return; The zakat is delivered through Amil Zakat Body (BAZ) or Amil Zakat Institution (LAZ) formed or
approved by Central/Local Government;
Therefore non income zakat and zakat from income which does not fulfil those conditions above are not allowed to be burdened as expense.
f. Adjustments pursuant to Article 9 Paragraph (1) Subparagraph h of Income Tax Law, Income Tax and Tax Credit are not considered as company’s expenses.
g. Pursuant to Article 4 Paragraph (3) Subparagraph i of Income Tax Law, part of a profit received or obtained by member of partnership whose capital is not divided into shares, partnership, association, firms, and kongsi is not considered as income. Therefore according to taxability and deductibility principle, the adjustment pursuant to Article 9 Paragraph (1) Subparagraph j of Income Tax Law, for those stated entities, payment of salary to their members can not be burdened as expenses.
h. Adjustments pursuant to Article 9 Paragraph (1) Subparagraph k of Income Tax Law, administrative penalty in terms of interests, fines, and increases of tax, and criminal penalties in terms of fines following tax laws are not considered expenses to the company.
i. Fill according to Special Attachment of I A / I B list of Depreciation and Amortization Fiscal.
j. Fill according to Special Attachment of I A / I B list of Depreciation and Amortization Fiscal.
k. Adjustments pursuant to Article 7 Government Regulation Number 138 of 2000, DGT Decree may determine certain times for cost recognation for certain Taxpayers following the Government policy.
See : * DGT Decree Number Kep- 184/PJ./2002; * DGT Circular Number SE- 08/PJ.42/2002.
l. Adjustments according to general provision article 4 and Article 6 and their implementing regulations, in case of:
There is income which is not recognized commercially but considered as Taxable Object imposed by non Finalized Tax;
There are other company’s expenses or loss which are commercially recognized but are not recognized for the tax purpose;
There is overseas loss whether from Permanent Establishment (PE) or not, after adjusted for the tax purpose.
See : Minister of Finance Decree Number 164/KMK.03/2002.
DGT Circular Number SE-04/PJ.42/2002; DGT Circular Number SE-01/PJ.33/2005.
Item 6 : NEGATIVE ADJUSTMENTS
Negative adjusment for tax purpose is the adjustment of net commercial income (excluding income which is imposed by Finalized Tax and non taxable object in order to calculate Income Tax according to Income Tax Law and its implementing regulations, which is reducing the income and or increasing commercial costs stated in number 1.
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a. Fill according to Special Attachment of I A / I B List of Depreciation and Amortization Fiscal.
b. Fill according to Special Attachment of I A / I B List of Depreciation and Amortization Fiscal.
c. Adjustment pursuant to Article 7 of the Government Regulation Number 138 of 2000, DGT Decree may determine certain times for revenue recognation for certain Taxpayers according to the Government policy.
See : * DGT Decree Number Kep-141 / PJ. / 1999; * DGT Decree Number Kep-563 / PJ. / 2001; * DGT Decree Number Kep-184 / PJ. / 2002; * DGT Circular Number SE-08 / PJ.42 / 2002.
d. Adjustment pursuant to Article 6 of Income Tax Law and its implementing regulations, in case a company has other expenses or loss which are commercially not recognized but fiscally recognized.
Item 7 : INVESTMENT ALLOWANCE
Item 7a Fill with what period the facilities have been used
Item 7b Fill with the amount of net income deduction facilities for investment which has already been approved by an authoritative officer as mentioned in the list of investment facilities number 5b (Tax Return Special Attachment 4A/4B).
Item 8 : FISCAL NET INCOME
Fill with the result of number 3 deducted by number 4 added by number 5m deducted by number 6e deducted by number 6e deducted by number 7b.
ATTACHMENT II
( FORM 1771 – II and FORM 1771 – II / $ )
DETAIL OF COST OF SALES, OPERATING EXPENSES AND NON OPERATING EXPENSES
Fill with detail of Cost of Sales, Operating Expenses and Non Operating Expenses taken from Form 1771-I point 1 item b, c, and f.
Column (1) Fill according to numbers in sequence
Column (2) Details
Column (3) Fill with expenses included in Cost of Sales
Column (4) Fill with Operating Expenses excluded from Cost of Sales
Column (5) Fill with Direct Cost relevant to non-business income
Column (6) fill with the result of Column (3) added with Column (4) added with Column (5)
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ATTACHMENT III
( FORM 1771 - III and FORM 1771 – III / $ )
DOMESTIC TAX CREDIT
Fill with detail of Income Tax Article 22 and Income Tax Article 23 / 26 Withholding Receipts for incomes which are imposed by non-Finalized Tax Income received/obtained and reported in current Annual Tax Return.
The withholding of Income Tax Article 26 that can be credited with Income Tax Due for the taxable year concerned is the tax withholding as mentioned in Article 26 paragraph (5) of Income Tax Law.
Column (1) Fill with the numbers in sequence for each type of taxes Column (2) Fill with Name of Withholding Agent. In term of Income Tax Article 22 paid by
taxpayer him/herself, filled the column with the name of Bank. Column (3) Fill with TIN of Withholding Agent. In term of Income Tax Article 22 paid by Taxpayer
him/herself, filled the column with the address of Bank. Column (4) Fill the column with:
- Fill with Type of Transaction or Payment for Income Tax Article 22 - Fill with Type of Income tax withheld for Income Tax Article 23 and Article 26
Column (5) Fill with the amount that is basis of Withholding Column (6) Fill with the amount of Income Tax Withheld
For Income Tax Article 22 who paid by his/her own, Column (6) shall be filled with the word “SSP” or “SSPCP”.
Column (7) Fill with Number of Withholding Tax Receipt. Column (8) Fil with Date of Withholding Tax Receipt with writng format dd/mm/yy
Taxpayer shall be obliged to show and gave a Withholding Notice of third parties if being asked for tax audit purposes.
ATTACHMENT IV
( FORM 1771 – IV AND FORM 1771 – IV / $ )
FINAL INCOME TAX AND NON TAXABLE INCOME
This Attachment shall be filled with certain incomes that is imposed by Finalized Tax whether withheld by other parties or paid by Taxpayer himself and other incomes excluded from Taxable Object received or obtained during the year, according to gross amount or the value of transaction. Taxpayer is obliged to show and make a list of Tax Withholding Notice if being asked for tax audit purpose.
Income from derivative transaction in the form of futures contract that is traded in stock exchange is considered as non taxable income according with the unvalid of Government Regulation No.17 of 2009 Article 2, Article 3 paragraph (1), (2) and (3) and Article 5. Therefore, the column shall not be filled.
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ATTACHMENT V
( FORM 1771 – V and FORM 1771 – V / $ )
LIST OF SHAREHOLDERS/OWNERS AND TOTAL DIVIDENDS DISTRIBUTED
LIST OF DIRECTORS AND COMMISSIONERS
Part A : LIST OF SHAREHOLDERS/OWNERS AND TOTAL DIVIDENDS DISTRIBUTED
- Column (1) fill according to a numbers in sequence.
- Column (2) fill with the name of shareholders/capital owners according to ID card.
- Column (3) fill with the address of shareholders/capital owners according to ID card.
- Column (4) fill with Taxpayer’s identity number of shareholders or capital owners. For shareholders or capital owners who do not have a Taxpayer’s Identification Number (for example non-resident Taxpayers, Taxpayers who have income below personal Tax Exemption limit) fill with “none”.
- Column (5) fill with amount of capital deposited.
- Column (6) fill with percentage of ownership.
- Column (7) fill with amount of dividend to shareholders.
Part B : LIST OF DIRECTORS AND COMMISSIONERS
- Column (1) fill according to numbers in sequence
- Column (2) fill with the name of shareholders / capital owners according to ID card.
- Column (3) fill with the address of shareholders / capital owners according to ID card.
- Column (4) fill with Taxpayer’s Identification Number of shareholders or capital owners. For shareholders or capital owners who do not have Taxpayer’s identity number (for example non-resident Taxpayers, Taxpayers who have income below the non-taxable income) fill with “none”.
- Column (5) fill with position of board of directors or commissioners.
Notes:
Foundation Taxpayers and other bodies which are not owned on the basis of capital ownership, as well as KIK mutual fund and KIK – EBA, fill the list of share holders / capital ownership with the statement: “none”, in column (2).
Taxpayers whose companies are listed in the stock market, public shareholders have no obligation to write in detail per name (can be stated cumulatively) except if the ownership of shares amounts to 5% (five) or more from the amount of capital deposited.
List of structure of board of directors and comissioners must be filled completely but without those at managerial positions.
See : DGT Circular Number SE-02/PJ.42/2003
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ATTACHMENT VI
( FORM 1771 – VI and FORM 1771 – VI / $ )
LIST OF CAPITAL INVESTMENT IN AFFILIATED COMPANIES
LIST OF LOANS (ACCOUNT PAYABLE) FROM SHAREHOLDER AND/OR AFFILIATED COMPANIES
LIST OF LOANS (ACCOUNT RECEIVABLE) TO SHAREHOLDER AND/OR AFFILIATED COMPANIES
1. Those lists above must be fill with end of year balance based on transcript of citation of elemens from financial statements attached to Annual Tax Return.
2. Equity participation declared is the equity participation in other companies which falls to the category of related parties.
3. Account Payable/receivable declared are the loans from / to other related parties.
4. Taxpayers who have no equity participation or have equity participation but do not fall to the category of related parties and Taxpayers who have no account payable/recievable from/to other related parties, fill the list with “none”, in column (2).
PRIMARY TAX RETURN
( FORM 1771 and FORM 1771 / $ )
TAXABLE YEAR : Fill available boxes with company’s yearbook and period of company’s yearbook.
Example: Yearbook 2010
If a Taxpayer file amended tax Return, fill “X” in the appropriate box and fill in the blank next the box with a number of the tax return have been amended. But, if a Taxpayer file a normal Tax Return, a box is unnecessary to be filled.
IDENTITY
Taxpayers Identification Number /
(NPWP) : Fill according to Taxpayers’ Identification Number as stated in the NPWP card.
Taxpayers’ name : Fill according to name as stated in the NPWP card.
Types of Business : Fill according to business classification of the company. In the case where there is more than one type of businesses, then state the most prominent/core business.
2 0 1 0
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Business classification : For the code of Business Classification Number (KLU), fill according to the Director General of Taxes Decree Number KEP-34/PJ./2003. If the information is not clear, please contact the tax office where you are registered.
Telephone Number : Fill according to Taxpayer’s number telephone. Number telephone is obliged to filed by Taxpayer.
Facsimile Number : Fill according to Taxpayer’s Facsimile number. Faximile Number is obliged to filed by Taxpayer.
Accounting Period : Fill according to Taxpayer Accounting Period For instance Taxpayer use Period January – December
Period January – December Period April – Maret
Foreign Domicile of Head Office : Fill according to name of domicile country of head office of the permanent established bodies overseas according to the Agreement for The Avoidance of the Double Taxation; or in the cases where an agreement are not yet concluded, following the Indonesian tax laws.
FINANCIAL STATEMENT : In case of having books of account in US Dollars state the number and date of the approval letter from Director General of Taxes, as well as the year started. State whether the financial statement of the company for the current yearbook is “audited” or “not audited” by a public accountant, by filling the appropriate box with “X”. In case the company is audited, state the opinion of the public accountant in the boxes available according to the code number below:
1 - for opinion : Unqualified Opinion 2 - for opinion : Qualified Opinion 3 - for opinion : Adverse Opinion 4 - for opinion : Disclaimer of opinion
Name of Accounting Firm : Fill according to name of Accounting Firm who signed the audit report
TIN of Accounting Firm : Fill according to TIN of Accounting Firm in case the company
was audited by a public accountant Name of Public Accountant : Fill according to name of Public Accountant who signed the audit
report
Name of Tax Consulting Firm : Fill with the name of Tax Consulting Firm according to the power of attorney letter and the name of tax consulting firm . TIN of Tax Consulting Firm : Fill with TIN of Tax Consulting Firm in the events of performing
their tax duties and rights, a Taxpayer uses the services of a tax consultant.
0 1 1 0 to 1 2 1 0
0 4 1 0 to 0 3 1 1
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Name of Tax Consultant : Fill with the name of tax consultant according to the power of attorney letter
TIN of Tax Consultant : Fill with TIN of Tax Consultant according to the power of attorney.
.
A. TAXABLE INCOME:
Item 1 - FISCAL NET INCOME
Fill with amount of Fiscal Net Income from form 1771-I number 8 column (3)
Item 2 - .LOSS CARRIED FORWARD
Loss carried forward from past tax years according to Article 6 Paragraph (2) of Income Tax Law or because of receiving tax investments facilities in the form of longer compensations of the loss. Fill from the calculation of the compensations of the loss carried forward the amount of this tax year column (special attachment of the tax returns). Fill with the amount of loss carried forward of the column “this tax year” from the special
Attachment 2A/2B Calculations of the Loss Carried Forward. Fill with number “0” (zero), if item 1 says loss (negative).
(See example of fillings of special Attachment form 2A/2B)
Item 3 – TAXABLE INCOME Fill with calculations of number 1 deducted by number 2.
B. INCOME TAX DUE:
Item 4 - TAX DUE Choose one of these rate calculation of Income tax due in accordance with Taxpayer conditions and fill ”X” in the available box.
a. Income Tax Rate of Article 17 paragraph (1) subparagraph b This rate apply to domestic corporate and Permanent Establishment is 28%. However, according to the Article 17 paragraph (2a), the tariff become 25% since the taxable year of 2010, Tax due is calculated by multiplying rate of Income tax and taxable income.
Example: The amount of gross income for FY 2010 is IDR 54.000.000.000,00 The amount of taxable income for FY 2010 is IDR 4.000.000.000,00 Tax Due is = 28% IDR 4.000.000.000,00 = IDR 1.000.000.000,- If Corporate Taxpayer is imposed by tariff stated in Income Tax Law Art. 31E if its gross income is
about Rp 50.000.000.000,00 (fifty billion rupiah).
b. Income Tax Rate of Article 17 paragraph (2b)
This rate apply to Listed Company that have ownership at least 40% of all shares traded in Indonesia Stock Exchange and fulfill other certain requirement. This type of Taxpayer can get 5% lower tariff than tariff stated in Inc. Tax Law No.36/2008 Art. 17 paragraph (1) subparagraph b and paragraph (2a).
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Example: Taxable Income FY 2010 = Rp 1.250.000.000,00 Income tax due = (25% - 5%) x Rp 1.250.000.000,00 = IDR 250.500.000,00
See : Government Regulation Number 81/2007
c. Income Tax Rate of Article 31E Domestic entity Taxpayer which has gross profit up to Rp 50.000.000.000,00 (fifty billion rupiah) get special deduction 50% of tariff stated in Inc. Tax Law No.36/2008 Art. 17 paragraph (1) subparagraph b and paragraph (2a). that imposed to taxable income which as a portion of gross profit up to Rp 4.800.000.000,00 (four billion and eight hundred million rupiah). Calculation of this terms can be divided into two ways: 1. If taxable income is up to IDR 4.800.000.000,00 ; Income tax due = 50% x 28% x Taxable Income 2. If taxable income in between IDR 4.800.000.000,00 and IDR 50.000.000.000,00, the
calculation of tax due is :
Income Tax Due
= (50% X 25%) X Facilitated
Taxable Income +25% X Unfacilitated Taxable
Income
The calculation of facilitated taxable income ;
Rp 4.800.000.000,00 X total taxable income
Gross Income
The calculation of unfacilitated taxable income ;
Unfacilitated taxable income = Total Taxable Income – Facilitated Taxable Income
Example 1): Gross income of PT Y in FY 2010 is Rp 4.500.000.000,00, while taxable income is IDR 500.000.000,00. The counting of tax due = taxable income is multiplied by 50% tariff of current enterprise’s Income Tax Rate because the amount of gross income not more than IDR 4.800.000.000,00. Tax due = 50% x 25% x IDR 500.000.000,00 = Rp 62.500.000,00 Example 2): Total gross income of PT ”X” amounted IDR. 30.000.000.000,00 in taxable year of 2010, taxable income is IDR 3.000.000.000,00. Calculation of Income Tax Due is as follows:
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Total facilitated taxable income = (IDR 4.800.000.000,00 : IDR 30.000.000.000,00) x IDR 3.000.000.000,00 = IDR 480.000.000,00
Total of unfacilitated taxable income = IDR 3.000.000.000,00 – IDR 480.000.000,00 = IDR 2.520.000.000,00
Income Tax Due = (50%x 25% x IDR480.000.000,00) + (25% x IDR2.520.000.000,00) = IDR 60.000.000,00 + IDR 630.000.000,00 = IDR 690.000.000,00
Note: for tax rate application purposes, the total of taxable income must be rounded down in full thousand rupiahs;
Item 5 – ADJUSTMENT FOR FOREIGN TAX CREDITS REFUNDED AND HAD BEEN CREDITED
IN THE PREVIOUS YEAR’S RETURN (Income Tax Art.24)
In cases of obtaining tax deductions or refund from tax payable/paid overseas (income tax Article 24), which has been already calculated as income tax credit payable in the previous year, fill with amount of tax deduction or refund.
See : Minister of Finance Decree Number 164/KMK.03/2002.
Item 6 – TOTAL OF TAX DUE Fill with amount of calculations of number 4 added by number 5. C. TAX CREDIT
Item 7 – Tax Borned By The Government
In case where Taxpayer is granted with a facility in the form of Income Tax Borned by the Government for income received or derived by main contractor, consultant and supplier of a Government project funded by foreign grants or foreign loans, please fill with the amount of non finalized income tax calculated using the following formula:
THE AMOUNT OF FOREIGN LOAN / GRANT ----------------------------------------------------------- X INCOME TAX DUE TOTAL PROJECT COSTS
See:
Government Regulation Number 42 of 1995 as lastly amended by Government Regulation Number 25 of 2001;
Government Regulation Number 138 of 2000; Government Regulation Number 51 of 2008; Minister of Finance Regulation Number 187/PMK.03/2008;
Item 8 – Domestic and Foreign Tax Credit
a. : Fill with the amount of domestic tax credit taken from Form 1771-III column (6) / form 1771-III$ column (6) and column (7)
b. : Fill with the amount of foreign tax credit as calculated in the Special Attachment 7A/7B . c. : Sufficiently clear
Item 9 – Income Tax must be paid by Taxpayer/ Overwithheld Income Tax
Fill “X” in the appropriate box based on the amount resulted from subtraction of the amount in Point 6 with the amount in Point 7 and Point 8c.
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Item 10 – Income Tax paid by Taxpayer
Point a : fill with the amount of prepaid tax of Article 25.
Point b : fill with the principal amount of the income tax article 25 paid based on Notice of Tax Collection.
Point c : Sufficiently clear
D. INCOME TAX UNDER/OVERPAYMENT
Item 11
Fill “X” in the appropriate box based on the amount resulted from subtraction of the amount in Point 9 with the amount in Point 10e.
Item 12
Fill with the date of Income Tax Article 29 paid.
Item 13
Fill “X” in the appropriate box based on the request made.
Request of Pre-Audit Refund of Tax Overpayment performed by Taxpayer with certain
criteria as referred in Article 17C of Tax Law. Rules of determination of Taxpayer with certain criteria is as referred by Minister of Financial Regulation. Taxpayer with certain criteria is a Taxpayer who meet the requirement as follows: a. filing Tax Return timely; b. not having tax arrears for any type of tax, except for tax arrears having been granted
permission to be paid in installment or tax payment to be postponed; c. having Financial Statement whish is audited by Public Accountant or by government
financial supervisory institustion with unqualified opinion for 3 (three) consecutive years; and
d. never been convicted guilty of tax crime under a definite court verdict over the last 5 (five) consecutive years
(Minister of Finance Regulation No. 192/PMK.03/2007)
Request of Pre-Audit Refund of Tax Overpayment as referred to Article 17D of Tax Law performed by Taxpayer who meets a certain requirement. Limitation of total gross income, total supplies of taxable goods, and tax overpayment that can be given pre-audit are regulated by Minister if Finance Regulation. Pre-Audit Refund of Tax Overpayment can be given to Entities Taxpayer which is have: a. a total maximum of gross income according to Income Tax Return is five billion
(5.000.000.000,00) rupiahs; and b. a total tax overpayment according to income tax return less than ten million rupiahs
(10.000.000,00). Pre-Audit Refund of Tax Overpayment can be given to Taxable Person which is have: a. a total maximum of supply for one taxable period according to Value Added Tax Return
is four hundred million (Rp 400.000.000,00) rupiahs; and b. a total maximum of tax overpayment according to Value Added Tax Return is twenty eight
million (IDR 28.000.000,00) rupiahs. (Minister of Finance Regulation No.193/PMK.03/2007 as lastly amended by Minister of Finance Regulation No. 54/PMK.03/2009)
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E. MONTHLY INSTALLMENT OF INCOME TAX ARTICLE 25 FOR THE SUBSEQUENT YEAR
Calculation of monthly Income Tax of Article 25 for current year for all Taxpayers is based on income which is not subject to Finalized Tax
Item 14.
a. Income that shall be the basis for installment calculation, for:
Taxpayers in general, is based on regular income reported on the previous Annual Income Tax Return;
Banks and Financial Lease Companies, is based on net income reported on the last quarterly income statement that has been annualized and deducted by Income Tax Article 24 (previous year paid or due in overseas), then divide into 12 (twelve).
State Owned Enterprises/Local Government Owned Enterprises, is based on income projection on RKAP for current year that has been approved by RUPS and has been adjusted in accordance with Income Tax Law. In case where the RKAP has not been approved by RUPS, income projection based on the previous year RKAP that has been adjusted in accordance with Income Tax Law shall be used.
Listed company and other Taxpayer that based on the rule has to create Periodic Income Statement ; is based on net /loss income reported on the last periodic income statement that has been annualized and deducted by Income Tax Article 22, Art 23 and 24 (previous year paid or due in overseas), then divided into 12 (twelve).
See: Minister of Finance Regulation Number 255/PMK.03/2008 as amended by Minister of Financial Regulation Number 208/PMK.03/2009
b. LOSS CARRIED FORWARD
Fill with Calculation of Loss Carried Forward, amount in Current Year column (From Special Attachment 2A/ 2B)
c. TAXABLE INCOME
Fill with the amount of point 14a deducted by the amount of point 14b
d. TAX DUE
Fill with Taxable Income (point 14c) times tax rates specified in Article 17 (Part B number 4)
e. PREVIOUS YEAR’S AMOUNT OF TAX CREDIT ON INCOME WITHIN THE MEANING OF POINT 14a THAT HAS BEEN WITHHELD BY OTHER PARTY
Fill with the previous year’s amount of tax credit on income within the meaning of point 14a that has been withheld by other party (Income Tax Article 22, 23 and 24)
f. TAX SHOULD BE PAID AFTER WITHHOLDINGS (14d – 14e)
Fill with the amount of point 14d deducted by the amount of point 14e
g. Income Tax Article 25
Installment of Income Tax Article 25 (1/12 x line f), for:
Taxpayers in general, take effect since the fourth month of the current year;
State Owned Enterprises/Local Government Owned Enterprises, take effect since the first month of the current year;
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Banks and financial lease company take effect for the first three month in the current year, and for the next period, shall be calculated again every three months using the same method.
Listed company and other Taxpayer that based on the rule has to create Periodic Income Statement, Income Tax Article 25 applied to months before Periodic Income Statement submitted, and after that, recalculated each report periodic with the same way.
F. FINALIZED INCOME TAX AND NON TAXABLE INCOME
Item 15
a - FINALIZED INCOME TAX
Fill with the amount of income tax payable on income that is subject to Finalized Income Tax taken from Form 1771-IV and 1771-IV/$ Total Part A amount in Column 5 (JBA)
b. NON TAXABLE INCOME
Fill with the amount of gross income which is not tax object taken from Form 1771-IV and 1771-IV/$ Total part B amount in Column 3 (JBB).
G. STATEMENT OF RELATED PARTIES TRANSACTION
Item 16 Put “X” in one of the boxes available which is on number 16 point a or b. Taxpayer is obligated to fill, to sign and to attach special attachment 3A, 3A-1 and 3A-2, or 3B, 3B-1 and 3B-2 if there are special transaction and/or transaction with parties which is the resident of tax haven country.
Related Parties among Taxpayer could happen because of dependency or bond among each other which are caused by:
a. Ownership or Capital Share Related Parties is perceived exist if there is an ownership relationship with the capital share of twenty five percent (25%) or more , directly or indirectly
b. The mastery/control through management or the use of technology. Related Parties among Taxpayers could also be created because of the mastery/control through management or the use of technology, even though there is no relation of ownership.
Related Parties is perceived exist if one or more companies are under the same control. As well as the relation among some companies in that same control.
The criteria of tax haven country is as follow: a. Country which imposes low tax rates or not imposes tax income: or. b. Country which applies bank secrecy policy and does not conduct information exchange
Country which imposes low rate is a country that charges tax rate of income less than 50% of corporate tax rate in Indonesia. (for 2009 less than 14% and for 2010 less than 12,5%).
Country which applies bank secrecy policy and do not conduct the information exchange is country or juridiction that based on its current law prohibits to render of customer information, including for the purpose of tax related information. Regulation concerning further tax haven country will be regulated in Minister of Finance.
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H. ATTACHMENTS
a. Third copy of Tax Payment Receipt of Tax Settlement :
Must be enclosed by all Taxpayers, except if there is no final payment (nil). In case the Taxpayer pays the tax using e-payment system, please attach a valid tax payment receipt as a replacement for the third copy of Tax Payment Receipt;
b. Financial Statements (Compulsory For all Taxpayer)
Must be enclosed by all Taxpayers without exception. In case the book of account/financial statements have been audited by a public accountant, please attach the audited financial statements. For Taxpayers having subsidiaries in Indonesia or overseas, and or having branches in foreign countries either in the form of Permanent Establishment or not, Consolidated Financial Statements and Taxpayer’s Financial Statement shall be enclosed separately;
c. Transcript of Elements Citation of Financial Statement Must be enclosed by all Taxpayer in accordance with Special Attachment Form- 8A-1 / 8A-2 / 8A-3 / 8A-4 / 8A-5 / 8A-6 / 8A-7 / 8A-8 / 8B-1 / 8B-2 / 8B-3 / 8B-4 / 81B-5 / 8B-6 / 8B-7 / 8B-8.
d. Depreciation and Amortization Tables
Must be enclosed by all Taxpayers following the format of Special Attachments 1A/1B, except where the Taxpayer does not have and use tangible assets and or intangible assets/other expenditures that must be capitalized through depreciation/amortization;
e. Loss Carried Forward Table
Must be enclosed by Taxpayers who have the right to compensate loss incurred in the previous tax years, following the form of Special Attachments 2A/2B;
f. Investment Facilities Provided
Must be enclosed by Taxpayers who have been granted investment facilities, following the form of Special Attachments 4A/4B;
g. List of Major Branches
Must be enclosed by Taxpayers who have major branches or business places in different locations, following the form of Special Attachments 5A/5B;
h. Third copy of Payment Receipt of Income Tax Article 26 paragraph (4) (branch profit tax)
Must be enclosed by all Permanent Establishments (other than foreign shipping/aircraft companies and representative offices), except where there is no tax payable. In case the Taxpayers pay taxes through e-payment system to the registered banks, please enclose a valid tax payment receipt as a replacement for the third copy of Tax Payment Receipt;
i. Calculation of Income Tax Article 26 Paragraph (4):
Must be enclosed by all Permanent Establishment (though there is no tax payable), following the form of Special Attachments 6A/6B;
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j. Foreign Tax Credits
Must be enclosed by Taxpayers who derive income from overseas and such an income has been subjected to tax in the source country, following the form of Special Attachments 7A/7B;
k. Power of Attorney
Must be enclosed by Taxpayers who assign somebody else to fill out their Annual Income Tax Return.
l - Other Attachments List of Bad Debt Account, must be enclosed by Taxpayer which perform bad debt
account write-off. List of creditor which has credit classified as substandard, doubtful, and loss, must
be attached by Taxpayer in banking industries which reporting income from non-performing loan interest on cash basis.
Copy of Fiscal payment slip (TBPFLN), then should to filed by Taxpayer if there is Foreign Fiscal tax Credit.
Particularly for Contractor Production Sharing (Migas) should to file a Financial Quarterly Report for the last period in a year corcerned.
Other Attachments in the form of supported document or to describe the calculation of total income that made by Taxpayer himself.
Nominative List of promotion expenses, must be submitted by taxpayer who spend promotional cost.
Financial Statement component of business- sharia basis which is includes Sources Report and Zakat Utilizing and Sources and Fund Utilizing Report, shall be enclosed by Taxpayer which has principal business on sharia-basis.
DECLARATION:
Fill with the place where and date when the Annual Tax Return is completed along with full name, Taxpayer Identification Number (NPWP) and signed by authorized board of directors. In the case where the Annual Tax Return is completed by an authorised representative/proxy, fill the blank with full name, Taxpayer Identification Number (NPWP) and signed. Fill “X” in the appropriate box. Seal with company stamp.
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SPECIAL ATTACHMENTS TO THE ANNUAL TAX RETURN
1. CALCULATION OF DEPRECIATION AND AMORTIZATION FOR TAX PURPOSE(SPECIAL ATTACHMENT 1A/1B)
Fill with any type of tangible / intangible assets owned and used in the operation of the company which can be depreciated / amortized.
“NOTE” column shall be filled with any relevant information regarding:
=> Years of which assets revaluation have been undertaken
=> Investment facilities in form of accelerated depreciation / amortization
“DEPRECIATION / AMORTIZATION METHOD” column shall be filled with code as follow:
DEPRECIATION / AMORTIZATION METHOD CODE UTILIZATION
Straight Line GL Commercial / Fiscal
Sum of the Years Digit JAT Commercial
Declining Balance SM Commercial / Fiscal
Double Declining Balance SMG Commercial
Sum of Service Hours JJJ Commercial
Sum of Unit Production JSP Commercial / Fiscal
Other Methods ML Commercial For Taxpayers using United States currency in maintain book of account, provisions on conversion rate for fixed assets regulated by Minister of Finance Decree No. 196/PMK.03/2007 shall be taken into account.
See: Minister of Finance Regulation Number 96/PMK.03/2009; Minister of Finance Decree Number 521/KMK.04/2000; Director General of Taxes Decree Number KEP-220/PJ./2002; Director General of Taxes Deccre Number KEP-316/PJ./2002; Director General of Taxes Circular Number SE-07/PJ.42/2002; Director General of Taxes Circular Number. SE-09/PJ.42/2002;
2. CALCULATION OF LOSS CARRIED FORWARD (SPECIAL ATTACHMENT 2A/2B)
Computation of loss carried forward shall consist only of fiscal loss incurred from the business operation in Indonesia, shall not include fiscal loss incurred from business operation outside Indonesia either through Permanent Establishment or not. Based on Minister of Finance Decree Number 164/PMK.03/2002 jo. Director General of Taxes Circular Number SE-03/PJ.31/2004, fiscal loss incurred from business operation outside Indonesia shall only be compensated to the taxable income derived from the business operation outside Indonesia in the same country (per country basis). In that case, separated calculation of loss carried forward shall be made using the same format.
Column “LOSS AND NET TAXABLE INCOME” shall be filled with the amount taken from Notice of Tax Assessment or Objection Decision/Appeal Decision, or in the case where such decision has not been issued taken from Annual Tax Return.
Columns “LOSS CARRIED FORWARD” shall be filled with the amount of loss carried forward distributed from the amount for each year after the year in which such fiscal loss incurred. In
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case where investment facilities are granted in the form of loss carried forward for more than 5 years (fiscal loss incurred from investment since commercial production firstly started), the number of year and column may be added using the second sheet.
For Taxpayers using United States Dollar in the books of account, provisions regarding loss carried forward as regulated by Minister of Finance Decree Number 5196/PMK.03/2007 shall be taken into account.
Move the amount in the column (8) “THIS TAXABLE YEAR” to FORM 1771 or FORM 1771 / $ (Sub Paragraph A Point 2), and move the amount in the column (9) “CURRENT YEAR” to FORM 1771 or FORM 1771 / $ (Subparagraph E item 14 sub item b).
Example (Form of Special Attachment 2A):
PT ABC was established in 2002. In 2010, the Taxpayer derived taxable income at the amount of IDR 50.000.000,-. Previous years’ taxable incomes or fiscal losses are as follow:
Year 2002, fiscal loss IDR 20.000.000,- Year 2003, fiscal loss IDR 5.000.000,- Year 2004, fiscal loss IDR 1.000.000,- Year 2005, fiscal loss IDR 100.000.000,- Year 2006, fiscal loss IDR 20.000.000,- Year 2007, taxable income IDR 30.000.000,- Year 2008, taxable income IDR 10.000.000,- Year 2009, fiscal loss Rp 5.000.000,- Filling to the Special Form 2A is as the following:
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NO
LOSS AND NET TAXABLE INCOME LOSS CARRIED FORWARD
YEAR CURRENCY AMOUNT YEAR. 2006 US$/(IDR)
YEAR. 2007 US$/(IDR)
YEAR. 2008 US$/(IDR)
YEAR. 2009 US$/(IDR)
YEAR. 2010 HIS TAXABLE YEAR
US$/(IDR)* )
YEAR. 2011 (CURRENT YEAR)
US$/(IDR)**)
(1) (2) (3) (4) (5) (6) (7) (8) (9)
1 2002 (20.000.000,00) 0,00 20.000.000,00 0,00 0,00 --- ---
2 2003 (5.000.000,00) 0,00 5.000.000,00 0,00 0,00 --- ---
3 2004 (1.000.000,00) 0,00 1.000.000,00 0,00 0,00 --- ---
4 2005 (100.000.000,00) 0,00 4.000.000,00 10.000.000,00 0,00 50.000.000,00 ---
5 2006 (20.000.000,00) 0,00 --- 0,00 0,00 --- 20.000.000,00
6 2007 30.000.000,00 0,00 --- 0,00 0,00 --- ---
7 2008 10.000.000,00 0,00 --- 0,00 0,00 --- ---
8 2009 (5.000.000,00) 0,00 --- 0,00 0,00 --- 5.000.000,00
9 2010 50.000.000,00 0,00 --- 0,00 0,00 --- --- TOTAL : 0,00 30.000.000,00 10.000.000,00 0,00 50.000.000,00 25.000.000,00
ES :
COPY THE AMOUNT OF COLUMN (8)TO FORM 1771 PART A LINE 2
COPY THE AMOUNT OF THIS COLUMN TO FORM 1771 PART E LINE 14 SUBLINE b TAXPAYER / AUTHORISED REPRESENRTATIVES,
( …………..……………………. )
SPECIAL ATTACHMENT OF ANNUAL TAX RETURN CORPORATE INCOME TAX
TAXABLE YEAR
LOSS CARRIED FORWARD CALCULATION FOR TAX PURPOSE
FOR TAXABLE YEAR AND CURRENT TAXABLE YEAR
: NAME : PT ABC
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3. STATEMENT OF TRANSACTION IN RELATED PARTIES (SPECIAL ATTACHMENT 3A/3B; 3A-1/3B-1; and 3A-2/3B-2)
.Attachment 3A/3B is a tool for Taxpayer for reporting parties that have special relationship and transaction which performed with them.
Taxpayer who obliged to fill Attachment 3A/3B Taxpayer who obliged to fill attachment 3A/3B is any Taxpayer who have related parties and/or have a transaction with related parties.
Parties that have special relationship is a parties as regulated in : Article 18 paragraph (4) of Income Tax Law; Article 2 paragraph (2) of VAT Law; Article 9 paragraph (1) of Indonesia Double Taxation Treaty with partner agreement.
A. SPECIAL ATTACHMENT 3A/3B (STATEMENT OF TRANSACTION WITH RELATED
PARTIES) I. LIST OF RELATED PARTIES Fill with list of Related Parties .
1. Name Fill with a full name of Related Parties.
2. Address Fill with address of related parties .
3. Tax Identification Number Fill with TIN Related Parties from both resident and foreign Taxpayer. In term of affiliation Taxpayer is a foreign Taxpayer that don’t have taxpayer identification in their country, so that, in column of TIN can be given with “-“ mark, with statement of letter that should be attached when taxpayer submit the tax return
4. Business Activities Fill with a major activities which conducted by related parties in transaction with Taxpayer .
5. Types of relationship with Taxpayer Fill with select more than one form of relationship that have Taxpayer made with parties that have special relationship. The following form of those relationship are: a. Related Parties because of share ownership which is regulated in Article 18 paragraph
(4) subparagraph a Income Tax Law. b. Related Parties because of mastery/controlling which is regulated in Article 18 paragraph
(4) subparagraph b of Income Tax Law. c. Related Parties because of family relationship which is regulated in Article 18 paragraph
(4) subparagraph c Income Tax Law. d. Related parties because of controlling which is regulated in Tax Treaty Agreement Article
9 paragraph (1) between Indonesia and Taxpayer’s related parties domicile country.
II. DETAILS OF TRANSACTION WITH PARTIES THAT HAVE SPECIAL RELATIONSHIP (RELATED PARTIES)
1. Number of Sequence To be stated with number based on sequences transaction.
2. Name of Transaction Partner
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To be stated with the name of transaction partner with parties that have special relationship with Taxpayer as reported in table I.
3. Types of Transaction To be stated with: a. Selling/ purchasing of tangible goods (materials, finished goods and merchandises), b. Selling/purchasing of capital goods, included fixed assets, c. transfer/utilization of intangible assets, d. rental of money, e. transfer of services, f. transfer /obtaining of financial instrument such as shares and bonds, g. etc.
4. Transaction Value To be stated with the total of transaction value.
5. Method of Determination of Prices To be stated with selected method used for determine of reasonable transfer pricing in transaction with parties that have special relationship, as arranged by Income Tax Law. The following methods are: 1. Comparable Uncontrolled Price 2. Cost Plus Method 3. Resale Price Method 4. Transactional Net Margin Method 5. Profit Split Method
6. Reasons of using Methods To be stated with any reasons of why should the Taxpayer select for using one in these methods in calculate of transfer pricing.
B. SPECIAL ATTACHMENT 3A-1/3B-1 (STATEMENT OF TRANSACTION IN RELATED PARTIES) DOCUMENTATION REASONABLE PRICING Fill “ X” in the available box (Yes or not) of each statements, in accordance with condition of documentation owned by the Taxpayer. The Document as reffered in this special attachment of 3A-1/3B-1, should be adjusted with international prevalence in term of Taxpayer stated that they have the document. Taxpayer could determine types and form of transfer pricing document by their own which is adjusted with their business field, as long as the document supporting the utilize of determination method of fairly price that chosen by Taxpayer.
C. SPECIAL ATTACHMENT 3A-2/3B-2 (STATEMENT OF TRANSACTION WITH PARTIES THAT PART OF TAX HAVEN COUNTRY RESIDENT) Taxpayer who should fill this Attachment Taxpayer who should fill this attachment is a Taxpayer who had transaction with tax haven country resident I. IF A TAXPAYER IS MAKING TRANSACTION WITH PARTIES THAT ARE TAX HAVEN
COUNTRY IN THIS TAXABLE YEAR. To be stated with list of parties that are tax haven country resident whom have a transaction with Taxpayer.
1. Name To be stated with full name of parties that are tax haven country resident.
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2. Types of Transaction To be stated with: a. selling/purchasing of tangible goods (materials, finished goods and merchadises), b. selling/pirchasing of capital goods, included fixed assets, c. transfer/utilization of intangible assets, d. rental of money, e. transfer of services, f. transfer/obtaining of financial instrument such as share and bonds, g. etc.
3. Country To be stated with countries of transaction partner that are tax haven in accordance with existing regulations.
4. Transactions Value To be stated with the total of transactions value.
II. DETERMINATION OF TRANSACTIONS VALUE ABOVE, STIPULATED BY USING THE
TERM ARM’S LENGTH OR ORDINARY BUSINESS PRINSIPAL Fill “yes” or “no” answer and fill “X” in the appropriate box, according to transaction condition and price determination that have made by Taxpayer.
4. LIST OF INVESTMENT FACILITIES (SPECIAL ATTACHMENT 4A/4B)
Point 1: a. Fill with Number / Date of the Approval Letter from the Investment Coordinating Board (BKPM).
b. Fill with Number / Date of Minister of Finance Decree on the granting of investment facilities.
Point 2: a. THE AMOUNT OF INVESTMENT APPROVED, fill with the amount of investment as approved by BKPM using currency as in the approval. If the currency differs from that of used by the company in the bookkeeping, please specify the equivalent amount using actual rate at the time when transfer was made to the company’s bank account. In case the transfer has not been made, the equivalent amount shall be calculated using the actual rate at the time when approval from BKPM was issued (make a footnote when necessary).
a. INVESTMENT, new or expansion, cross in the appropriate box based on the approval from BKPM;
b. FIELD OF INVESTMENT, fill with the business field approved for the investment based on the approval from BKPM;
c. FACILITIES GRANTED, cross in the appropriate box based on the type of facilities granted (and point 6 to 10 in the year box) based on the Minister of Finance Decree.
Point 3: INVESTMENT REALIZATION:
a. THIS YEAR, fill with the amount of investment realized in the tax year of the Annual Tax Return during the period until commercial production has been started.
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b. UP TO THIS YEAR, fill with the cumulative amount of investment realized until the tax year of the Annual Tax Return during the period until commercial production has been started, based on investment realization report that has been audited by a public accountant.
Point 4: Fill with the date when commercial production was firstly made based on the investment realization report that has been audited by a public accountant.
Point 5: NET INCOME REDUCTION FACILITY,
fill in the year box with number 1 to 6 consecutively for each tax year since the year when commercial production has been started, and the amount of net income deduction facility for such a year which is calculated by multiplying 5% from the amount of investment realization as stated in Point 3 Item b above. Move the amount calculated in Point 5 to FORM 1771 – I or FORM 1771 – I / $ (Line 7 Column 3).
See: Government Regulation Number 1 of 2007 as lastly amended by Government Regulation No. 62
year 2008; Minister of Finance Regulation Number 16/PMK.03/2007; Director General of Taxes Regulation Number PER-67/PJ./2007.
5. LIST OF MAJOR BRANCHES (SPECIAL ATTACHMENT 5A/5B)
Fill only with information of complete address and TIN (if has been registered in tax service office – location), of the main branches or places of business. For minor branches or representative offices under such major branches, please specify only the number. Foreign branches or representative offices shall also be disclosed.
- Column (1) filled with Numbers in sequence - Column (2) filled with major branch address - Column (3) filled with TIN of location - Column (4) filled with amount of sub-Branches
6. CALCULATION OF INCOME TAX ARTICLE 26 PARAGRAPH (4) (SPECIAL ATTACHMENT 6A/6B)
Point 1: COMMERCIAL NET INCOME,
fill with the amount taken from FORM 1771 – I or 1771 – I / $ (line 3 column (3))
Point 2: TAX ADJUSTMENT,
fill with the amount taken from FORM 1771 – I or FORM 1771 – I / $ (Amount Point 5m and Point 6e). In case the Taxpayer / Permanent Establishment is subject to Finalized Tax, positive / negative tax adjustment shall be computed separately in accordance with the bookkeeping / financial statements.
Point 3: FISCAL NET INCOME
if the amount is negative then it is not necessary to make further filling because Income Tax Article 26 Paragraph (4) will not be payable.
Point 4: TAX DUE,
fill with the amount taken from FORM 1771 or FORM 1771 / $ (Sub Paragraph B Point 6), or in case subjected to Finalized Tax, fill with the amount taken from FORM 1771 – IV or FORM 1771 – IV / $ (Part A Point 7 or 8).
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Point 5: TAX BASE FOR BRANCH PROFIT TAX CALCULATION,
if the amount is negative then it is not necessary to make further filling because Income Tax Article 26 Paragraph (4) will not be payable.
Point 6: BRANCH PROFIT TAX,
if any, fill “X” in the appropriate box and provide necessary information in the blank next to the box.
See : Ministry of Finance Regulation Number 257/PMK.03/2008
7. FOREIGN TAX CREDITS (SPECIAL ATTACHMENT 7A/7B)
Fill with the detail of withholding tax receipt / income payment receipt payable in the country outside Indonesia with supported by financial statement of income from foreign country, copy of Annual Tax Return which is applied in foreign country and copy of tax payment document in foreign country. The calculation method should to refer on Article 24 of Income Tax Law jo. Ministry of Finance Decree Number 164/KMK.03/2002, dated 19 April 2002.
The amount of income tax payable or has been paid outside Indonesia that can be credited shall not exceed the amount that is calculated using the following formula.
The amount of Income derived from outside Indonesia ---------------------------------------------------------------------------------------------------------- X Total Income Tax Payable
Taxable Income or the same as Total Income Tax Payable, whichever is smaller
In case where foreign income is received/derived from several countries, tax credit shall be computed using the above formula for each of the country (ordinary credit per country basis). Taxable Income on that formula not including subject to finalized tax as ammended in Article 4 paragraph (2), Article 8 paragraph (1) and paragraph 4 Income Tax Law.
See: Minister of Finance Decree Number 164/KMK.03/2002
- Column (1), fill with Numbers in sequence
- Column (2), fill with Name of Withholding Agent Overseas
- Column (3), fill with Address of Withholding Agent Overseas
- Column (4), fill with Type of Income
- Column (5), fill with the Amount of Net Income Received
- Column (6), fill with the amount of tax payable/paid outside Indonesia in Rupiah currency calculated using conversion rate at the time when the tax is paid or payable.
- Column (7), fill with the amount of tax payable/paid outside Indonesia in foreign currency.
- Column (8), fill with the amount of calculated tax credit according to provision of Article 24 Income Tax Law, Ministry of Finance Number 164/KMK.03//2002.
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8. FINANCIAL STATEMENT OF ELEMENTS CITATION TRANSCRIPT (SPECIAL ATTACHMENT 8A-1 / 8A-2 / 8A-3 / 8A-4 / 8A-5 / 8A-6 / 8B-1 / 8B-2 / 8B-3 / 8B-4 / 8B-5 / 8B-6/ 8B-7 / 8B-8)
Financial Statement of Elements Citation Transcript is summary of financial statement which show all the content of financial statement. Financial Statement Citation Transcript differentiate according to Taxpayer’s business types, that is:
No. Form Code Types of Business
1. 8A-1 8B-1 Industrial Companies
2. 8A-2 8B-2 Trading Companies
3. 8A-3 8B-3 Conventional Banks
4. 8A-4 8B-4 Sharia Banks
5. 8A-5 8B-5 Insurance Companies
6. 8A-6 8B-6 Non-Qualification (except those five business types)
7. 8A-7 8B-7 Pension Fund
8. 8A-8 8B-8 Finance Companies
Form Code which contain of “A” , is form code for Taxpayer who maintain bookkeeping in rupiahs currency, whereas Form Code which contain of “B”, is Form Code for Taxpayer who permitted to maintain bookkeeping in United State Currency.
Every Taxpayer should to fill one of those Financial Statement of Element Citation Transcrip according to their business types.
INSTRUCTION OF COMPLETION
Taxable Year : filed with a number yearbook and a period yearbook of companies. TIN : filed with TIN as stated in TIN card Taxpayer’s Name : filed with Names as stated on TIN card Elements of Balace Sheet Element of balance sheet consist of two sides, asset’s, liability and equity’s side. Each balance account in financial statement should be moved properly in to balance sheet
account within the transcript Taxpayer files Balance account within citation transcript as needed according to the account
within financial statement. If balance sheet account is not existing within financial statement, the column of those within
citation transcript is sufficiently filled with minus (-) sign. If balance sheet account in financial statement is not appropriate within citation transcript, those
account value of financial statement shall be moved in to similar account or any other account within citation transcript, for example goodwill account moves in to other non current asset account.
Elements of Income Statement Each account balance of income statement within financial statement shall be properly moved in
to income statement account within citation transcript. Taxpayer files income statement account within citation transcript as needed according to
account in financial statement. If income statement account in citation transcript is not existing within financial statement, the
column of those citation transcript is sufficiently filled with minus (-) sign.
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If Income Statement account in financial statement is not appropriate within citation transcript, those account value of income statement shall be moved in to similar account or any other account within citation transcript.
Elements of Transaction with parties that have special relationship in accordance with PSAK No.7 Parties that have special relationship is a parties that perceived having the capability of
controlling other parties or having significant influences of taking financial and operational decision.
The transaction between parties that have special relationship is a transfer of sources or obligation between parties that have special relationship, without recking of whether the price is calculated.
The following belows are an example of transaction between parties that have special relationship that probably needs some disclosure: - Selling or purchasing goods - Selling or purchasing of property and other assets - Furnishing or receiving services - Transfer of research and development - fund (including loan and deposits of capital both in cash and benefit in kind ) - guarantee and collateral - contract of management
Statement a. to be stated with date and place when the transcript was made b. fill “X” in the appropriate box c. to be stated with full name management/representative d. box to be stated with signature and company’s seal
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1A
FOR TAXABLE YEAR 2 0
T I N : TAXPAYER'S NAME :
TANGIBLE ASSETS Group 1 : …………………………………………………. Group 2 : …………………………………………………. Group 3 : …………………………………………………. Group 4 : …………………………………………………. BUILDINGS Permanent …………………………………………………. Not Permanent : ………………………………………………….
TOTAL DEPRECIATION (For Tax purpose)……………..……………..……………..……………..……………..……………..……………..……………..……………..……………..…………………………………..…Ø TOTAL COMMERCIAL DEPRECIATION ……………..……………..……………..……………..……………..……………..……………..……………..……………..………………….………………………….……… Ø DIFFERENCE ( COPY TO FORM 1771-I LINE 5 LETTER i OR LINE 6 LETTER a) ……………..……………..……………..……………..……………….………………………..……………………….. Ø INTANGIBLE ASSETS Group 1 : …………………………………………………. Group 2 : …………………………………………………. Group 3 : …………………………………………………. Group 4 : …………………………………………………. Other Group ………………………………………………….
TOTAL AMORTIZATION (For Tax purpose)……………..……………..……………..……………..……………..……………..……………..……………..………………………………...…..……………..…………… R TOTAL COMMERCIAL AMORTIZATION ……………..……………..……………..……………..……………..……………..……………..……………..……………………….………………...……………..………… Ø DIFFERENCE ( COPY TO FORM 1771-I LINE 5 LETTER j OR LINE 6 LETTER b) …………..…...……………..……………..……………..…………………………………………………. Ø
…………………………...…,
TAXPAYER/AUTHORIZED REPRESENTATIVE
(……………………………………………………………)
NOTEYEAR OF(IDR) (IDR) COMMERCIAL VALUEACQUISITION FISCAL (IDR)
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
LIST OF DEPRECIATION AND AMORTIZATION FISCAL
GROUP / TYPES OF ASSETSMONTH/
COST OF ACQUISITIONDEPRECIATION/ AMORTIZATION
METHODFISCAL DEPRECIATION/AMORTIZATION
IN CURRENT YEARBEGINNING BALANCE
31
1B
FOR TAXABLE YEAR 2 0
T I N : TAXPAYER'S NAME :
TANGIBLE ASSETS Group 1 : …………………………………………………. Group 2 : …………………………………………………. Group 3 : …………………………………………………. Group 4 : …………………………………………………. BUILDINGS Permanent …………………………………………………. Not Permanent : ………………………………………………….
TOTAL DEPRECIATION (For Tax purpose)……………..……………..……………..……………..……………..……………..……………..……………..……………..……………..…………………………………..…Ø TOTAL COMMERCIAL DEPRECIATION ……………..……………..……………..……………..……………..……………..……………..……………..……………..………………….………………………….……… Ø DIFFERENCE ( COPY TO FORM 1771-I LINE 5 LETTER i OR LINE 6 LETTER a) ……………..……………..……………..……………..……………….………………………..……………………….. Ø INTANGIBLE ASSETS Group 1 : …………………………………………………. Group 2 : …………………………………………………. Group 3 : …………………………………………………. Group 4 : …………………………………………………. Other Group ………………………………………………….
TOTAL AMORTIZATION (For Tax purpose)……………..……………..……………..……………..……………..……………..……………..……………..………………………………...…..……………..…………… R TOTAL COMMERCIAL AMORTIZATION ……………..……………..……………..……………..……………..……………..……………..……………..……………………….………………...……………..………… Ø DIFFERENCE ( COPY TO FORM 1771-I LINE 5 LETTER j OR LINE 6 LETTER b) …………..…...……………..……………..……………..…………………………………………………. Ø
…………………………...…,
TAXPAYER/AUTHORIZED REPRESENTATIVE
(……………………………………………………………)
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
NOTEYEAR OFACQUISITION (US$) (US$) COMMERCIAL VALUE FISCAL (US$)
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
LIST OF DEPRECIATION AND AMORTIZATION FISCAL
GROUP / TYPES OF ASSETSMONTH/
COST OF ACQUISITION BEGINNING BALANCEDEPRECIATION/ AMORTIZATION
METHODFISCAL DEPRECIATION/AMORTIZATION
IN CURRENT YEAR
32
2A
TAXABLE YEAR 2 0
FOR TAXABLE YEAR AND CURRENT TAXABLE YEAR
T I N : TAXPAYER'S NAME
YEAR. YEAR. YEAR. YEAR. YEAR. YEAR.
(1)
1
2
3
4
5 etc
NOTE: …………………………...…,
*) COPY THE AMOUNT OF THIS COLUMN TO FORM 1771 LETTER A LINE 2
**) COPY THE AMOUNT OF THIS COLUMN TO FORM 1771 LETTER E LINE 14 POINT b TAXPAYER / AUTHORIZED REPRESENTATIVE
(……………………………………………………………)
TTLTOTAL
(8) (9)(2) (3) (4) (5) (6) (7)
(CURRENT TAXABLE YEAR)
(IDR) (IDR) (IDR) (IDR) IDR *) IDR **)
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
CALCULATION OF FISCAL LOSS CARRY FORWARD
NO
LOSS AND FISCAL NET INCOME FISCAL LOSS CARRY FORWARD
YEAR IDR(THIS TAXABLE YEAR)
33
2B
TAXABLE YEAR 2 0
FOR TAXABLE YEAR AND CURRENT TAXABLE YEAR
T I N : TAXPAYER'S NAME
YEAR. YEAR. YEAR. YEAR. YEAR. YEAR.
(1)
1
2
3
4
5 etc
NOTE: …………………………...…,
*) COPY THE AMOUNT OF THIS COLUMN TO FORM 1771 LETTER A LINE 2
**) COPY THE AMOUNT OF THIS COLUMN TO FORM 1771 LETTER E LINE 14 POINT b TAXPAYER / AUTHORIZED REPRESENTATIVE
(……………………………………………………………)
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
TOTAL TTL
(8) (9)(2) (3) (4) (5) (6) (7)
(CURRENT TAXABLE YEAR)
(IDR) (IDR) (IDR) (IDR) IDR *) IDR **)
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
CALCULATION OF FISCAL LOSS CARRY FORWARD
NO
LOSS AND FISCAL NET INCOME FISCAL LOSS CARRY FORWARD
YEAR IDR(THIS TAXABLE YEAR)
34
3A
FOR TAXABLE YEAR
T I N:
TAXPAYER'S NAME :
I LIST OF RELATED PARTIES
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
II DETAILS OF TRANSACTION WITH RELATED PARTIES
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
………………………,
TAXPAYER/AUTHORIZED REPRESENTATIVE
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
(……………………………………………………………)
Determination of Price Method shall be used
Determination of MethodsTypes of Transaction Transaction's Value
STATEMENT OF TRANSACTION WITH RELATED PARTIES
Address Tax Identification Number (TIN) Business Activities
ANNUAL INCOME TAX RETURN FOR CORPORATE SPECIAL ATTACHMENT
NameNo.
Name No.
Types of Relationship with Taxpayer
35
3B
FOR TAXABLE YEAR
T I N:
TAXPAYER'S NAME :
I LIST OF RELATED PARTIES
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
II DETAILS OF TRANSACTION WITH RELATED PARTIES
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
………………………,
TAXPAYER/AUTHORIZED REPRESENTATIVE
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
(……………………………………………………………)
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
Determination of Price Method shall be used
Determination of MethodsNo. Name Types of Transaction Transaction's Value
STATEMENT OF TRANSACTION WITH RELATED PARTIES
No. Name Address Tax Identification Number (TIN) Business Activities Types of Relationship with Taxpayer
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
36
3A-1
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME/PERMANENT ESTABLISHMENT :
Yes
Concerning of Transaction
Yes
Transaction with related parties
Yes
Taxpayer business strategy at the time when carry out the affiliation transaction
Yes
…………………….., …………………………………
TAXPAYER/AUTHORIZED REPRESENTATIVE
____________________________________________
3
That we have made note about :
No
4 Concerning of determination of Fair Price
Functional analysis which is the primary consideration of tax payers' transactions with related parties companies, all risks assumed and assets are being used in those transactions.
The economic conditions when the transactions is happened.
Terms of transactions, including agreement between Taxpayers with related parties from foreign countries
Taxpayer's transaction with company which is not influenced by related parties or information about comparing transaction.
No
Operating aspects of Taxpayers business operations including details of functions which is delivered by units in the Taxpayers organization.
Description of Business Environment in detail.
2That we have made note about :
That we have made note about :
Ownership structure that refer to the dependability between all company in one group of multinational company.
The application of the determination methodology of transfer price and the use of comparing data in the determination of transfer price.
Concerning of Comparation Analysis Result Notes
Characteristic of product (goods, service, loans, finance instrument, etc) which has been transacted.
That we have made note about :
No
Methodology of price determination which applicable by Taxpayer, which shows how the fair price is acquired, and the reasons why this method is chosen, compared to other methods.
Comparing data used by the Taxpayer to determine of transfer price.
Corcerning of company's description in detail
In case of tax payers act as the selling, rendering, or borrowing party as mentioned on the above transactions, we have conducted records as follows :
- Pricing Policy and price list for the last 5 (five) years.
- Details of manufacturing cost or acquisition cost or service preparation cost.
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
STATEMENT OF TRANSACTION IN RELATED PARTIES
Organizational structure of Taxpayer Company.
No
These are some particular notes that we made to support the fact that transactions that have been made with related parties are in accordance with the arm's length principle and the common practice.
1
I DOCUMENTATION OF ARM'S LENGTH TRANSACTION DETERMINATION
37
3B-1
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME/PERMANENT ESTABLISHMENT :
Yes
Concerning of Transaction
Yes
Transaction with related parties
Yes
Taxpayer business strategy at the time when carry out the affiliation transaction
Yes
…………………….., …………………………………
TAXPAYER/AUTHORIZED REPRESENTATIVE
____________________________________________
That we have made note about :
No
Methodology of price determination which applicable by Taxpayer, which shows how the fair price is acquired, and the reasons why this method is chosen, compared to other methods.
Comparing data used by the Taxpayer to determine of transfer price.
The application of the determination methodology of transfer price and the use of comparing data in the determination of transfer price.
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
Characteristic of product (goods, service, loans, finance instrument, etc) which has been transacted.
Functional analysis which is the primary consideration of tax payers' transactions with related parties companies, all risks assumed and assets are being used in those transactions.
The economic conditions when the transactions is happened.
Terms of transactions, including agreement between Taxpayers with related parties from foreign countries
4 Concerning of determination of Fair Price
Taxpayer's transaction with company which is not influenced by related parties or information about comparing transaction.
In case of tax payers act as the selling, rendering, or borrowing party as mentioned on the above transactions, we have conducted records as follows :
- Pricing Policy and price list for the last 5 (five) years.
- Details of manufacturing cost or acquisition cost or service preparation cost.
3 Concerning of Comparation Analysis Result NotesThat we have made note about :
No
Operating aspects of Taxpayers business operations including details of functions which is delivered by units in the Taxpayers organization.
Description of Business Environment in detail.
2That we have made note about :
No
No
Ownership structure that refer to the dependability between all company in one group of multinational company.
Organizational structure of Taxpayer Company.
These are some particular notes that we made to support the fact that transactions that have been made with related parties are in accordance with the arm's length principle and the common practice.
1 Corcerning of company's description in detailThat we have made note about :
STATEMENT OF TRANSACTION IN RELATED PARTIES
I DOCUMENTATION OF ARM'S LENGTH TRANSACTION DETERMINATION
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
38
3A-2
FOR TAXABLE YEAR
TIN:
TAXPAYER'S NAME :
I
No
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
II DETERMINATION OF TRANSACTION'S VALUE ABOVE , SHALL BE REFERRED TO THE TERM ARMS LENGTH AND ORDINARY BUSINESS PRINCIPLE
YES NO
……………………….., ………………………TAXPAYER/AUTHORIZED REPRESENTATIVE
( ………………………… )
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
ANNUAL INCOME TAX RETURN FOR CORPORATE
STATEMENT OF TRANSACTION WITH PARTIES OF TAX HAVEN COUNTRY RESIDENT
5
4
3
2
1
IN CASE OF THE COMPANY HAS MADE TRANSACTIONS WITH PARTIES OF TAX HAVEN COUNTRY RESIDENT IN THIS TAXABLE YEAR
Name of Transaction Colleagues Types of Transaction Country Transaction Value
SPECIAL ATTACHMENT
39
3B-2
FOR TAXABLE YEAR
TIN:
TAXPAYER'S NAME :
I
No
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
II DETERMINATION OF TRANSACTION'S VALUE ABOVE , SHALL BE REFERRED TO THE TERM ARMS LENGTH AND ORDINARY BUSINESS PRINCIPLE
YES NO
……………………….., ………………………TAXPAYER/AUTHORIZED REPRESENTATIVE
( ………………………… )
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
5
4
3
2
1
STATEMENT OF TRANSACTION WITH PARTIES OF TAX HAVEN COUNTRY RESIDENT
IN CASE OF THE COMPANY HAS MADE TRANSACTIONS WITH PARTIES OF TAX HAVEN COUNTRY RESIDENT IN THIS TAXABLE YEAR
Name of Transaction Colleagues Types of Transaction Country Transaction Value
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
40
4A
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME :
IN CASE OF THE COMPANY HAS BEEN GRANTED TAX FACILITIES ON INVESTMENT, PLEASE EXPLAIN:
a. LETTER OF APPROVAL FROM BKPM b. LETTER OF MINISTER OF FINANCE DECREE
1 NUMBER : ……………………………………………………….. 1 NUMBER : ………………………………………………………..
2 DATE : ……………………………………………………….. 2 DATE : ………………………………………………………..
a. AMOUNT OF INVESTMENT APPROVED: 1. IN FOREX : 2a1
2. EQUIVALENT IDR. : 2a2 *)
3. IN IDR. : 2a3
4. TOTAL IDR. : 2a4
b. INVESTMENT : 1 NEW 2 EXPANSION
c. …………………………………………………………………………………………………………………………
d. FACILITIES GRANTED : 1 INVESTMENT ALLOWANCE
2 ACCELERATED DEPRECIATION/AMORTIZATION
3 LOSS CARRIED FORWARD 4 YEAR
INVESTMENT REALIZATION
a. THIS YEAR : IDR a
b. UP TO THIS YEAR : IDR b
FACILITIES OF INVESTMENT ALLOWANCE : YEAR a b IDR. **)
(5% X REALIZATION OF INVESTMENT UP TO CPS)
NOTE:
*) ……………………………,
**) COPY THE AMOUNT IN LINE 5 b TO FORM 1771-I TAXPAYER/AUTHORIZED REPRESENTATIVE
LINE 7 COLUMN (3)
5.
(……………………………………………………………)
4. TIME WHEN COMMERCIAL PRODUCTION STARTED (CPS), DATE:
PLEASE USE ACTUAL CONVERTION RATE AT THE TIME OF TRANSFER TO THE COMPANY'S ACCOUNT
5
3.
10 % TAX ON DIVIDENDS PAID TO FOREIGN SHAREHOLDERS
FIELD AND/OR REGION OF INVESTMENT:
1.
2.
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
2 0LIST OF INVESTMENT FACILITIES
41
4B
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME :
IN CASE OF THE COMPANY HAS BEEN GRANTED TAX FACILITIES ON INVESTMENT, PLEASE EXPLAIN:
a. LETTER OF APPROVAL FROM BKPM b. LETTER OF MINISTER OF FINANCE DECREE
1 NUMBER : ……………………………………………………….. 1 NUMBER : ………………………………………………………..
2 DATE : ……………………………………………………….. 2 DATE : ………………………………………………………..
a. AMOUNT OF INVESTMENT APPROVED: 1. IN FOREX : 2a1
2. EQUIVALENT IDR. : 2a2 *)
3. IN US$. : 2a3
4. TOTAL US$. : 2a4
b. INVESTMENT : 1 NEW 2 EXPANSION
c. …………………………………………………………………………………………………………………………
d. FACILITIES GRANTED : 1 INVESTMENT ALLOWANCE
2 ACCELERATED DEPRECIATION/AMORTIZATION
3 LOSS CARRIED FORWARD 4 YEAR
INVESTMENT REALIZATION
a. THIS YEAR : US$. a
b. UP TO THIS YEAR : US$. b
FACILITIES OF INVESTMENT ALLOWANCE : YEAR a b US$. **)
(5% X REALIZATION OF INVESTMENT UP TO CPS)
NOTE:
*) ……………………………,
**) COPY THE AMOUNT IN LINE 5 b TO FORM 1771-I TAXPAYER/AUTHORIZED REPRESENTATIVE
LINE 7 COLUMN (3)
5.
PLEASE USE ACTUAL CONVERTION RATE AT THE TIME OF TRANSFER TO THE COMPANY'S ACCOUNT
(……………………………………………………………)
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
3.
4. TIME WHEN COMMERCIAL PRODUCTION STARTED (CPS), DATE:
FIELD AND/OR REGION OF INVESTMENT:
5 10 % TAX ON DIVIDENDS PAID TO FOREIGN SHAREHOLDERS
1.
2.
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
2 0LIST OF INVESTMENT FACILITIES
42
5A
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME :
NOTE: ……………………………,
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
TAXPAYER /AUTHORIZED REPRESENTATIVE
etc.
(……………………………………………………………)
24
25
22
23
20
21
18
19
16
17
14
15
12
13
10
11
8
9
6
7
4
5
2
3
(1) (2) (3) (4)
1
NO ADDRESS OF MAIN BRANCHES OFFICE TIN LOCATIONNUMBER OF MAIN
BRANCHES
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
2 0LIST OF BRANCH MAJOR
43
5B
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME :
NOTE: ……………………………,
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
TAXPAYER /AUTHORIZED REPRESENTATIVE
25
etc.
(……………………………………………………………)
23
24
21
22
19
20
17
18
15
16
13
14
11
12
9
10
7
8
5
6
3
4
1
2
NO ADDRESS OF MAIN BRANCHES OFFICE TIN LOCATIONNUMBER OF MAIN
BRANCHES
(1) (2) (3) (4)
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
2 0LIST OF BRANCH MAJOR
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
44
6A
FOR TAXABLE YEAR
T I N :
:
COMMERCIAL NET INCOME : ……………………………………………………… (BASED ON FINANCIAL STATEMENT)
FISCAL ADJUSTMENTS :
a. POSITIVE : IDR.
b. NEGATIVE : IDR.
c. TOTAL (a – b) : …………………………………………………………………
FISCAL NET INCOME : (1 +/- 2c) ……………………………………………………
CORPORATE INCOME TAX PAYABLE: ……………………………………………….
TAX BASE FOR INCOME TAX ART. 26 PARAGRAPH (4) : (3 - 4) ……………………………………
INCOME TAX ARTICLE 26 PARAGRAPH (4) :
a PAYABLE : …… *) % X AMOUNT IN LINE 5 ………………………………………
b NOT PAYABLE, BECAUSE:
c PROVISIONS OF TAX TREATY INDONESIA - …………………………
d REINVESTED WHOLLY IN INDONESIA IN A NEW LIMITED COMPANY: **)
………………………………………………………………………………………
TIN : e
ADDRESS : f ………………………………………………………………………………………
………………………………………………………………………………………
g CITY : …………………………………… POSTAL CODE : h
NOTE: ……………………,
*) TAX RATE OF 20% RATE STIPULATED IN TAX TREATY
**) PLEASE ATTACH THE DOCUMENTATION OF REINVESTMENT TAXPAYER/AUTHORIZED REPRESENTATIVE
TAXPAYER'S NAME/PERMANENT ESTABLISHMENT
SPECIAL ATTACHMENTANNUAL INCOME TAX RETURN FOR CORPORATE
2 0CALCULATION OF INCOME TAX ARTICLE 26 PARAGRAPH (4)
IDR
1.
2.
3.
4.
(……………………………………………………………)
5.
6.
45
6B
FOR TAXABLE YEAR
T I N :
:
COMMERCIAL NET INCOME : ……………………………………………………… (BASED ON FINANCIAL STATEMENT)
FISCAL ADJUSTMENTS :
a. POSITIVE : US$.
b. NEGATIVE : US$.
c. TOTAL (a – b) : …………………………………………………………………
FISCAL NET INCOME : (1 +/- 2c) ……………………………………………………
CORPORATE INCOME TAX PAYABLE: ……………………………………………….
TAX BASE FOR INCOME TAX ART. 26 PARAGRAPH (4) : (3 - 4) ……………………………………
INCOME TAX ARTICLE 26 PARAGRAPH (4) :
a PAYABLE : …… *) % X AMOUNT IN LINE 5 ………………………………………
b NOT PAYABLE, BECAUSE:
c PROVISIONS OF TAX TREATY INDONESIA - …………………………
d REINVESTED WHOLLY IN INDONESIA IN A NEW LIMITED COMPANY: **)
………………………………………………………………………………………
TIN : e
ADDRESS : f ………………………………………………………………………………………
………………………………………………………………………………………
g CITY : …………………………………… POSTAL CODE : h
NOTE: ……………………,
*) TAX RATE OF 20% RATE STIPULATED IN TAX TREATY
**) PLEASE ATTACH THE DOCUMENTATION OF REINVESTMENT TAXPAYER/AUTHORIZED REPRESENTATIVE
(……………………………………………………………)
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
4.
5.
6.
3.
IDR
1.
2.
TAXPAYER'S NAME/PERMANENT ESTABLISHMENT
SPECIAL ATTACHMENTANNUAL INCOME TAX RETURN FOR CORPORATE
2 0CALCULATION OF INCOME TAX ARTICLE 26 PARAGRAPH (4)
46
7A
T I N : TAXPAYER'S NAME :
NOTES : ……………………,
• PLEASE FILL WITH THE DETAIL OF EACH WITHHOLDING RECEIPT/TAX PAYMENT.
• TAXPAYER / AUTHORIZED REPRESENTATIVE
• TAX CREDIT THAT CAN BE CREDITED IN COLUMN (8) SHALL BE CALCULATED BY ORDINARY CREDIT PER COUNTRY BASIS METHOD
• COPY THE TOTAL AMOUNT IN COLUMN (8) TO FORM 1771 LETTER C LINE 8.b.
• COPY THE TOTAL AMOUNT IN COLUMN (5) TO FORM 1771-I line 2.
• IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
(……………………………………………………………)
ANNUAL INCOME TAX RETURN FOR CORPORATE
FOREIGN TAX CREDIT
TAX CREDITABLE
COLUMN (6) IDR FILL WITH CONVERTION VALUE FROM THE NUMBER IN COLUMN (7) FOREIGN EXCHANGE USING EXCHANGE RATE PREVAILING AT THE TIME OF TAX PAYMENT/TAX DUE IN FOREIGN COUNTRY
TOTAL TTL
10.
9.
8.
7.
6.
5.
4.
3.
2.
(7) (8)
1,
(1) (2) (3) (4) (5) (6)
IN FOREIGN COUNTRY
NAME ADDRESS(IDR)
IDR FOREIGN EXCHANGE (IDR)
NO.
WITHHOLDING AGENT
TYPES OF INCOMENET AMOUNT
TAX DUE / PAID
SPECIAL ATTACHMENT
TAXABLE YEAR
2 0
47
7B
TAXABLE YEAR
T I N : TAXPAYERS NAME :
NOTE ……………………,
• PLEASE FILL WITH THE DETAIL OF EACH WITHHOLDING TAX RECEPIT/TAX PAYMENT. WAJIB PAJAK / KUASA
• COLUMN (5) IDR, FILL WITH CONVERSION VALUE FORM COLUMN (6) FOREX, USING EXCHANGE RATE PREVAILING AT THE TIME OF TAX
PAYMENT/DUE IN FOREIGN (SOURCE) COUNTRY.
• TAX CREDIT THAT CAN BE CREDITED IN COLUMN (7) SHALL BE CALCULATED USING ORDINARY CREDIT PER COUNTRY BASIS METHOD
• PLEASE COPY THE TOTAL AMOUNT OF COLUMN (7) TO FORM 1771 ITEM C NUMBER 8.b
• PLEASE COPY THE TOTAL AMOUNT OF COLUMN (4) TO FORM 1771-I NUMBER 2.
• THIS FORM MAY BE COPIED IF NEED
2 0
etc
10
7
6
9
8
3
2
5
4
(5) (6)
1
(1) (2) (3) (4)
NET AMOUNT TAX PAID
US$ FOREX
(……………………………………………………………)
FOREIGN WITHHOLDING AGENT
SPECIAL ATTACHMENTANNUAL CORPORATE INCOME TAX RETURN
FOREIGN TAX CREDITS
FOR TAXPAYERS WHO ARE PERMITTED TO MAINTAIN BOOKEEPING
IN THE UNITED STATES DOLLAR CURRENCY
NO.
TTLT O T A L
(7)
TAX
NAME AND ADDRESS OF TYPE OF INCOME (US$) OUTSIDE INDONESIA CREDITABLE
(US$)
48
LIST OF TAXES REGULATION
No. Regulatins Number Date Concerning
1. Undang-Undang 28 17/07/2007 Perubahan Ketiga atas atas Undang-Undang Nomor 6 Tahun 1983 tentang Ketentuan Umum dan Tata Cara Perpajakan
2. Undang-Undang 16 25/03/2009 Penetapan Peraturan Pemerintah Pengganti Undang-Undang Nomor 5 Tahun 2008 tentang Perubahan Keempat atas Undang-Undang Nomor 6 Tahun 1983 tentang Ketentuan Umum dan Tata Cara Perpajakan
3. Undang-Undang 36 23/09/2008 Perubahan Keempat atas Undang-Undang Nomor 7 Tahun 1983 tentang Pajak Penghasilan
4. Peraturan Pemerintah
80 28/12/2007 Tata Cara Pelaksanaan Hak dan Kewajiban Perpajakan Berdasarkan Undang-Undang Nomor 6 Tahun 1983 tentang tentang Ketentuan Umum dan Tata Cara Perpajakan sebagaimana telah Beberapa Kali Diubah Terakhir dengan Undang-Undang Nomor 28 Tahun 2007
5. Peraturan Pemerintah
138 21/12/2000 Penghitungan Penghasilan Kena Pajak Dan Pelunasan Pajak Penghasilan Dalam Tahun Berjalan
6. Peraturan Pemerintah
25 18/05/2001 Perubahan Ketiga atas Peraturan Pemerintah Nomor 42 Tahun 1995 tentang Bea Masuk, Bea Masuk Tambahan, Pajak Pertambahan Nilai Dan Pajak Penjualan Atas Barang Mewah Dan Pajak Penghasilan Dalam Rangka Pelaksanaan Proyek Pemerintah Yang Dibiayai Dengan Hibah Atau Dana Pinjaman Luar Negeri
7. Peraturan Pemerintah
81 28/12/2007 Penurunan Tarif Pajak Penghasilan bagi Wajib Pajak Badan Dalam Negeri yang Berbentuk Perseroan Terbuka
8. Peraturan Pemerintah
51 20/07/2008 PPh atas Penghasilan dari Usaha Jasa Konstruksi
9. Peraturan Pemerintah
62 23/09/2008 Perubahan atas Peraturan Pemerintah Nomor 1 Tahun 2007 tentang Fasilitas Pajak Penghasilan Untuk Penanaman Modal Di Bidang-Bidang Usaha Tertentu Dan/Atau Di Daerah-Daerah Tertentu
10. Peraturan Menteri Keuangan
16/PMK.03/2007 19/02/2007 Pemberian Fasilitas Pajak Penghasilan Untuk Penanaman Modal Di Bidang-Bidang Usaha Tertentu dan/atau di Daerah-DaerahTertentu
11. Peraturan Menteri Keuangan
181/PMK.03/2007 28/12/2007 Bentuk dan Isi Surat Pemberitahuan serta Tata Cara Pengambilan, Pengisian, dan Penandatanganan dan Penyampaian Surat Pemberitahuan
12. Peraturan Menteri Keuangan
152/PMK.03/2009 29/09/2009 Perubahan atas Peraturan Menteri Keuangan Nomor 181/PMK.03/2007 Tentang Bentuk dan Isi Surat Pemberitahuan serta Tata Cara
49
No. Regulatins Number Date Concerning
Pengambilan, Pengisian, dan Penandatanganan dan Penyampaian Surat Pemberitahuan
13. Peraturan Menteri Keuangan
192/PMK.03/2007 28/12/2007 Tata Cara Penetapan Wajib Pajak Dengan Kriteria Tertentu Dalam Rangka Pengembalian Pendahuluan Kelebihan Pembayaran Pajak
14. Peraturan Menteri Keuangan
193/PMK.03/2007 28/12/2007 Batasan Jumlah Peredaran Usaha, Jumlah Penyerahan, dan Jumlah Lebih Bayar bagi Wajib Pajak yang Memenuhi Persyaratan Tertentu yang Dapat Diberikan Pengembalian Pendahuluan Kelebihan Pajak
15. Peraturan Menteri Keuangan
54/PMK.03/2009 27/03/2009 Perubahan atas Peraturan Menteri Keuangan Nomor 193/PMK.03/2007 tentang Batasan Jumlah Peredaran Usaha, Jumlah Penyerahan, dan Jumlah Lebih Bayar bagi Wajib Pajak yang Memenuhi Persyaratan Tertentu yang Dapat Diberikan Pengembalian Pendahuluan Kelebihan Pajak
16. Peraturan Menteri Keuangan
196/PMK.03/2007 28/12/2007 Tata Cara Penyelenggaraan Pembukuan Dengan Menggunakan Bahasa Asing Dan Satuan Mata Uang Selain Rupiah Serta Kewajiban Penyampaian Surat Pemberitahuan Tahunan Pajak Penghasilan Wajib Pajak Badan
17. Peraturan Menteri Keuangan
187/PMK.03/2008 20/11/2008 Tata Cara Pemotongan, Penyetoran, Pelaporan, dan Penatausahaan PPh atas Penghasilan dari Usaha Jasa Konstruksi
18. Peraturan Menteri Keuangan
255/PMK.03/2008 21/12/2008 Penghitungan Besarnya Angsuran Pajak Penghasilan Dalam Tahun Pajak Berjalan Yang Harus Dibayar Sendiri Oleh Wajib Pajak Baru, Bank, Sewa Guna Usaha Dengan Hak Opsi, Badan Usaha Milik Negara, Badan Usaha Milik Daerah, Wajib Pajak Masuk Bursa Dan Wajib Pajak Lainnya Yang Berdasarkan Ketentuan Diharuskan Membuat Laporan Keuangan Berkala Termasuk Wajib Pajak Orang Pribadi Pengusaha Tertentu
50
No. Regulatins Number Date Concerning
19. Peraturan Menteri Keuangan
208/PMK.03/2009 10/12/2009 Perubahan atas Peraturan Menteri Keuangan Nomor 255/PMK.03/2008 tentang Penghitungan Besarnya Angsuran Pajak Penghasilan dalam Tahun Pajak Berjalan yang harus Dibayar Sendiri oleh Wajib Pajak Baru, Bank, Sewa Guna Usaha dengan Hak Opsi, Badan Usaha Milik Negara, Badan Usaha Milik Daerah, Wajib Pajak Masuk Bursa dan Wajib Pajak lainnya yang Berdasarkan Ketentuan Diharuskan membuat laporan Keuangan Berkala Termasuk Wajib Pajak Orang Pribadi Pengusaha Tertentu
20. Peraturan Menteri Keuangan
257/PMK.03/2008 31/12/2008 Perlakuan Perpajakan Atas Penghasilan Kena Pajak Sesudah Dikurangi Pajak Dari Suatu Bentuk Usaha Tetap
21. Peraturan Menteri Keuangan
81/PMK.03/2009 22/04/2009 Pembentukan Atau Pemupukan Dana Cadangan Yang Boleh Dikurangkan Sebagai Biaya
22. Peraturan Menteri Keuangan
83/PMK.03/2009 22/04/2009 Penyediaan Makanan dan Minuman bagi Seluruh Pegawai serta Penggantian atau Imbalan dalam Bentuk Natura dan Kenikmatan di Daerah Tertentu dan Yang Berkaitan dengan Pelaksanaan Pekerjaan yang Dapat Dikurangkan dari Penghasilan Brito Pemberi Kerja
23. Peraturan Menteri Keuangan
96/PMK.03/2009 15/05/2009 Jenis-Jenis Harta yang Termasuk dalam Kelompok Harta Berwujud Bukan Bangunan untuk Keperluan Penyusutan
24. Peraturan Menteri Keuangan
153/PMK.03/2009 29/09/2009 Perubahan atas Peraturan Menteri Keuangan Nomor 187/PMK.03/2008 Tentang Tata Cara Pemotongan, Penyetoran, Pelaporan, dan Penatausahaan PPh atas Penghasilan dari Usaha Jasa Konstruksi
25. Keputusan Menteri Keuangan
604/KMK.04/1994 21/12/1994 Badan-Badan dan Pengusaha Kecil yang Menerima Harta Hibahan yang Tidak Termasuk sebagai Objek PPh
26. Keputusan Menteri Keuangan
521/KMK.04/2000 14/12/2000 Jenis-Jenis Harta Yang Termasuk Dalam Kelompok Harta Berwujud untuk Keperluan Penyusutan Bagi Kontraktor Yang Melakukan Eksplorasi dan Eksploitasi Minyak Dan Gas Bumi Dalam Rangka Kontrak Bagi Hasil dengan Perusahaan Pertambangan Minyak Dan Gas Bumi Negara (Pertamina)
27. Keputusan Menteri Keuangan
534/KMK.04/2000 22/12/2000 Bentuk dan Isi Surat Pemberitahuan serta Surat Keterangan dan/atau Dokumen yang Harus Dilampirkan
28. Keputusan Menteri Keuangan
164/KMK.03/2002 19/04/2002 Kredit Pajak Luar Negeri
51
No. Regulatins Number Date Concerning
29. Peraturan Dirjen Pajak
PER-67/PJ./2007 05/04/2007 Tata Cara Pemberian Fasilitas Pajak Penghasilan Untuk Penanaman Modal Di Bidang-Bidang Usaha Tertentu dan/atau di Daerah-Daerah Tertentu
30. Peraturan Dirjen Pajak
PER-38/PJ/2008 24/09/2008 Tata Cara Pemberian Angsuran atau Penundaan Pembayaran Pajak
31. Keputusan Dirjen Pajak
KEP-141/PJ./1999 21/06/1999 Pengakuan Penghasilan Dari Pengalihan Harta/Agunan Berupa Tanah Dan/Atau Bangunan Bagi Wajib Pajak Tertentu
32. Keputusan Dirjen Pajak
KEP-214/PJ./2001 15/03/2001 Keterangan dan/atau Dokumen yang Harus Dilampirkan dalam Surat Pemberitahuan
33. Keputusan Dirjen Pajak
KEP-563/PJ./2001 08/08/2001 Saat Pengakuan Penghasilan Berupa Keuntungan Karena Pembebasan Utang Yang Diperoleh Debitur Tertentu Dari Perjanjian Restrukturisasi Utang Usaha
34. Keputusan Dirjen Pajak
KEP-184/PJ./2002 11/04/2002 Pengakuan Penghasilan Atas Penghasilan Bank Berupa Bunga Kredit Non Performing
35. Keputusan Dirjen Pajak
KEP-220/PJ./2002 18/04/2002 Perlakuan Pajak Penghasilan atas Biaya Pemakaian Telepon Seluler dan Kendaraan Perusahaan
36. Keputusan Dirjen Pajak
KEP-316/PJ./2002 17/06/2002 Perlakuan Pajak Penghasilan atas Pengeluaran/Biaya Perolehan Perangkat Lunak (Software) Komputer
37. Surat Edaran Dirjen Pajak
SE-04/PJ.42/2002 02/04/2002 Perlakuan Pajak Penghasilan Atas Pemberian Imbalan Bunga Kepada Wajib Pajak
38. Surat Edaran Dirjen Pajak
SE-07/PJ.42/2002 08/05/2002 Penghitungan Penyusutan Atas Komputer, Printer, Scanner dan Sejenisnya
39. Surat Edaran Dirjen Pajak
SE-08/PJ.42/2002 17/05/2002 Pengakuan Penghasilan Atas Penghasilan Bank Berupa Bunga Kredit Non-Performing
40. Surat Edaran Dirjen Pajak
SE-09/PJ.42/2002 17/05/2002 Perlakuan Pajak Penghasilan atas Biaya Pemakaian Telepon Seluler dan Kendaraan Perusahaan
41. Surat Edaran Dirjen Pajak
SE-02/PJ.42/2003 04/02/2003 kewajiban Mencantumkan Nomor Pokok Wajib Pajak dalam SPT Tahunan Pajak Penghasilan Wajib Pajak Badan Bagi Pemegang Saham/Pemilik Modal, Pengurus dan Komisaris
42. Surat Edaran Dirjen Pajak
SE-03/PJ.31/2004 03/03/2004 Kompensasi Kerugian Fiskal dalam Penghitungan Pajak Penghasilan
43. Surat Edaran Dirjen Pajak
SE-01/PJ.33/2005 19/01/2005 Pemberian Imbalan Bunga Kepada Wajib Pajak
` Notes: All the Taxation Regulation above can be found at website http://www.pajak.go.id
PDF FORM 1771
a. Folio/Government Legal (8,5 X 13 inch); b. Minimum weight of 70 gr
others are available in this form, so that taxpayers do not need to do a recount;
5. <AUTO> sign shows the calculation results automatically. There are times when automatic
re-checking of results of calculations on this tax return, especially in the field <AUTO> ;
7. SHOW button is used to display calculation formulas in filling this form;
8. RESET button is used to clean up this form from the information that has been loaded previously. After completing the income tax annual return and print it, do not forget to save to another file (Save-as and give it a name that is different from the original file), then use the RESET button to clear the file;
you want to do it manually filling;
1. This form is in compliance with the Director General of Taxes Decree No. Per-
be used for completion of income tax annual return form tax year 2010 and onwards.
2. The Tax Return shall be signed by the Taxpayer or his/her authorized proxy/representative and paper should not be folded or rumpled. For printing use the HVS paper size :
3. To be able to use this form optimally, please use Adobe Reader version 8 or newer and recharge by clicking on the field to be filled. To know which field that can be filled in, please click on
has been included in the CD or can be downloaded by the Taxpayer for free on the Internet; the menu HIGHLIGHTS FIELDS located on the upper right. The Adobe Reader application itself
4. Fill the first annexes. Summation and reduction formulas, due to certain sections and
then press DELETE key followed by ENTER. However, Taxpayer is expected to keep doing
9. HIDE button is used to hide the calculation formulas so that it can be printed blank form if
calculation is too late to execute, to make sure it runs well, point the cursor pointer tothe field where the calculation formula should be run, block the numbers there,
6. If additional form of 1771-III, 1771-IV, 1771-V and 1771-VI are needed more because the information to be loaded is more than one page, that forms are now available in the directory (folder) . These files can be reproduced to adjust the needs in a way to copy and replace filename (rename), for example: 1770-III-1, 1771-III-2 etc;
GENERAL INSTRUCTIONS FOR THE COMPLETION
34/PJ/2010 about Income Tax Annual Return Form and General Instructions and can only
10. More complete explanations about annual income tax return completion are available in softcopy version of the Income Tax Annual Guidebook included in this digital form;
ATTENTION: • FOLLOW INSTRUCTIONS
• PRINT OR TYPE WITH CAPITAL LETTER OR BLACK INK
• MARK "X" IN THE APPROPRIATE BOX
T I N :
TAXPAYER'S NAME :
BUSINESS CLASIFICATION : KLU :
TELEPHONE NUMBER : ‐ ‐
ACCOUNTING PERIOD : to
FINANCIAL STATEMENT : AUDITED AUDIT OPINION UNAUDITED
NAME OF PUBLIC ACCOUNTANT FIRM :
T I N OF PUBLIC ACCOUNTANT FIRM :
NAME OF CPA :
T I N OF CPA :
NAME OF TAX CONSULTANT FIRM :
T I N OF TAX CONSULTANT FIRM :
NAME OF TAX CONSULTANT :
T I N OF TAX CONSULTANT :
*) The filling of coloumns of Rupiahs must be without decimal value (see example in Intructions page. 3)
1. FISCAL NET INCOME
(Copy from Form 1771-I line 8 column 3) ………………………………………
2. FISCAL LOSS CARRY FORWARD (Copy from Special Attachment 2A Total of column 8) ………………………
3. TAXABLE INCOME (1-2) ……...…..…………………………….
4. INCOME TAX DUE (Choose one of these Rates according to Taxpayer criteria. See Instructions)
a. Tax Rate Article 17 paragraph (1) letter b X line 3 …….
b. Tax Rate Article 17 paragraph (2b) X line 3 ……..…………………
c. Tax Rate Article 31E paragraph (1)(See Instructions)
5.
6. TOTAL TAX DUE (4 + 5) …..…………………………………….
7. INCOME TAX BORNED BY THE GOVERNMENT (Foreign Aid Project) …
8. a. DOMESTIC TAX CREDIT (Copy from Form 1771-III Total of column 6) ……….……………..…...
b. FOREIGN TAX CREDIT (Copy from Special Attachment 7A Total of column 8) ……….…………
9. a. TAX DO AFTER CREDIT
b. TAX OVERLY WITHHELD
10. PREPAID TAX: a. MONTHLY INSTALLMENT TAX ARTICLE 25….……..………………..
b. NOTICE OF TAX COLLECTION (Principal only) …….….…..……….…
c. TOTAL (10a + 10b) …….……………………...………………
11. a. UNDERPAID TAX (INCOME TAX ARTICLE 29)
b. OVERPAID TAX (INCOME TAX ARTICLE 28A)
12. UNDERPAID TAX ON NUMBER 11.a SETTLED ON …………..
13. OVERPAID AMOUNT STATED IN 11.b WOULD BE:
a. REFUNDED b. COMPENSATED WITH OUTSTANDING TAX PAYABLE
Refund for a Taxpayer with Certain Criteria only: Preliminary Refund (Tax Law on Article 17C or 17D )
F.1.1.32.14
ANNUAL INCOME TAX RETURNFOR CORPORATE
DATE
10b
c. TOTAL ( 8a + 8b ) ……...……………..….…………………………….
10a
8b
3
5
(6 – 7 – 8c) …
8c
ADJUSTMENT FOR FOREIGN TAX CREDIT REFUNDED THAT HAD BEEN CREDITED IN THE PREVIOUS YEAR'S RETURN (Income Tax Art. 24)
1
DIRECTORATE GENERAL OF TAXES
B.
INC
OM
E T
AX
DU
EF
OR
M 1771MINISTRY OF FINANCE OF THE
REPUBLIC OF INDONESIA
(3)
2
6
IDR*)
IDE
NT
ITY
(1) (2)
C. T
AX
CR
ED
ITS
8a
MONTH
FACSIMILE NO:
FOREIGN DOMICILE OF HEAD OFFICE (Permanent Establisment only)
A. T
AX
AB
LE
INC
OM
E
10c
(9 – 10c) …
7
YEAR
9
11
D. I
NC
OM
E T
AX
UN
DE
R/O
VE
R
PA
ID
4
……...AMENDED RETURN
TAXABLE YEAR
2 0
Form 1771 Page 2
14. a.
b. FISCAL LOSS CARRY FORWARD: (From Special Attachment 2A Total of Column 9) .………... Ø
c. TAXABLE INCOME (14a – 14b) …..…………………………… Ø
d. TAX DUE……………………………………………….. ( Tax Rate from Part B line 4 X 14c) Ø
Ø
f. INCOME TAX MUST BE PAID (14d – 14e) …………………… Ø
g. INCOME TAX ARTICLE 25 : (1/12 X 14f) ………..…….………Ø
15 a. FINAL TAX : (From Form 1771-IV Total Part A Column 5) …..……..………Ø
b. NON-TAXABLE INCOME: GROSS INCOME (From Form 1771-IV Total Part B of Column 3) …..……..……Ø
16 a.
b.
17 OTHER THAN FORM OF 1771-I, 1771-II, 1771-III, 1771-IV, 1771-V, AND 1771-VIWITH THIS ALSO ATTACHED:
a. THIRD COPY OF TAX PAYMENT RECEIPT OF INCOME TAX ARTICLE 29
b. FINANCIAL STATEMENTS
c. TRANCRIPT OF CITATION OF ELEMENTS FROM FINANCIAL STATEMENT (Special Attachment 8A-1 / 8A-2 / 8A-3 / 8A-4 / 8A-5 / 8A-6 / 8A-7 / 8A-8)*
d. DEPRECIATION AND AMORTIZATION TABLES (Special Attachment 1A of Annual Income Tax Return Manual)*
e. CALCULATION OF FISCAL LOSS CARRY FORWARD (Special Attachment 2A of Income Tax Return Manual)*
f. INVESTMENT FACILITIES PROVIDED (Special Attachment 4A of the Income Tax Return Manual)
g. LIST OF MAJOR BRANCHES (Special Attachment 5A of the Income Tax Return Manual)
h. THIRD COPY OF PAYMENT RECEIPT OF INCOME TAX ARTICLE 26 PARAGRAPH (4) (For Permanent Establishment only)
i. CALCULATION OF INCOME TAX ART. 26 PARAGRAPH (4) (Permanent Establishment only) (Special Attachment 6A of Income Tax Return Manual)*
j. FOREIGN TAX CREDITS (Special Attachment 7A Income Tax Return Manual)*
k. POWER OF ATTORNEY (If needed)
l.
m.
n.
*
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, IncludingAll Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
a. TAXPAYER b. c. …………………………………, d.
(Place)
SIGNATURE AND COMPANY SEAL:
FULL NAME
: e.
T I N : f.
F.1.1.32.14
MANAGEMENT / REPRESENTATIVE
INCOME BASE FOR CALCULATION OF MONTHLY TAX INSTALLMENT…………………………………………..
All Attachment above can be downloaded on website http://www.pajak.go.id. or take it at the nearest Tax Office.
month
DECLARATION
15b
(1) (2)
(Compulsory to submit Special Attachment 3A, 3A-1, and 3A-2 Manual Book of Annual Return)*
There is not a Transaction in Related Parties and/or with Tax Heaven Country Resident.
AUTHORIZED REPRESENTATIVE
14c
E.
MO
NT
HL
Y I
NS
TA
LL
ME
NT
OF
AR
T.
25
FO
R C
UR
RE
NT
YE
AR
G. S
TA
TE
ME
NT
OF
T
RA
NS
AC
TIO
N IN
R
EL
AT
ED
PA
RT
IES
14g
15a
14d
14b
14e
14f
There is a Transaction in Related Parties and/or with Tax Haven Country Resident
e.
(3)
IDR
14a
yeardate
H.A
TT
AC
HM
EN
TS
F. F
INA
L T
AX
AN
D N
ON
-T
AX
AB
LE
INC
OM
E
WITHHOLDING TAX PAID BASED ON NUMBER 14a
T I N :
TAXPAYER'S NAME :
ACCOUNTING PERIOD :
DOMESTIC COMMERCIAL NET INCOME:
a. GROSS INCOME Ø
b. COST OF GOOD SOLD …………...…………...…………...…………...…………...… Ø
c. OTHER EXPENSES .…………...…………....…………...…………....…………...…… Ø
d. NET INCOME FROM BUSINESS ( 1a - 1b - 1c ) ..…………...………….....………… Ø
e. INCOME FROM NON BUSINESS ACTIVITIES .…………...…………....………….. Ø
f. EXPENSE FROM NON BUSINESS ACTIVITIES.…………...…………....………… Ø
g. NET INCOME FROM NON BUSINESS ACTIVITIES ( 1e - 1f )..…….…………..... Ø
h. TOTAL ( 1d + 1g ) : .…………...…………....…………...…………....………… Ø
FOREIGN COMMERCIAL NET INCOME
(From Special Attachment 7A Column 5) .…………...…………....…………...………….. Ø
TOTAL OF COMMERCIAL NET INCOME (1h + 2) …………………...………………… Ø
INCOME SUBJECT TO FINAL TAX
AND NON-TAXABLE INCOME ..…………...………….....…………...………….....……… Ø
POSITIVE ADJUSTMENT:
a. EXPENSES CHARGED OR INCURRED FOR THE PERSONAL BENEFIT OF
SHAREHOLDERS, PARTNERSHIP OR MEMBERS. ..…………...………….....…… Ø
b. FORMATION OR ACCUMULATION OF ALLOWANCES..…………...…………..... Ø
c. CONSIDERATION OR REMUNERATION RELATED TO EMPLOYMENT OR
SERVICES GIVEN IN THE FORM OF A BENEFIT IN KIND..…………...………… Ø
d. EXCESSIVE COMPENSATION PAID TO SHAREHOLDERS OR OTHER
ASSOCIATED PARTIES AS A CONSIDERATION OF WORK PERFORMED
………………………………………………………………………………………… Ø
e. GIFTS, AIDS OR DONATION ..…………...………….....…………...………….....… Ø
f. INCOME TAX.…………...………….....…………...………….....…………...………… Ø
g. SALARIES PAID TO A MEMBER OF ASSOCIATION, FIRMA, OR LIMITED
PARTNERSHIP WHICH CAPITAL DOES NOT CONSIST OF STOCKS..………… Ø
h. ADMINISTRATION PENALTIES ..…………...………….....…………...…………..... Ø
i. LESS COMMERCIAL DEPRECIATION OVER FISCAL DEPRECIATION ..……… Ø
j. LESS COMMERCIAL AMORTIZATION OVER FISCAL AMORTIZATION ..……… Ø
k. DEFERRED EXPENSES Ø
l. OTHER POSITIVE FISCAL ADJUSTMENTS ..…………...………….....…………... Ø
m. TOTAL 5a to 5l : ..…………...………….....…………...………….....………… Ø
NEGATIVE FISCAL ADJUSTMENT:
a. LESS COMMERCIAL DEPRECIATION UNDER FISCAL DEPRECIATION..……… Ø
b. LESS COMMERCIAL AMORTIZATION UNDER FISCAL AMORTIZATION..……… Ø
c. DEFERRED INCOME Ø
d. OTHER NEGATIVE FISCAL ADJUSTMENTS..…………...………….....………….. Ø
e. TOTAL 6a to 6d ..…………...………….....…………...………….....…………...… Ø
FACILITIES OF INVESTMENT ALLOWANCES
………YEAR 7a (From Special Attachment 4A Line 5b) ..…………...…… Ø
NOTES : Copy Total of Line 8 to Form 1771 Letter A Line 1.
D.1.1.32.31
MINISTRY OF FINANCE OF THE REPUBLIC OF INDONESIA
1771 - IFO
RM
5h
6e
6b
5j
5k
5a
6c
7b
5l
5e
5g
5m
5c
5b
8.
5f
7.
6.6a
6d
FISCAL NET INCOME (3 - 4 + 5m - 6e - 7b) ..…………...………….....…………..
5i
8
TA
XA
BL
E Y
EA
R
ANNUAL INCOME TAX RETURN FOR CORPORATE
(2)
DIRECTORATE GENERAL OF TAXES
NO IDR(3)
DESCRIPTIONS
to
(1)
IDE
NT
ITY
1a
1.
5.
2.
3.
4.4
3
2
1h
1b
1c
1d
1e
5d
1f
1g
ATTACHMENT - I
CALCULATION OF FISCAL NET INCOME
2 0 A A
T I N : TAXPAYER'S NAME
ACCOUNTING PERIOD :
(1)
1. PURCHASE OF MATERIAL/MERCHANDISE
2.
3. TRANSPORTATION EXPENSE
4.
5. RENTAL EXPENSES
6. INTEREST EXPENSE
7. EXPENSE RELATED TO SERVICE
8. BAD DEBT EXPENSE
9. ROYALTIES EXPENSE
10. MARKETING AND PROMOTION EXPENSE
11. OTHER EXPENSES
12. BEGINNING INVENTORY
13. ENDING INVENTORY (-/-)
Note:• Number 1 for Trading Company fill with inventory, for industry fill with purchase of material, indirect material and finished good.• Number 7 includes management fee, technical assistance fee, and other services • Line 11 includes total expenses not covered in Line 1 to 10•
D.1.1.32.54
MINISTRY OF FINANCE OF THE REPUBLIC OF INDONESIA
SALARIES, WAGES, BONUSES, GRATIFICATIONS
DETAILS OF COST OF GOOD SOLD, OTHER OPERATING EXPENSE AND COMMERCIAL NON-OPERATING EXPENSE
Line 12 and 13 for trading companies, filled with beginning/ending balances of merchandise inventory, for industrial companies, filled with beginning/ending balances of raw materials, indirect materials, work in process, and finished goods inventory
DEPRECIATION AND AMORTIZATION EXPENSE
(6) = (3) + (4) + (5)(5)
IDE
NT
ITY
(IDR)(4)
NO.
(2)
to
(IDR)
TOTAL OF LINE 1 TO 12 MINUS LINE 1314
OTHER OPERATING EXPENSECOST OF GOOD SOLD
(3)
DETAILS(IDR)(IDR)
DIRECTORATE GENERAL OF TAXES
ATTACHMENT- II ANNUAL INCOME TAX RETURN FOR CORPORATE
TA
XA
BL
E Y
EA
R
TOTALNON-OPERATING EXPENSE
FO
RM 1771 - II
2 0 A A
T I N : TAXPAYER'S NAME:
BOOKS OF ACCOUNT PERIOD :
NO.
(1)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
etc
TOTAL
Notes:• Filled with calculation of each Withholding Tax Receipt.• Copy of Total Income Tax Article 22, Income Tax Article 23 and Income Tax Article 26 column (6) to Form 1771 Letter C Line 8.a.
Page- from page Attachment-III
D.1.1.32.32
WITHHOLDING AGENT
NAME
(2) (3)
TIN
(5)
(IDR)
(4)
WITHHOLDING OBJECTTYPES OF INCOME/
TRANSACTION
1771 - III
DIRECTORATE GENERAL OF TAXES
IF NEEDED. ADDITIONAL PAGES MAY BE ADDEED
TTL
(7)(6) (8)
ANNUAL INCOME TAX RETURN FOR CORPORATE
DATE
TA
XA
BL
E Y
EA
R
WITHHOLDING RECEIPT/TAX PAYMENT SLIP (SSP)/SSPCP
MINISTRY OF FINANCE OF THE REPUBLIC OF INDONESIA
(IDR)
INCOME TAX WITHHELD
FO
RM
FOREIGN TAX CREDIT
to
IDE
NT
ITY
ATTACHMENT - III
NUMBER
2 0A A
T I N :
TAXPAYER'S NAME :
BOOKS OF ACCOUNT PERIOD :
PART A: FINAL INCOME TAX
INCOME FROM SALES VALUES OF SHARE
TRADED IN STOCK EXCHANGE
INCOME FROM DISTRIBUTOR / DEALER /
AGENT OF OIL PRODUCTS
CONSTRUCTION RELATED FEE:
a. CONTRUCTOR
b. DESIGNER
c. CONSTRUCTION SUPERVISOR
GROSS SALES OF REPRESENTATIVE OFFICE
REVALUATION OF FIXED ASSET
PART B : NON-TAXABLE INCOME
AID/DONATION
GRANT
CONTRIBUTION AND SPECIFIC INCOME RECEIVED BY A PENSION FUND
…………………………………………………….…………
page- page Attachment-IV
D.1.1.32.34
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
(2)
TYPES OF INCOME
4.
5.
etc.
2.
1771 - IVMINISTRY OF FINANCE OF THE
REPUBLIC OF INDONESIA
DIRECTORATE GENERAL OF TAXES
1.
(3) (4)
RATE(%)
3.
(1)
TYPES OF INCOME
(2)
FO
RM
IDE
NT
ITY
NO.INCOME TAX PAYABLE
(IDR)
(5)
TA
XA
BL
E Y
EA
R
ANNUAL INCOME TAX RETURN FOR CORPORATE
FINAL INCOME TAX AND NON-TAXABLE INCOME
to
ATTACHMENT - IV
TAX BASE(IDR)
9.
10.
6.
7.
3.
7.
(1)
2.
1.
6.
4.
NO
Copy to Form 1771 letter F line 15 point b
GROSS INCOME
(IDR)
(3)
TOTAL PART B TPB
5.
14.
12.
8.
13.
GROSS INCOME OF DOMESTIC SHIPPING COMPANY
GROSS INCOME OF FOREIGN SHIPPING / AIRLINES COMPANY
11.
Copy of Form 1771 letter F line 15 point a
TOTAL PART A
SHARES OF PROFIT RECEIVED BY VENTURE CAPITAL COMPANIES FROM ITS PARTNERS
TPA
……………………………………………………………
DIVIDEND FROM INVESTMENT/OWNERSHIP OF SHARES OF THE INDONESIAN BUSINESS ENTITIES (Article 4 Paragraph (3) Item f of Income Tax Law)
from
EXCESS INCOME RECEIVED BY NONPROFIT AND REGISTERED EDUCATION INSTITUTION OR RESEARCH AND DEVELOPMENT ESTABLISHMENT WHICH ARE REINVESTED IN THE FORM OF FACILITIES AND IN INFRASTRUCTURE FOR EDUCATIONAL AND/OR R&D ACTIVITIES.
INTEREST INCOME ON TIME DEPOSITS/OTHER SAVINGS AND DISCOUNT OF CENTRAL BANK'S SERTIFICATE/SECURITIES STATE
INTEREST/DISCOUNT OF BOND
INCOME FROM TRANSFER VALUE OF RIGHT ON LAND/BUILDING
INCOME FROM LEASE/RENT VALUE OF LAND/BUILDING
DERIVATIVE TRANSACTION TRADE IN CAPITAL MARKET
INCOME FROM SALES VALUE OF VENTURE CAPITAL SHARE
2 0 A A
• LIST OF SHAREHOLDERS/CAPITAL OWNERS AND TOTAL DIVIDENDS DISTRIBUTED
• LIST OF DIRECTORS AND COMMISSIONERS
T I N :
TAXPAYER'S NAME :
BOOKS OF ACCOUNT PERIOD :
PART A: LIST OF SHAREHOLDERS/CAPITAL OWNERS AND TOTAL DIVIDENDS DISTRIBUTED
PART B: LIST OF DIRECTORS AND COMMISSIONERS
Page page Attachment-V
D.1.1.32.35
MINISTRY OF FINANCE OF THE REPUBLIC OF INDONESIA
T I NNAME ADDRESS
(2) (3) (4)
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
TA
XA
BL
E Y
EA
R
(1)
FO
RM 1771 - V
ATTACHMENT - V ANNUAL INCOME TAX RETURN FOR CORPORATE
to
IDE
NT
ITY
NO%
(2)
NAME ADDRESS T I N
(3) (4)
1.
NO
(1)
2.
3.
7.
10.
etc
DIVIDENDTOTAL PAID IN SHARES
(5)(IDR)
(7)(IDR)
(6)
10.
(5)
POSITION
4.
5.
6.
5.
8.
8.
TPA
etc
3.
6.
7.
1.
2.
4.
9.
9.
from
DIRECTORATE GENERAL OF TAXES
100%TOTAL PART A
2 0 A A
• LIST OF CAPITAL CONTRIBUTION IN AFFILIATION COMPANIES
• LIST OF ACCOUNT PAYABLE FROM SHARESHOLDERS AND/OR AFFILIATION COMPANIES
• LIST OF ACCOUNT RECEIVABLE TO SHARESHOLDERS AND/OR AFFILIATION COMPANIES
T I N :
TAXPAYER'S NAME :
BOOKS OF ACCOUNT PERIOD :
PART A : LIST OF CAPITAL CONTRIBUTION IN AFFILIATION COMPANIES
(1)
5.
etc.
PART B : LIST OF ACCOUNT PAYABLE FROM SHARESHOLDER AND/OR AFFILIATION COMPANIES
(1)
1.
2.
3.
4.
5.
6.
7.
8.
9
10.
11.
12.
etc.
PART C : LIST OF ACCOUNT RECEIVABLE TO SHARESHOLDER AND/OR AFFILIATION COMPANIES
(1)
1.
2.
3.
4.
5.
6.
7.
8.
9
10.
11.
12.
etc.
Page- page Attachment-VI
D.1.1.32.36
TA
XA
BL
E Y
EA
R
FO
RM 1771 - VI
IDE
NT
ITY
to
DIRECTORATE GENERAL OF TAXES
ATTACHMENT - VI
MINISTRY OF FINANCE OF THE REPUBLIC OF INDONESIA
ANNUAL INCOME TAX RETURN FOR CORPORATE
NO%
ADDRESS T I NAMOUNT OF CAPITAL CONTRIBUTION
(IDR)NAME
(6)
1.
(2) (3) (4) (5)
2.
3.
TOTAL
NO NAME T I NTOTAL LOAN
4.
INTEREST/YR
(IDR) %
TTL
YEAR
(2) (3) (4) (5) (6)
(6)
INTEREST/YR
%
(4) (5)
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
NO NAME T I NTOTAL LOAN
YEAR(IDR)
from
(2) (3)
2 0 A A
PETUNJUK UMUM PENGISIAN FORMULIR DIGITAL SPT 1771
1. Format SPT ini telah sesuai dengan Peraturan Direktur Jenderal Pajak Nomor Per-
34/PJ/2010 Tentang Bentuk Formulir Surat Pemberitahuan Tahunan Pajak Penghasilan Wajib Pajak Orang Pribadi Dan Wajib Pajak Badan Beserta Petunjuk Pengisiannya dan hanya dapat digunakan untuk pengisian SPT Tahun Pajak 2010 dan seterusnya.
2. SPT hasil pencetakan ini wajib ditanda tangani dan tidak boleh dilipat atau kusut. Untuk pencetakan gunakan hanya kertas HVS berukuran:
Folio/Government Legal (8,5 x 13 inch)
Berat minimal 70 gr
3. SPT Digital ini dapat dibuka dan diisi dengan aplikasi Adobe Reader versi 8 ke atas atau aplikasi pdf reader sejenis dan lakukan pengisian dengan mengklik Field yang akan diisi. Untuk mengetahui Field yang dapat diisi silahkan klik pada menu HIGHLIGHT FIELDS yang terletak pada bagian kanan atas. Sementara untuk aplikasi Adobe Reader telah disertakan dalam CD atau dapat di unduh sendiri oleh Wajib Pajak secara gratis di internet;
4. Isilah dari lampiran-lampirannya terlebih dahulu. Rumus-rumus penjumlahan, pengurangan, kaitan dengan bagian tertentu dan lainnya telah tersedia pada form ini, sehingga WP tidak perlu melakukan penghitungan kembali;
5. Tanda <AUTO> menunjukan hasil perhitungan otomatis. Ada kalanya perhitungan otomatis ini terlambat melakukan eksekusi, untuk memastikan telah berjalan dengan baik, arahkan kursor penunjuk ke sel di mana rumus perhitungan seharusnya berjalan, blok angka yang ada, selanjutnya tekan tombol DELETE dilanjutkan dengan ENTER. Namun demikian Wajib Pajak diharapkan tetap melakukan pengecekan ulang atas hasil perhitungan pada SPT ini terutama pada field <AUTO>;
6. Jika formulir Lampiran 1771-III, 1771-IV, 1771-V dan 1771-VI diperlukan lebih banyak lagi karena data yang akan diisikan lebih dari 1 (satu) halaman, didalam direktori (folder ) SPT ini telah tersedia file dimaksud. File-file tersebut dapat diperbanyak dengan cara di-copy dan diganti nama filenya (rename), (mis. 1771-III-1, 1771-III-2 dst) sesuaikan dengan kebutuhan;
7. Tombol SHOW digunakan untuk menampilkan rumus-rumus perhitungan dalam pengisian SPT secara digital;
8. Tombol RESET digunakan untuk membersihkan file pdf ini dari data yang telah diisikan sebelumnya. Setelah selesai mengisi SPT dan mencetaknya, jangan lupa simpan ke file lain (Save-as dan beri nama yang berbeda dengan file semula), kemudian gunakan tombol RESET untuk membersihkan file;
9. Tombol HIDE digunakan untuk menyembunyikan rumus-rumus perhitungan sehingga Formulir ini dapat dicetak kosong apabila ingin dilakukan pengisian secara manual;
10. Penjelasan lebih lengkap mengenai pengisian SPT Tahunan silahkan baca Buku Petunjuk Pengisian SPT Tahunan yang bentuk softcopy-nya disertakan dalam SPT digital ini;
PERHATIAN: • SEBELUM MENGISI, BACA DAHULU BUKU PETUNJUK PENGISIAN
• ISI DENGAN HURUF CETAK/DIKETIK DENGAN TINTA HITAM
• BERI TANDA "X" PADA (KOTAK PILIHAN) YANG SESUAI
N P W P :
NAMA WAJIB PAJAK :
JENIS USAHA : KLU :
NO. TELEPON : - NO. FAKS : -
PERIODE PEMBUKUAN : s.d.
NEGARA DOMISILI KANTOR PUSAT (khusus BUT) :
PEMBUKUAN / LAPORAN KEUANGAN : DIAUDIT OPINI AKUNTAN TIDAK DIAUDIT
NAMA KANTOR AKUNTAN PUBLIK :
NPWP KANTOR AKUNTAN PUBLIK :
NAMA AKUNTAN PUBLIK :
N P W P AKUNTAN PUBLIK :
NAMA KANTOR KONSULTAN PAJAK :
N P W P KANTOR KONSULTAN PAJAK :
NAMA KONSULTAN PAJAK :
NPWP KONSULTAN PAJAK :
*) Pengisian kolom-kolom yang berisi nilai rupiah harus tanpa nilai desimal (contoh penulisan lihat buku petunjuk hal. 3)
1. PENGHASILAN NETO FISKAL (Diisi dari Formulir 1771-I Nomor 8 Kolom 3) ………………………………………………………………….
2. KOMPENSASI KERUGIAN FISKAL (Diisi dari Lampiran Khusus 2A Jumlah Kolom 8) …………………………
3. PENGHASILAN KENA PAJAK (1-2) ……...…..…………………………….
4. PPh TERUTANG (Pilih salah satu sesuai dengan kriteria Wajib Pajak. Untuk lebih jelasnya, lihat Buku Petunjuk Pengisian SPT)
a. Tarif PPh Ps. 17 Ayat (1) Huruf b X Angka 3 …….
b. Tarif PPh Ps. 17 ayat (2b) X Angka 3 ……..…………………..
c. Tarif PPh Ps. 31E ayat (1) (Lihat Buku Petunjuk)
5. PENGEMBALIAN / PENGURANGAN KREDIT PAJAK LUAR NEGERI (PPh Ps. 24) YANG TELAH DIPERHITUNGKAN TAHUN LALU …………
6. JUMLAH PPh TERUTANG (4 + 5) …..…………………………………….
7. PPh DITANGGUNG PEMERINTAH (Proyek Bantuan Luar Negeri) ……..………………..………………..………
8. a. KREDIT PAJAK DALAM NEGERI (Diisi dari Formulir 1771-III Jumlah Kolom 6) ……….……………..…....………………..………………..………………..……
b. KREDIT PAJAK LUAR NEGERI (Diisi dari Lampiran Khusus 7A Jumlah Kolom 8) ……….………………..………………..………………..………………..…
c. JUMLAH ( 8a + 8b ) ……...……………..….…………………………………………………………………………..………
9. a. PPh YANG HARUS DIBAYAR SENDIRI b. PPh YANG LEBIH DIPOTONG / DIPUNGUT
10. PPh YANG DIBAYAR SENDIRI a. PPh Ps. 25 BULANAN ….……..………………..…………………………………..…………………..…………
b. STP PPh Ps. 25 (Hanya Pokok Pajak) …….….…..……….…………………………………………………
c. JUMLAH (10a + 10b ) …….……………………...………………
11. a. PPh YANG KURANG DIBAYAR (PPh Ps. 29) b. PPh YANG LEBIH DIBAYAR (PPh Ps. 28A)
12. PPh YANG KURANG DIBAYAR PADA ANGKA 11.a DISETOR TANGGAL …………..
13. PPh YANG LEBIH DIBAYAR PADA ANGKA 11.b MOHON :
a. DIRESTITUSIKAN b. DIPERHITUNGKAN DENGAN UTANG PAJAK
Khusus Restitusi untuk Wajib Pajak dengan Kriteria Tertentu : Pengembalian Pendahuluan (Pasal 17C atau Pasal 17D UU KUP)
F.1.1.32.14
TAHUN PAJAK
SPT PEMBETULAN
1771SPT TAHUNAN
PAJAK PENGHASILAN WAJIB PAJAK BADAN 2 0
KE- …
11
D. P
Ph K
UR
AN
G/ L
EBIH
BA
YAR
4
THNBLN
10c
FOR
MU
LIR
KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
IDEN
TITA
S
(1) (2)
2
6
1
8b
3
5
7
RUPIAH *)
(6 – 7 – 8c) …
10a
A. P
ENG
HA
SILA
N
KEN
A P
AJA
KB
. PP
h TE
RU
TAN
G
(3)
C.
KR
EDIT
PA
JAK
8a
TGL
(9 – 10c) ……
10b
9
8c
Formulir 1771 Halaman 2
14. a. PENGHASILAN YANG MENJADI DASAR PENGHITUNGAN ANGSURAN ………..……………………………………………………………………
b. KOMPENSASI KERUGIAN FISKAL: (Diisi dari Lampiran Khusus 2A Jumlah Kolom 9) .………………
c. PENGHASILAN KENA PAJAK (14a – 14b) …..…………………………………….…………………..………..
d. PPh YANG TERUTANG (Tarif PPh dari Bagian B Nomor 4 X 14c) ………………………….
e. KREDIT PAJAK TAHUN PAJAK YANG LALU ATAS PENGHASILAN YANG TERMASUK DALAM ANGKA 14a YANG DIPOTONG / DIPUNGUT OLEH PIHAK LAIN …..……..………...…..……..………………..
f. PPh YANG HARUS DIBAYAR SENDIRI (14d – 14e) ………………………………………………..………..
g. PPh PASAL 25 : (1/12 X 14f) ………..…….…………………………………………………..………….
15 a. PPh FINAL : (Diisi dari Formulir 1771-IV Jumlah Bagian A Kolom 5) …..……..………...…..……..………………..
b. PENGHASILAN YANG TIDAK TERMASUK OBJEK PAJAK : PENGHASILAN BRUTO (Diisi dari Formulir 1771-IV Jumlah Bagian B Kolom 3) …..……..………...…..……..………………..
16 a.
b.
17 SELAIN LAMPIRAN-LAMPIRAN 1771-I, 1771-II, 1771-III, 1771-IV, 1771-V, DAN 1771-VIBERSAMA INI DILAMPIRKAN PULA :
a. SURAT SETORAN PAJAK LEMBAR KE-3 PPh PASAL 29
b. LAPORAN KEUANGAN
c. TRANSKRIP KUTIPAN ELEMEN-ELEMEN DARI LAPORAN KEUANGAN (Lampiran Khusus 8A-1 / 8A-2 / 8A-3 / 8A-4 / 8A-5 / 8A-6 / 8A-7 / 8A-8)*
d. DAFTAR PENYUSUTAN DAN AMORTISASI FISKAL (Lampiran Khusus 1A Buku Petunjuk Pengisian SPT)*
e. PERHITUNGAN KOMPENSASI KERUGIAN FISKAL (Lampiran Khusus 2A Buku Petunjuk Pengisian SPT)*
f. DAFTAR FASILITAS PENANAMAN MODAL (Lampiran Khusus 4A Buku Petunjuk Pengisian SPT)*
g. DAFTAR CABANG UTAMA PERUSAHAAN (Lampiran Khusus 5A Buku Petunjuk Pengisian SPT)*
h. SURAT SETORAN PAJAK LEMBAR KE-3 PPh PASAL 26 AYAT (4) (Khusus bagi BUT)
i. PERHITUNGAN PPh PASAL 26 AYAT (4) (Khusus BUT) (Lampiran Khusus 6A Buku Petunjuk Pengisian SPT)*
j. KREDIT PAJAK LUAR NEGERI (Lampiran Khusus 7A Buku Petunjuk Pengisian SPT)*
k. SURAT KUASA KHUSUS (Bila dikuasakan)
l.
m.
n.
*
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku,saya menyatakan bahwa apa yang telah saya beritahukan di atas beserta lampiran-lampirannya adalah benar, lengkap dan jelas.
a. WAJIB PAJAK b. KUASA c. …………………………………, d.(Tempat)
TANDA TANGAN DAN CAP PERUSAHAAN :
NAMA LENGKAP
PENGURUS / KUASA : e.
N P W P : f.
F.1.1.32.14
H. L
AM
PIR
AN
F. P
Ph F
INA
L D
AN
PE
NG
HA
SILA
N B
UK
AN
O
BJE
K P
AJA
KE.
AN
GSU
RA
N P
Ph P
ASA
L 25
TA
HU
N B
ERJA
LAN
14f
G. P
ERN
YATA
AN
TR
AN
SAK
SI D
ALA
M
HU
BU
NG
AN
ISTI
MEW
A
14g
15a
14d
14b
14a
Tidak Ada Transaksi Dalam Hubungan Istimewa dan/atau Transaksi dengan Pihak yang Merupakan Penduduk Negara Tax Haven
Country .
thntgl
(3)RUPIAH
bln
(Wajib melampirkan Lampiran Khusus 3A, 3A-1, dan 3A-2 Buku Petunjuk Pengisian SPT)*
14c
PERNYATAAN
15b
Wajib Pajak dapat langsung mengunduh dari situs Direktorat Jenderal Pajak dengan alamat http://www.pajak.go.id. atau mengambil di KPP/KP2KP terdekat.
(1) (2)
Ada Transaksi Dalam Hubungan Istimewa dan/atau Transaksi dengan Pihak yang Merupakan Penduduk Negara Tax Haven Country.
14e
N P W P :
NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
PENGHASILAN NETO KOMERSIAL DALAM NEGERI :
a. PEREDARAN USAHA …………..……………………………...…………...…………...…………...……………...…...………………………….Ø
b. HARGA POKOK PENJUALAN …………...…………...…………...…………...…………...…………...…………...…………...…………...…….Ø
c. BIAYA USAHA LAINNYA .…………...…………....…………...…………....…………...…………....…………...…………....…………...……Ø
d. PENGHASILAN NETO DARI USAHA ( 1a - 1b - 1c ) ..…………...………….....…………...………….....…………...………….....…………...….Ø
e. PENGHASILAN DARI LUAR USAHA .…………...…………....…………...…………....…………...…………....…………...………………….Ø
f. BIAYA DARI LUAR USAHA .…………...…………....…………...…………....…………...…………....…………...…………....…………...……Ø
g. PENGHASILAN NETO DARI LUAR USAHA ( 1e - 1f )..…….………….....…………...…...………..…….....…....…………...……….Ø
h. JUMLAH ( 1d + 1g ) : .…………...…………....…………...…………....…………...…………....…………...…………....…………...……………….Ø PENGHASILAN NETO KOMERSIAL LUAR NEGERI (Diisi dari Lampiran Khusus 7A Kolom 5) .…………...…………....…………...…………....…………...…………....…………...………………….Ø
JUMLAH PENGHASILAN NETO KOMERSIAL (1h + 2) …………………...…………………...…………………...………………….…………...………Ø
PENGHASILAN YANG DIKENAKAN PPh FINAL DAN YANG TIDAK TERMASUK OBJEK PAJAK ..…………...………….....…………...………….....…………...………….....…………...…….Ø
PENYESUAIAN FISKAL POSITIF : a. BIAYA YANG DIBEBANKAN / DIKELUARKAN UNTUK KEPENTINGAN
PEMEGANG SAHAM, SEKUTU, ATAU ANGGOTA. ..…………...………….....…………...………….....…………...……………………………Ø
b. PEMBENTUKAN ATAU PEMUPUKAN DANA CADANGAN ..…………...………….....…………...………….....…………...……………..Ø c. PENGGANTIAN ATAU IMBALAN PEKERJAAN ATAU
JASA DALAM BENTUK NATURA DAN KENIKMATAN ..…………...………….....…………...………….....…………...………….....…………Ø
d. JUMLAH YANG MELEBIHI KEWAJARAN YANG DIBAYARKAN KEPADA PEMEGANG SAHAM / PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SEHUBUNGAN DENGAN PEKERJAAN ..…………...………….....…………...………….....…………...………….....…………...……………..Ø
e. HARTA YANG DIHIBAHKAN, BANTUAN ATAU SUMBANGAN ..…………...………….....…………...………….....…………...………..Ø
f. PAJAK PENGHASILAN ..…………...………….....…………...………….....…………...………….....…………...………….....…………...……..Ø g. GAJI YANG DIBAYARKAN KEPADA ANGGOTA PERSEKUTUAN, FIRMA
ATAU CV YANG MODALNYA TIDAK TERBAGI ATAS SAHAM ..…………...………….....…………...………….....…………...………………Ø
h. SANKSI ADMINISTRASI ..…………...………….....…………...………….....…………...………….....…………...………….....…………...…….Ø
i. SELISIH PENYUSUTAN KOMERSIAL DI ATAS PENYUSUTAN FISKAL ..…………...………….....…………...………….....……………Ø
j. SELISIH AMORTISASI KOMERSIAL DI ATAS AMORTISASI FISKAL ..…………...………….....…………...………….....…………...…..Ø
k. BIAYA YANG DITANGGUHKAN PENGAKUANNYA ..…………...………….....…………...………….....…………...………….....………..Ø
l. PENYESUAIAN FISKAL POSITIF LAINNYA ..…………...………….....…………...………….....…………...………….....…………...………Ø
m. JUMLAH 5a s.d. 5l : ..…………...………….....…………...………….....…………...………….....…………...………….....…………...…………..Ø
PENYESUAIAN FISKAL NEGATIF : a. SELISIH PENYUSUTAN KOMERSIAL DI BAWAH PENYUSUTAN FISKAL ..…………...………….....…………...……………..………..Ø
b. SELISIH AMORTISASI KOMERSIAL DI BAWAH AMORTISASI FISKAL ..…………...………….....…………...………….....…………….Ø
c. PENGHASILAN YANG DITANGGUHKAN PENGAKUANNYA ..…………...………….....…………...………….....…………...……………Ø
d. PENYESUAIAN FISKAL NEGATIF LAINNYA ..…………...………….....…………...………….....…………...………….....…………...…….Ø
e. JUMLAH 6a s.d. 6d ..…………...………….....…………...………….....…………...………….....…………...………….....…………...………………..Ø
FASILITAS PENANAMAN MODAL BERUPA PENGURANGAN PENGHASILAN NETO: TAHUN KE - 7a (Diisi dari Lampiran Khusus 4A Angka 5b) ..…………...………….…………...………………...………….....…………...…….Ø
CATATAN : Pindahkan jumlah Angka 8 ke Formulir 1771 Huruf A Angka 1.
D.1.1.32.31
5d
1f
1g
LAMPIRAN - I
PENGHITUNGAN PENGHASILAN NETO FISKAL
5c
1h
1b
1c
1d
1e
5b
5.
2.
3.
4.4
3
2
URAIAN
s.d.
(1)
IDEN
TITA
S
1a
1.
TAH
UN
PA
JAK
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
(2)
KEMENTERIAN KEUANGAN RIDIREKTORAT JENDERAL PAJAK
NO RUPIAH(3)
FOR
MU
LIR 1771 - I
8.
5f
7.
6.6a
6d
PENGHASILAN NETO FISKAL (3 - 4 + 5m - 6e - 7b) ..…………...………….....…………..
5i
5j
5k
8
5a
6c
7b
5l
5e
5g
5m
5h
6e
6b
2 0 A A
N P W P : NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
(1)
1. PEMBELIAN BAHAN/BARANG DAGANGAN
2. GAJI, UPAH, BONUS, GRATIFIKASI,HONORARIUM, THR, DSB
3. BIAYA TRANSPORTASI
4. BIAYA PENYUSUTAN DAN AMORTISASI
5. BIAYA SEWA
6. BIAYA BUNGA PINJAMAN
7. BIAYA SEHUBUNGAN DENGAN JASA
8. BIAYA PIUTANG TAK TERTAGIH
9. BIAYA ROYALTI
10. BIAYA PEMASARAN/PROMOSI
11. BIAYA LAINNYA
12. PERSEDIAAN AWAL
13. PERSEDIAAN AKHIR (-/-)
Catatan :• Nomor 1 untuk Perusahaan Dagang diisi pembelian barang dagangan, untuk perusahaan industri diisi pembelian bahan baku, bahan penolong dan barang jadi.• Nomor 7 termasuk management fee, technical assistance fee, dan jasa lainnya• Nomor 11 diisi dengan total biaya yang tidak tertampung dalam perincian 1 s.d. 10.• Nomor 12 dan 13 untuk perusahaan dagang diisi total persediaan awal dan akhir barang dagangan, untuk perusahaan industri diisi total persediaan
awal/akhir bahan baku/bahan penolong ditambah barang setengah jadi ditambah barang jadi.
D.1.1.32.54
(Rupiah)(Rupiah)
FOR
MU
LIR
DIREKTORAT JENDERAL PAJAK
LAMPIRAN - IISPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
PERINCIAN HARGA POKOK PENJUALAN, BIAYA USAHA LAINNYA DAN BIAYA DARI LUAR USAHA SECARA KOMERSIAL
TAH
UN
PA
JAK1771 - II
KEMENTERIAN KEUANGAN RI
JUMLAHBIAYA DARI LUAR USAHA
JUMLAH 1 S.D. 12 DIKURANGI 1314
BIAYA USAHA LAINNYAHARGA POKOK PENJUALAN
(3)
PERINCIAN
IDEN
TITA
S
(Rupiah)(4)
NO.
(2)
s.d.
(Rupiah)(6) = (3) + (4) + (5)(5)
2 0 A A
N P W P : NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
(1)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
JUMLAH
Catatan :• Diisi dengan rincian per Bukti Pemotongan / Pemungutan Pajak.• Pindahkan hasil penjumlahan PPh Pasal 22, PPh Pasal 23 dan PPh Pasal 26 Kolom (6) ke Formulir 1771 Huruf C Angka 8.a.
Halaman ke- dari halaman Lampiran-III
D.1.1.32.32
BUKTI PEMOTONGAN / PEMUNGUTAN/SSP/SSPCP
NOMOR
(7) (8)TRANSAKSI (Rupiah)
(4) (5)
YANG DIPOTONG / DIPUNGUT(Rupiah)
(6)
TANGGAL
PEMOTONG / PEMUNGUT PAJAK
NAMA NPWP
PAJAK PENGHASILAN
(2)
TAH
UN
PA
JAK
FOR
MU
LIR 1771 - III
KREDIT PAJAK DALAM NEGERI
NO.
(3)
OBJEK PEMOTONGAN / PEMUNGUTANJENIS PENGHASILAN /
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
JML
s.d.
IDEN
TITA
SLAMPIRAN - III
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADANKEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
2 0 A A
N P W P :
NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
BAGIAN A : PPh FINAL
BUNGA DEPOSITO / TABUNGAN, DAN DISKONTO SBI / SBN
BUNGA / DISKONTO OBLIGASI
PENGHASILAN PENJUALAN SAHAM YANG DIPERDAGANGKAN DI BURSA EFEK
PENGHASILAN PENJUALAN SAHAM MILIK PERUSAHAAN MODAL VENTURA
PENGHASILAN USAHA PENYALUR / DEALER / AGEN PRODUK BBM
PENGHASILAN PENGALIHAN HAK ATAS TANAH / BANGUNAN
PENGHASILAN PERSEWAAN ATAS TANAH / BANGUNAN IMBALAN JASA KONSTRUKSI : a. PELAKSANA KONSTRUKSI
b. PERENCANA KONSTRUKSI
c. PENGAWAS KONSTRUKSI
PERWAKILAN DAGANG ASING
PELAYARAN / PENERBANGAN ASING
PELAYARAN DALAM NEGERI
PENILAIAN KEMBALI AKTIVA TETAP
TRANSAKSI DERIVATIF YANG
DIPERDAGANGKAN DI BURSA
BAGIAN B : PENGHASILAN YANG TIDAK TERMASUK OBJEK PAJAK
BANTUAN / SUMBANGAN
HIBAH
DIVIDEN / BAGIAN LABA DARI PENYERTAAN MODAL
PADA BADAN USAHA DI INDONESIA (Pasal 4 Ayat (3) Huruf f UU PPh)
IURAN DAN PENGHASILAN TERTENTU YANG DITERIMA DANA PENSIUN
BAGIAN LABA YANG DITERIMA PERUSAHAAN MODAL VENTURA
DARI BADAN PASANGAN USAHA SISA LEBIH YANG DITERIMA ATAU DIPEROLEH BADAN ATAU LEMBAGA NIRLABA YANG BERGERAK DALAM BIDANG PENDIDIKAN DAN/ATAU BIDANG PENELITIAN DAN PENGEMBANGAN, YANG TELAH TERDAFTAR PADA INSTANSI YANG MEMBIDANGINYA, YANG DITANAMKAN KEMBALI DALAM BENTUK SARANA DAN PRASARANA KEGIATAN PENDIDIKAN DAN/ ATAU PENELITIAN DAN PENGEMBANGAN (Pasal 4 Ayat (3) Huruf m UU PPh)
…………………………………………………….…………
Halaman ke- dari halaman Lampiran-IV
D.1.1.32.34
Pindahkan ke Formulir 1771 huruf F angka 15 butir a
JUMLAH BAGIAN A
(1)
JBA
6.
……………………………………………………………14.
JUMLAH BAGIAN B JBB
8.
12.
3.
10.
NO
4.
13.
Pindahkan ke Formulir 1771 huruf F angka 15 butir b
PENGHASILAN BRUTO(Rupiah)
(3)
2.
1.
6.
11.
9.
5.
5.
TAH
UN
PA
JAK
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
PPh FINAL DAN PENGHASILAN YANG TIDAK TERMASUK OBJEK PAJAK
s.d.
LAMPIRAN - IV
DASAR PENGENAAN PAJAK(Rupiah)
PPh TERUTANG(Rupiah)
(5)(3) (4)
TARIF(%)
FOR
MU
LIR 1771 - IV
KEMENTERIAN KEUANGAN RIDIREKTORAT JENDERAL PAJAK
IDEN
TITA
S
NO.
(1)
JENIS PENGHASILAN
(2)
2.
1.
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
(2)
JENIS PENGHASILAN
4.
3.
7.
7.
2 0 A A
• DAFTAR PEMEGANG SAHAM/PEMILIK MODAL DAN JUMLAH DIVIDEN YANG DIBAGIKAN• DAFTAR SUSUNAN PENGURUS DAN KOMISARIS
N P W P :
NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
BAGIAN A : DAFTAR PEMEGANG SAHAM / PEMILIK MODAL DAN JUMLAH DIVIDEN YANG DIBAGIKAN
(1)
JBA
BAGIAN B : DAFTAR SUSUNAN PENGURUS DAN KOMISARIS
NO
(1)
Halaman ke- dari halaman Lampiran-V D.1.1.32.35
5.
6.
7.
8.
9.
10.
NPWP JABATAN
1.
2.
3.
4.
NAMA
(2) (4) (5)
ALAMAT
(3)
JUMLAH BAGIAN A
7.
8.
9.
10.
1.
2.
3.
4.
5.
6.
%DIVIDEN(Rupiah)
(2) (3) (4) (5) (6) (7)
NO NAMA ALAMAT NPWPJUMLAH MODAL DISETOR
(Rupiah)
100%
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
FOR
MU
LIR
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
s.d.
IDEN
TITA
S
TAH
UN
PA
JAK
LAMPIRAN - V
KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
1771 - V 2 0 A A
• DAFTAR PENYERTAAN MODAL PADA PERUSAHAAN AFILIASI• DAFTAR UTANG DARI PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI • DAFTAR PIUTANG KEPADA PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
N P W P :
NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
BAGIAN A : DAFTAR PENYERTAAN MODAL PADA PERUSAHAAN AFILIASI
(1)
JBA
BAGIAN B : DAFTAR UTANG DARI PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
(1)
1.
2.
3.
4.
5.
6.
7.
8.
9
10.
11.
12.
13.
BAGIAN C : DAFTAR PIUTANG KEPADA PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
(1)
1.
2.
3.
4.
5.
6.
7.
8.
9
10.
11.
12.
13.
Halaman ke- dari halaman Lampiran-VI
D.1.1.32.36
(Rupiah)JUMLAH PENYERTAAN MODAL
%(5) (6)(3)
(2) (3) (4) (5) (6)
BUNGA/TH%
BUNGA/TH(Rupiah)
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
NO NAMA N P W P JUMLAH PINJAMAN TAHUN(Rupiah)
%(2) (3) (4) (5) (6)
NO NAMA NPWP JUMLAH PINJAMAN
4.
TAHUN
JUMLAH BAGIAN A
5.
2.
3.
LAMPIRAN - VI
TAH
UN
PA
JAK
FOR
MU
LIR 1771 - VI SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
1.
IDEN
TITA
S
s.d.
NO NAMA ALAMAT
(2)
NPWP
(4)
2 0 A
GENERAL INSTRUCTIONS FOR THE COMPLETION
PDF FORM 1771/$
be used for completion income tax annual return form tax year 2010 and onwards.
2. The Tax Return shall be signed by the Taxpayer or his/her authorized proxy/representative and paper should not be fold or rumpled. For printing use the HVS paper size : a. Folio/Government Legal (8,5 X 13 inch); b. Minimum weight of 70 gr
4. Fill the first annexes. Summation and reduction formulas, due to certain sections and
5. <AUTO> sign shows the calculation results automatically. There are times when automatic
pointer to the field where the calculation formula should be run, block numbers there, then
re-checking of results of calculations on this tax return, especially in the field <AUTO> ;
7. SHOW button is used to display calculation formulas in filling this form;
8. RESET button is used to clean up this form from the information that has been loaded previously. After completing the income tax annual return and print it, do not forget to save to another file (Save-as and give it a name that is different from the original file), then use the RESET button to clear the file;
9. HIDE button are used to hide the calculation formulas so that it can be printed blank form if you want to do it manually filling;
10. More complete explanation about completion income tax annual please read the Income Tax Annual Guidebook that his softcopy included in this digital form;
3. To be able to use this form optimally, please use Adobe Reader version 8 or newer and
1. This form is in compliance with the Director General of Taxes Decree No. Per-
recharge by clicking on the Field to be filled. To know which the field that can be filled in, please
34/PJ/2010 about Income Tax Annual Return Form and a General Instructions and can only
click on menu HIGHLIGHTS FIELDS located on the upper right. The Adobe Reader applicationhas been included in the CD or can be downloaded by the Taxpayer for free on the Internet;
calculation is too late to execute, to make sure it runs well, point the cursor
others are available in this form, so that Taxpayer does not need to do a recount;
press DELETE key followed by ENTER. However, Taxpayer are expected to keep doing
6. If additional form of 1771-III/$, 1771-IV/$, 1771-V/$ and 1771-VI/$ is needed more because the information to be loaded more than one page, the forms are now available
to copy and replace filename (rename), for example: 1770-III$-1, 1771-III$-2 etc; in the directory (folder). These files can be reproduced adjust to the needs in a way
11. In the 1771 / $ Form, fill the Rupiah column with exchange value of the US $ column using effective tax rate at the end of tax year except for section F. Final Income Tax and Non Taxable Income that Taxpayer filled from the contents of the 1771-IV / $ Form. The Taxpayer only need to enter a value in a column of U.S. $ and the Rupiah columen value of the conversion amount will automatically appear. In order to run these automated processes, please enter the Exchange Rate Dollar Against Rupiah (USD-IDR) as follow:
• MARK "X" IN THE APPROPRIATE BOX
T I N :
TAXPAYER'S NAME :
BUSINESS CLASIFICATION : KLU :
TELEPHONE NUMBER : ‐ ‐
ACCOUNTING PERIOD : to
APPROVAL TO MAINTAIN BOOKS OF ACCOUNT IN US DOLLAR CURRENCY:
NUMBER : ………………………………………. DATE : STARTING TAXABLE YEAR:
FINANCIAL STATEMENT : AUDITED AUDIT OPINION UNAUDITED
NAME OF PUBLIC ACCOUNTANT FIRM :
T I N OF PUBLIC ACCOUNTANT FIRM :
NAME OF CPA :
T I N OF CPA :
NAME OF TAX CONSULTANT FIRM :
T I N OF TAX CONSULTANT FIRM :
NAME OF TAX CONSULTANT :
T I N OF TAX CONSULTANT :
*) The filling of columns of US Dollars and Rupiahs must be without decimal value (see example in the manual page. 3)
1. FISCAL NET INCOME (Copy from Form 1771-I/$ line 8 column 3) …………………………………
2. FISCAL LOSS CARRIED FORWARD (Copy from Special Attachment 2B Total of column 8) ………………………
3. TAXABLE INCOME (1-2) ……...…..…………………………….
4. INCOME TAX DUE (Choose one of these rates according to the Taxpayer criteria. See manual book)
a. Tax Rate Article 17 paragraph (1) letter b X line 3 …….
b. Tax Rate Article 17 paragraph (2b) X line 3 ……..…………………
c. Tax Rate Article 31E paragraph (1)(see Instructions)
5.
6. TOTAL TAX DUE (4 + 5) …..…………………………………….
7. INCOME TAX BORNED BY THE GOVERNMENT (Foreign Aid Project) …
8. a. DOMESTIC TAX CREDIT (Copy from Form 1771-III/$ Total of column 6) ……….……………..…
b. FOREIGN TAX CREDIT (Copy from Special Attachment 7B Total of column 8) ……….………
c. TOTAL ( 8a + 8b ) ……...……………..….……………………………
9. a. TAX DUE AFTER CREDIT
b. TAX OVERLY WITHHELD
10. PREPAID TAX: a. MONTHLY INSTALLMENT TAX ARTICLE 25….……..……………….
b. NOTICE OF TAX COLLECTION (Principal only) …….….…..……….…
c. TOTAL (10a + 10b)……………………...…………………
11. a. UNDERPAID TAX (INCOME TAX ARTICLE 29)
b. OVERPAID TAX (INCOME TAX ARTICLE 28A)
12. UNDERPAID TAX ON NUMBER 11.a SETTLED ON …………..
13. OVERPAID AMOUNT STATED IN 11.b WOULD BE:
a. REFUNDED b. COMPENSATED WITH OUTSTANDING TAX PAYABLE
Refund for a Taxpayer with Certain Criteria only: Preliminary Refund (Tax Law on Article 17C or 17D )
Rupiah's column should be filled with the conversion number from item in column US$, using tax rate which is valid in the end of taxable yearF.1.1.32.15
FACSIMILE NO:
A. T
AXA
BLE
INC
OM
E
ADJUSTMENT FOR FOREIGN TAX CREDIT REFUNDED THAT HAD BEEN CREDITED IN THE PREVIOUS YEAR'S RETURN (Income Tax Art. 24)
(9 – 10c)
D. I
NC
OM
E TA
X O
VER
/UN
DER
PA
ID
11
10c
ANNUAL INCOME TAX RETURN FOR CORPORATE
FOR
M
DIRECTORATE GENERAL OF TAXES
11
FOREIGN DOMICILE OF HEAD OFFICE (Permanent Establisment only)
8c
10c
10b
YEAR
9
MONTH
Notes :
DATE
7
8a
8b
9
IDEN
TITY
(1) (2)
10a
C.
TAX
CR
EDIT
S
4
5
10b
6
• FOLLOW INSTRUCTION IN THE MANUAL
• PRINT OR TYPE WITH CAPITAL LETTER OR BLACK INK
(6 – 7 – 8c)
8c
8a
8b
(IDR)(4)(3)
1 1
6
7
10a
B.
INC
OM
E TA
X D
UE
22
5
ATTENTION:
3
4
3
US $
1771/$MINISTRY OF FINANCE OF THE
REPUBLIC OF INDONESIA
TAXABLE YEAR
……..AMENDED RETURN
0FOR CORPORATE PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY 2
Form 1771/$ Page 2
14 a.
b. FISCAL LOSS CARRIED FORWARD: (From Special Attachment 2B Total of Column 9) .………...
c. TAXABLE INCOME (14a – 14b) …..…………………………………….
d. TAX DUE……………………………………………….. ( Tax Rate from Part B line 4 X 14c)
f. INCOME TAX MUST BE PAID (14d – 14e) ………………………………
g. INCOME TAX ARTICLE 25 : (1/12 X 14f) ………..…….………………
Rupiah's column should be filled with the conversion number from item in Column US$, using tax rate which is valid in the end of taxable year
15 a. FINAL TAX : (From Form 1771-IV/$ Total Part A Column 5) …..……..……Ø
b. NON-TAXABLE INCOME: GROSS INCOME (From Form 1771-IV/$ Total Part B of Column 3) …..……..………...…
16 a.
b.
17 OTHER THAN FORM OF 1771-I/$, 1771-II/$, 1771-III/$, 1771-IV/$, 1771-V/$, AND 1771-VI/$WITH THIS ALSO ATTACHED:
a. THIRD COPY OF TAX PAYMENT RECEIPT OF INCOME TAX ARTICLE 29
b. FINANCIAL STATEMENTS
c. TRANCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT (Special Attachment 8B-1 / 8B-2 / 8B-3 / 8B-4 / 8B-5 / 8B-6/8B-7/8B-8)*
d. DEPRECIATION AND AMORTIZATION TABLES (Special Attachment 1B of the Annual Income Tax Return Manual)*
e. CALCULATION OF FISCAL LOSS CARRIED FORWARD (Special Attachment 2B of Income Tax Return Manual)*
f. INVESTMENT FACILITIES PROVIDED (Special Attachment 4B of the Income Tax Return Manual)
g. LIST OF MAJOR BRANCHES (Special Attachment 5B of the Income Tax Return Manual)
h. THIRD COPY OF PAYMENT RECEIPT OF INCOME TAX ARTICLE 26 PARAGRAPH (4) (For Permanent Establishment only)
i. CALCULATION OF INCOME TAX ART. 26 PARAGRAPH (4) (Permanent Establishment only) (Special Attachment 6B of Income Tax Return Manual)*
j. FOREIGN TAX CREDITS (Special Attachment 7B Income Tax Return Manual)*
k. POWER OF ATTORNEY (If needed)
l.
m.
n.
*
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, IncludingAll Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
a. TAXPAYER b. c. …………………………………., d.
(Place)
SIGNATURE AND COMPANY SEAL:
FULL NAME OF
: e.
T I N : f.
F.1.1.32.15
MANAGEMENT / REPRESENTATIVE
e.
E. M
ON
THLY
INST
ALL
MEN
T O
F A
RT.
25 F
OR
CU
RR
ENT
YEA
R
There is a Transaction in Related Parties and/or with Tax Haven Country Resident(Compulsory to submit Special Attachment 3B, 3B-1, and 3B-2 Manual Book of Annual Return)*
There is not a Transaction in Related Parties and/or with Tax Heaven Country Resident .
All Attachment above can be downloaded on website http://www.pajak.go.id. or take it at the nearest Tax Office.
(1)
INCOME BASE FOR CALCULATION OF MONTHLY TAX INSTALLMENT…………………………………………..
(IDR)
DECLARATION
F. F
INA
L TA
X A
ND
NO
N-
TAXA
BLE
INC
OM
E
15a
H.
ATT
AC
HM
ENTS
date month year
G. S
TATE
MEN
T O
F TR
AN
SAC
TIO
N IN
R
ELA
TED
PA
RTI
ES
AUTHORIZED REPRESENTATIVE
Notes :
14g
14e
14f
WITHHOLDING TAX PAID BASED ON NUMBER 14a………
15b
15a
14g
15b
14d
14c
14b
14a
(4)
14a
14c
14d
14e
14f
14b
(2) (3)US $
T I N :
TAXPAYER'S NAME :
ACCOUNTING PERIOD :
DOMESTIC COMMERCIAL NET INCOME:
a. GROSS INCOME …………..……………………………...…………...…………...… Ø
b. COST OF GOOD SOLD …………...…………...…………...…………...………….. Ø
c. OTHER EXPENSE .…………...…………....…………...…………....…………...… Ø
d. NET INCOME FROM BUSINESS ( 1a - 1b - 1c ) ..…………...………….....……… Ø
e. INCOME FROM SIDE BUSINESS .…………...…………....…………...…………. Ø
f. EXPENSE FROM SIDE BUSINESS.…………...…………....…………...………… Ø
g. NET INCOME FROM SIDE BUSINESS ( 1e - 1f )..…….………….....………….. Ø
h. TOTAL ( 1d + 1g ) : .…………...…………....…………...…………....……… Ø
FOREIGN COMMERCIAL NET INCOME (From Special Attachment 7B Column 5) .…………...…………....…………...………… Ø
TOTAL OF COMMERCIAL NET INCOME (1h + 2) …………………...……………… Ø
INCOME SUBJECT TO FINAL TAX AND NON-TAXABLE INCOME ..…………...………….....…………...………….....…… Ø
POSITIVE FISCAL ADJUSTMENT: a. EXPENSES CHARGED OR INCURRED FOR THE PERSONAL BENEFIT OF
SHAREHOLDERS, PARTNERSHIP OR MEMBERS. ..…………...………….....… Ø
b. FORMATION OR ACCUMULATION OF ALLOWANCES..…………...…………. Ø
c. CONSIDERATION OR REMUNERATION RELATED TO EMPLOYMENT OR
SERVICES GIVEN IN THE FORM OF A BENEFIT IN KIND..…………...……… Ø
d. EXCESSIVE COMPENSATION PAID TO SHAREHOLDERS OR OTHER
ASSOCIATED PARTIES AS A CONSIDERATION OF WORK PERFORMED
……………………………………………………………………………………. Ø
e. GIFTS, AID OR DONATIONS..…………...………….....…………...………….....… Ø
f. INCOME TAX.…………...………….....…………...………….....…………...……… Ø
g. SALARIES PAID TO A MEMBER OF AN ASSOCIATION, FIRMA, OR LIMITED
PARTNERSHIP WHICH CAPITAL DOES NOT CONSIST OF STOCKS..……… Ø
h. ADMINISTRATION PENALTIES..…………...………….....…………...…………... Ø
i. LESS COMMERCIAL DEPRECIATION OVER FISCAL DEPRECIATION ..…… Ø
j. LESS COMMERCIAL AMORTIZATION OVER FISCAL AMORTIZATION ..…… Ø
k. DEFERRED EXPENSES..…………...………….....…………...………….....……… Ø
l. OTHER POSITIVE FISCAL ADJUSTMENTS ..…………...………….....………… Ø
m. TOTAL 5a to 5l : ..…………...………….....…………...………….....……… Ø
NEGATIVE FISCAL ADJUSTMENT: a. LESS COMMERCIAL DEPRECIATION UNDER FISCAL DEPRECIATION..…… Ø
b. LESS COMMERCIAL AMORTIZATION UNDER FISCAL AMORTIZATION..…… Ø
c. DEFERRED INCOME..…………...………….....…………...………….....………… Ø
d. OTHER NEGATIVE FISCAL ADJUSTMENTS..…………...………….....………… Ø
e. TOTAL 6a to 6d ..…………...………….....…………...………….....…………...… Ø
FACILITIES OF INVESTMENT ALLOWANCE …….YEAR 7a (From Special Attachment 4B Line 5b) ..…………...…… Ø
NOTES : Copy Total of Line 8 to Form 1771/$ Letter A Line 1.
D.1.1.32.37
6b
6e
5m
5e
1a
1b
1c
1d
1e
5g
5b
5f
5l
6a
5d
5c
8. FISCAL NET INCOME (3 - 4 + 5m - 6e - 7b) ..…………...………….....………….. 8
5h
5i
5j
6c
6d
5k
7b
1f
3
4
2
5a
4.
2.
3.
7.
6.
5.
1.
1g
1h
(3)
to
IDEN
TITY
DESCRIPTIONS(1) (2)
US$NO
ATTACHMENT - ICORPORATE ANNUAL INCOME TAX RETURN
FOR CORPORATE PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
CALCULATION OF FISCAL NET INCOME TAXA
BLE
YEA
R
FOR
M 1771 - I/$MINISTRY OF FINANCE OF THE
REPUBLIC OF INDONESIA
DIRECTORATE GENERAL OF TAXES
2 0A A
T I N : TAXPAYER'S NAME
ACCOUNTING PERIOD :
(1)
1. PURCHASE OF MATERIAL/MERCHANDISE
2.
3. TRANSPORTATION EXPENSE
4.
5. RENT EXPENSES
6. INTEREST EXPENSE
7. EXPENSE RELATED TO SERVICE
8. BAD DEBT EXPENSE
9. ROYALTIES EXPENSE
10. MARKETING AND PROMOTION EXPENSE
11. OTHER EXPENSES
12. BEGINNING INVENTORY
13. ENDING INVENTORY (-/-)
Note:• Number 1 for Trading Company fill with inventory, for industry fill with purchase of material, indirect material and finished good.• Number 7 includes management fee, technical assistance fee, and other services • Line 11 includes total expenses not covered in Line 1 to 10•
D.1.1.32.55
1771 - II/$MINISTRY OF FINANCE OF
THE REPUBLIC OF INDONESIA
DIRECTORATE GENERAL OF TAXES
SALARIES, WAGES, BONUSES, GRATIFICATIONS,HONORARIUM, AND OTHERS
DEPRECIATION AND AMORTIZATION EXPENSE
Line 12 and 13 for trading companies, fill with beginning/ending balances of merchandise inventory, for industrial companies, fill with beginning/ending balances of raw materials, indirect materials, work in process, and finished goods inventory
(4)(3)(US$)
(6) = (3) + (4) + (5)(US$)
(5)
TOTAL
FOR
M
TAXA
BLE
YEA
R
COST OF GOOD SOLD NON-OPERATING EXPENSEOTHER OPERATING EXPENSE
FOR CORPORATE PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
DETAILS OF COST OF GOOD SOLD, OTHER BUSINESS EXPENSE AND COMMERCIAL NON-OPERATING EXPENSE
ATTACHMENT- IICORPORATE ANNUAL INCOME TAX RETURN
14
(2)(US$)
TOTAL OF LINE 1 TO 12 MINUS LINE 13
DETAILS
IDEN
TITY
NO.
to
(US$)
2 0
T I N : TAXPAYER'S NAME :
ACCOUNTING PERIOD :
(1)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Notes:• Filled with calculation of each Withholding Tax Receipt.• Column (6) US$ filed with convertion value from the number in column (7) Rupiah, using Tax Rates which prevailing at the date of withholding• Copy of Total Income Tax Article 22, Income Tax Article 23 and Income Tax Article 26 column (6) to Form 1771/$ Letter C Line 8.a.
Pages- from page attachment-III
D.1.1.32.39
NAME TIN
WITHHOLDING AGENTNO.
TOTAL TTL
(5)
DIRECTORATE GENERAL OF TAXES FOREIGN TAX CREDIT
INCOME TAX WITHHELD
IF NEEDED. ADDITIONAL PAGES MAY BE ADDEED
NUMBER
(2) (3)
WITHHOLDING OBJECT
(US$)TYPES OF INCOME/
(4)
WITHHOLDING RECEIPT/TAX PAYMENT SLIP (SSP/SPPCP)
FOR
MID
ENTI
TY
TAXA
BLE
YEA
R
ATTACHMENT - IIICORPORATE ANNUAL INCOME TAX RETURN
to
FOR CORPORATE PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
1771 - III/$MINISTRY OF FINANCE OF THE REPUBLIC
OF INDONESIA
DATE
(9)(US$) (IDR)
(6) (7) (8)
2 0A A
T I N :
TAXPAYER'S NAME :
ACCOUNTING PERIOD :
PART A: FINAL INCOME TAX
CONSTRUCTION RELATED FEE:
a. CONSTRUCTOR
b. DESIGNER
c. CONSTRUCTION SUPERVISOR
GROSS SALES OF REPRESENTATIVE OFFICE
REVALUATION OF FIXED ASSET
Note : Column (5) US$ should be filled with convertion number of item in column (6) Rupiah, using tax rates prevailing on the date of withholding tax.
PART B : NON-TAXABLE INCOME
b page- page Attachment-IV
D.1.1.32.40
RATE
6.
3.
INCOME FROM SALES VALUE OF VENTURE CAPITAL SHARE
INCOME FROM SALES VALUES OF SHARE TRADED IN STOCK EXCHANGE
INCOME FROM DISTRIBUTOR / DEALER /AGENT OF OIL PRODUCTS
INCOME FROM LEASE/RENT VALUE OF LAND/BUILDING
INCOME FROM TRANSFER VALUE OF RIGHT ON LAND/BUILDING
1771 - IV/$MINISTRY OF FINANCE OF THE
REPUBLIC OF INDONESIA
DIRECTORATE GENERAL OF TAXES
DIVIDEND FROM INVESTMENT/OWNERSHIP OF SHARES OF THE INDONESIAN BUSINESS ENTITIES (Article 4 Paragraph (3) Item f of Income Tax Law)
`
8.
9.
DERIVATIVE TRANSACTION TRADE IN CAPITAL MARKET
11.
GROSS INCOME OF FOREIGN SHIPPING / AIRLINES COMPANY
GROSS INCOME OF DOMESTIC SHIPPING COMPANY
10.
FOR
M
2.
1.
7.
(6)(5)
(IDR)INCOME TAX PAYABLE
TAXA
BLE
YEA
R
(%)NO.
IDEN
TITY
(4)
TAX BASE
to
(1)
FOR CORPORATE PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
FINAL INCOME TAX AND NON-TAXABLE INCOME
INTEREST INCOME ON TIME DEPOSITS/OTHER SAVINGS AND DISCOUNT OF CENTRAL BANK'S SERTIFICATE/SECURITIES STATE
(US$)
(3)
INTEREST/DISCOUNT OF BOND
TYPES OF INCOME
(2)
4.
(1)
TOTAL PART A
NO
1.
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
Copy of Form 1771/$ letter F line 15 point a
TOTAL PART B TPB
TYPES OF INCOME
TPA
…………………………………………………….…………………………………
EXCESS INCOME RECEIVED BY NONPROFIT AND REGISTERED EDUCATION INSTITUTION OR RESEARCH AND DEVELOPMENT ESTABLISHMENT WHICH ARE REINVESTED IN THE FORM OF FACILITIES AND IN INFRASTUCTURE FOR EDUCATIONAL AND/OR RESEARCH AND DEVELOPMENT ACTIVITIES (Article 4 Paragraph (3) Letter m Income Tax Law)
GROSS INCOME
(US$)
(2)
from
(3)
3.
etc.
2.
Copy of Form 1771/$ letter F line 15 point b
etc.
14.
5.
………………………………………………………
13.
12.
ATTACHMENT - IV CORPORATE ANNUAL INCOME TAX RETURN
(US$)
2 0A A
• LIST OF SHAREHOLDERS/CAPITAL OWNERS AND TOTAL DIVIDENDS DISTRIBUTED• LIST OF DIRECTORS AND COMMISSIONERS
T I N :
TAXPAYER'S NAME :
ACCOUNTING PERIOD :
PART A: LIST OF SHAREHOLDERS/CAPITAL OWNERS AND TOTAL DIVIDENDS DISTRIBUTED
(3) (4)
PART B: LIST OF DIRECTORS AND COMMISSIONERS
(3) (4)
Page page Attachment-V
D.1.1.32.41
DIRECTORATE GENERAL OF TAXES
6.
8.
7.
5.
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
(6)
9.
100%TPATOTAL PART A
10. etc
etc.
2.
10.
7.
6.
8.
CORPORATE ANNUAL INCOME TAX RETURN
to
TAXA
BLE
YEA
R
(7)(US$)%
DIVIDEND
FOR
M
T I N
(2)
NAME ADDRESS
1771 - V/$MINISTRY OF FINANCE OF THE
REPUBLIC ON INDONESIA
NO
(1)
2.
4.
ATTACHMENT - V
3.
9.
TOTAL PAID IN SHARES(US$)
from
FOR CORPORATE PERMITTED TO MAINTAIN BOOKS IN ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
1.
3.
5.
IDEN
TITY
NO
4.
1.
(1)
(5)
POSITIONT I NNAME ADDRESS(2) (5)
2 0 A A
• LIST OF CAPITAL CONTRIBUTION IN AFFILIATION COMPANY• LIST OF PAYABLE FROM SHARESHOLDER AND/OR AFFILIATION COMPANY • LIST OF ACCOUNT RECEIVABLE TO SHARESHOLDER AND/OR AFFILIATION COMPANY
T I N :
TAXPAYER'S NAME :
ACCOUNTING PERIOD :
PART A : LIST OF CAPITAL CONTRIBUTION IN AFFILIATION COMPANY
(1)
5.
etc
PART B : LIST OF ACCOUNT PAYABLE FROM SHARESHOLDER AND/OR AFFILIATION COMPANY
(1)
1.
2.
3.
4.
5.
6.
7.
8.
9
10.
11.
12.
etc
PART C : LIST OF ACCOUNT RECEIVABLE TO SHARESHOLDER AND/OR AFFILIATION COMPANY
(1)
1.
2.
3.
4.
5.
6.
7.
8.
9
10.
11.
12.
etc
Page- page Attachment-VI
D.1.1.32.42
3.
to
NO%
TAXA
BLE
YEA
R
FOR
M
1.
IDEN
TITY
NO NAME T I NTOTAL LOAN
4.
(6)
2.
YEARINTEREST/YR
(US$) %
(2) (3) (4) (5) (6)
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED from
NO NAME T I NTOTAL LOAN
(2) (3) (4)
(US$)
(5) (6)
YEARINTEREST/YR
%
1771 - VI/$MINISTRY OF FINANCE OF THE
REPUBLIC OF INDONESIA
(US$)
AMOUNT OF CAPITAL CONTRIBUTIONT I NNAME
DIRECTORATE GENERAL OF TAXES
ATTACHMENT - VICORPORATE ANNUAL INCOME TAX RETURN
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
ADDRESS
(2) (3) (4) (5)
TOTAL PART A TPA
2 0 A A
PETUNJUK UMUM PENGISIAN FORMULIR DIGITAL SPT 1771/$
1. Format SPT ini telah sesuai dengan Peraturan Direktur Jenderal Pajak Nomor Per-34/PJ/2010 Tentang Bentuk Formulir Surat Pemberitahuan Tahunan Pajak Penghasilan Wajib Pajak Orang Pribadi Dan Wajib Pajak Badan Beserta Petunjuk Pengisiannya dan hanya dapat digunakan untuk pengisian SPT Tahun Pajak 2010 dan seterusnya
2. SPT hasil pencetakan ini wajib ditanda tangani dan tidak boleh dilipat atau kusut. Untuk pencetakan gunakan hanya kertas HVS berukuran:
Folio/Government Legal (8,5 x 13 inch)
Berat minimal 70 gr
3. SPT Digital ini dapat dibuka dan diisi dengan aplikasi Adobe Reader versi 8 ke atas atau aplikasi pdf reader sejenis dan lakukan pengisian dengan mengklik Field yang akan diisi. Untuk mengetahui Field yang dapat diisi silahkan klik pada menu HIGHLIGHT FIELDS yang terletak pada bagian kanan atas. Sementara untuk aplikasi Adobe Reader telah disertakan dalam CD atau dapat di unduh sendiri oleh Wajib Pajak secara gratis di internet;
4. Isilah dari lampiran-lampirannya terlebih dahulu. Rumus-rumus penjumlahan, pengurangan, kaitan dengan bagian tertentu dan lainnya telah tersedia pada form ini, sehingga WP tidak perlu melakukan penghitungan kembali;
5. Tanda <AUTO> menunjukan hasil perhitungan otomatis. Ada kalanya perhitungan otomatis ini terlambat melakukan eksekusi, untuk memastikan telah berjalan dengan baik, arahkan kursor penunjuk ke sel di mana rumus perhitungan seharusnya berjalan, blok angka yang ada, selanjutnya tekan tombol DELETE dilanjutkan dengan ENTER. Namun demikian Wajib Pajak diharapkan tetap melakukan pengecekan ulang atas hasil perhitungan pada SPT ini terutama pada field <AUTO>;
6. Jika formulir Lampiran 1771-III/$, 1771-IV/$, 1771-V/$ dan 1771-VI/$ diperlukan lebih banyak lagi karena data yang akan diisikan lebih dari 1 (satu) halaman, didalam direktori (folder ) SPT ini telah tersedia file dimaksud. File-file tersebut dapat diperbanyak dengan cara di-copy dan diganti nama filenya (rename), (mis. 1771-III$-1, 1771-III$-2 dst) sesuaikan dengan kebutuhan;
7. Tombol SHOW digunakan untuk menampilkan rumus-rumus perhitungan dalam pengisian SPT secara digital;
8. Tombol RESET digunakan untuk membersihkan file pdf ini dari data yang telah diisikan sebelumnya. Setelah selesai mengisi SPT dan mencetaknya, jangan lupa simpan ke file lain (Save-as dan beri nama yang berbeda dengan file semula), kemudian gunakan tombol RESET untuk membersihkan file;
9. Tombol HIDE digunakan untuk menyembunyikan rumus-rumus perhitungan sehingga Formulir ini dapat dicetak kosong apabila ingin dilakukan pengisian secara manual;
10. Penjelasan lebih lengkap mengenai pengisian SPT Tahunan silahkan baca Buku Petunjuk Pengisian SPT Tahunan yang bentuk softcopy-nya disertakan dalam SPT digital ini;
11. Pada SPT 1771/$ untuk Kolom Rupiah diisi dengan Nilai Konversi dari angka dalam Kolom US$, dengan menggunakan Kurs Pajak yang berlaku pada akhir Tahun Pajak kecuali untuk bagian F. PPh Final dan Penghasilan Bukan Objek Pajak yang WP isi dari Formulir 1771-IV/$. WP hanya memasukkan nilai pada kolom US $ dan secara otomatis akan muncul nilai konversi pada kolom Rupiah. Agar proses otomatis tersebut dapat berjalan silakan masukkan Kurs Dolar Terhadap Rupiah (USD-IDR) pada bagian bawah ini :
PERHATIAN: • SEBELUM MENGISI, BACA DAHULU BUKU PETUNJUK PENGISIAN
• ISI DENGAN HURUF CETAK/DIKETIK DENGAN TINTA HITAM
• BERI TANDA "X" PADA (KOTAK PILIHAN) YANG SESUAI
N P W P :
NAMA WAJIB PAJAK :
JENIS USAHA : KLU :
NO. TELEPON : - NO. FAKS : -
PERIODE PEMBUKUAN : s.d.
NEGARA DOMISILI KANTOR PUSAT (khusus BUT) :
PERSETUJUAN PEMBUKUAN DALAM MATA UANG DOLLAR AS :
NOMOR : ………………………………………. TANGGAL : MULAI TAHUN PAJAK :
PEMBUKUAN / LAPORAN KEUANGAN : DIAUDIT OPINI AKUNTAN TIDAK DIAUDIT
NAMA KANTOR AKUNTAN PUBLIK :
N P W P KANTOR AKUNTAN PUBLIK :
NAMA AKUNTAN PUBLIK :
N P W P AKUNTAN PUBLIK :
NAMA KANTOR KONSULTAN PAJAK :
N P W P KANTOR KONSULTAN PAJAK :
NAMA KONSULTAN PAJAK :
N P W P KONSULTAN PAJAK :
*) Pengisian kolom-kolom yang berisi nilai US$ dan Rupiah harus tanpa nilai desimal (contoh penulisan lihat buku petunjuk hal. 3)
1. PENGHASILAN NETO FISKAL (Diisi dari Formulir 1771-I/$ Nomor 8 Kolom 3) …………………………
2. KOMPENSASI KERUGIAN FISKAL ……………………………………………….
(Diisi dari Lampiran Khusus 2B Jumlah Kolom 8)
3. PENGHASILAN KENA PAJAK (1-2) ……...…..…………………………………….…………………..…………
4. PPh TERUTANG (Pilih salah satu sesuai dengan kriteria Wajib Pajak. Untuk lebih jelasnya, lihat Buku Petunjuk Pengisian SPT)
a. Tarif PPh Ps. 17 Ayat (1) Huruf b X Angka 3 ……..………………..……………
b. Tarif PPh Ps. 17 ayat (2b) X Angka 3 ……..…………………….
c. Tarif PPh Ps. 31E ayat (1) (Lihat Buku Petunjuk)
5. PENGEMBALIAN / PENGURANGAN KREDIT PAJAK LUAR NEGERI (PPh Ps. 24) YANG TELAH DIPERHITUNGKAN TAHUN LALU ……
6. JUMLAH PPh TERUTANG (4 + 5) …..………………………………….…………………..…………
7. PPh DITANGGUNG PEMERINTAH (Proyek Bantuan Luar Negeri) ……..………………..………………..………
8. a. KREDIT PAJAK DALAM NEGERI (Diisi dari Formulir 1771-III/$ Jumlah Kolom 6) ……….……………..…....…………
b. KREDIT PAJAK LUAR NEGERI (Diisi dari Lampiran Khusus 7B jumlah Kolom 8) ……….………………..………
c. JUMLAH ( 8a + 8b ) ……...……………..….……………………………
9. a. PPh YANG HARUS DIBAYAR SENDIRI b. PPh YANG LEBIH DIPOTONG / DIPUNGUT
10. PPh YANG DIBAYAR SENDIRI a. PPh Ps. 25 BULANAN ….……..………………..…………………………………..…………………..…………
b. STP PPh Ps. 25 (Hanya Pokok Pajak) …….….…..……….…………………………………………………
c. JUMLAH (10a + 10b )……………………...…………………
11. a. PPh YANG KURANG DIBAYAR (PPh Ps. 29) b. PPh YANG LEBIH DIBAYAR (PPh Ps. 28A)
12. PPh YANG KURANG DIBAYAR PADA ANGKA 11.a DISETOR TANGGAL ……
13. PPh YANG LEBIH DIBAYAR PADA ANGKA 11.b MOHON :
a. DIRESTITUSIKAN b. DIPERHITUNGKAN DENGAN UTANG PAJAK
Khusus Restitusi untuk Wajib Pajak dengan Kriteria Tertentu : Pengembalian Pendahuluan (Pasal 17C atau Pasal 17D UU KUP)
Kolom Rupiah diisi dengan Nilai Konversi dari angka dalam Kolom US$, dengan menggunakan Kurs Pajak yang berlaku pada akhir Tahun Pajak
F.1.1.32.15
0
3
SPT TAHUNANTAHUN PAJAK
SPT PEMBETULAN
KE- …
PAJAK PENGHASILAN WP BADANBAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUANDALAM BAHASA INGGRIS DAN MATA UANG DOLLAR AMERIKA SERIKAT
1 1
3
KEMENTERIAN KEUANGAN RI
1771/$ 2
5
(RUPIAH)(4)
8a
8b
THN
2
4
(6 – 7 – 8c)
8c
A.
P
EN
GH
AS
ILA
N
KE
NA
PA
JA
KB
. P
Ph
TE
RU
TA
NG
C.
KR
ED
IT P
AJA
K
8a
8b
IDE
NT
ITA
S
(1) (2)
7
FO
RM
UL
IR
DIREKTORAT JENDERAL PAJAK
10a
US $
2
4
(3)
5
6
9
TGL
10c
10b
(9 – 10c)
BLN
Catatan :
11
D.
PP
h K
UR
AN
G/
LE
BIH
BA
YA
R
8c
6
7
10c
9
11
10a
10b
Formulir 1771/$ Halaman 2(1)
14 a. PENGHASILAN YANG MENJADI DASAR PENGHITUNGAN ANGSURAN ………..………………………………………..…………………..…………
b. KOMPENSASI KERUGIAN FISKAL: (Diisi dari Lampiran Khusus 2B Jumlah Kolom 9) ……....……..……..……..……..……..……..……..……..……..………...
c. PENGHASILAN KENA PAJAK (14a – 14b) …..…………………………………….…………………..………..
d. PPh YANG TERUTANG (Tarif PPh dari Bagian B Nomor 4 X 14c)
e. KREDIT PAJAK TAHUN PAJAK YANG LALU ATAS PENGHASILAN YANG TERMASUK DALAM ANGKA 14a YANG DIPOTONG / DIPUNGUT OLEH PIHAK LAIN …..……..………...…..……..………………..
f. PPh YANG HARUS DIBAYAR SENDIRI (14d – 14e) ………………………………………………..………..
g. PPh PASAL 25 : (1/12 X 14f) ………..…….…………………………………………………..………….
Catatan : Kolom Rupiah diisi dengan Nilai Konversi dari angka dalam Kolom US$, dengan menggunakan Kurs Pajak yang berlaku pada akhir Tahun Pajak
15 a. PPh FINAL : (Diisi dari Formulir 1771-IV/$ Jumlah Bagian A Kolom 5) …..……..………...…..……..………………..
b. PENGHASILAN YANG TIDAK TERMASUK OBJEK PAJAK : PENGHASILAN BRUTO (Diisi dari Formulir 1771-IV/$ Jumlah Bagian B Kolom 3) …..……..………...…..……..………………..
16 a.
b.
17 SELAIN LAMPIRAN-LAMPIRAN 1771-I/$, 1771-II/$, 1771-III/$, 1771-IV/$, 1771-V/$, DAN 1771-VI/$BERSAMA INI DILAMPIRKAN PULA :
a. SURAT SETORAN PAJAK LEMBAR KE-3 PPh PASAL 29
b. LAPORAN KEUANGAN
c. TRANSKRIP KUTIPAN ELEMEN-ELEMEN DARI LAPORAN KEUANGAN (Lampiran Khusus 8B-1 / 8B-2 / 8B-3 / 8B-4 / 8B-5 / 8B-6 / 8B-7 / 8B-8)*
d. DAFTAR PENYUSUTAN DAN AMORTISASI FISKAL (Lampiran Khusus 1B Buku Petunjuk Pengisian SPT)*
e. PERHITUNGAN KOMPENSASI KERUGIAN FISKAL (Lampiran Khusus 2B Buku Petunjuk Pengisian SPT)*
f. DAFTAR FASILITAS PENANAMAN MODAL (Lampiran Khusus 4B Buku Petunjuk Pengisian SPT)*
g. DAFTAR CABANG UTAMA PERUSAHAAN (Lampiran Khusus 5B Buku Petunjuk Pengisian SPT)*
h. SURAT SETORAN PAJAK LEMBAR KE-3 PPh PASAL 26 AYAT (4) (Khusus bagi BUT)
i. PERHITUNGAN PPh PASAL 26 AYAT (4) (Khusus BUT) (Lampiran Khusus 6B Buku Petunjuk Pengisian SPT)*
j. KREDIT PAJAK LUAR NEGERI (Lampiran Khusus 7B Buku Petunjuk Pengisian SPT)*
k. SURAT KUASA KHUSUS (Bila dikuasakan)
l.
m.
n.
*
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi - sanksi sesuai dengan ketentuan perundang-undangan yang berlaku,saya menyatakan bahwa apa yang telah saya beritahukan di atas beserta lampiran-lampirannya adalah benar, lengkap dan jelas.
a. WAJIB PAJAK b. KUASA c. …………………………………., d.(Tempat)
TANDA TANGAN DAN CAP PERUSAHAAN :
NAMA LENGKAP
PENGURUS / KUASA : e.
N P W P : f.
F.1.1.32.15
Wajib Pajak dapat langsung mengunduh dari situs Direktorat Jenderal Pajak dengan alamat http://www.pajak.go.id. atau mengambil di KPP/KP2KP terdekat.
14a
(2) (3)US $
15a
E.
AN
GS
UR
AN
PP
h P
AS
AL
25 T
AH
UN
BE
RJA
LA
N
14a
14c
14d
14e
14f
14b
14g
14c
(4)
14d
(RUPIAH)
14b
14e
14f
14g
PERNYATAAN
F.
PP
h F
INA
L D
AN
PE
NG
HA
SIL
AN
BU
KA
N
OB
JE
K P
AJA
K
15a
H.
LA
MP
IRA
N
tgl bln thn
G.
PE
RN
YA
TA
AN
TR
AN
SA
KS
I D
AL
AM
HU
BU
NG
AN
IS
TIM
EW
A
(Wajib melampirkan Lampiran Khusus 3B, 3B-1, dan 3B-2 Buku Petunjuk Pengisian SPT)*
Tidak Ada Transaksi Dalam Hubungan Istimewa dan/atau Transaksi dengan Pihak yang Merupakan Penduduk Negara Tax Haven
Country .
15b15b
Ada Transaksi Dalam Hubungan Istimewa dan/atau Transaksi dengan Pihak yang Merupakan Penduduk Negara Tax Haven Country.
N P W P :
NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
PENGHASILAN NETO KOMERSIAL DALAM NEGERI :
a. PEREDARAN USAHA …………..……………………………...…………...…………...…………...……………...…...………………………….Ø
b. HARGA POKOK PENJUALAN …………...…………...…………...…………...…………...…………...…………...…………...…………...…….Ø
c. BIAYA USAHA LAINNYA .…………...…………....…………...…………....…………...…………....…………...…………....…………...……Ø
d. PENGHASILAN NETO DARI USAHA ( 1a – 1b - 1c ) ..…………...………….....…………...………….....…………...………….....…………...….Ø
e. PENGHASILAN DARI LUAR USAHA .…………...…………....…………...…………....…………...…………....…………...………………….Ø
f. BIAYA DARI LUAR USAHA .…………...…………....…………...…………....…………...…………....…………...…………....…………...……Ø
g. PENGHASILAN NETO DARI LUAR USAHA ( 1e - 1f )..…….………….....…………...…...………..…….....…....…………...……….Ø
h. JUMLAH ( 1d + 1g ) : .…………...…………....…………...…………....…………...…………....…………...…………....…………...……………….Ø PENGHASILAN NETO KOMERSIAL LUAR NEGERI
(Diisi dari Lampiran Khusus 7B Kolom 5) .…………...…………....…………...…………....…………...…………....…………...………………….Ø
JUMLAH PENGHASILAN NETO KOMERSIAL (1h + 2) …………………...…………………...…………………...………………….…………...………Ø
PENGHASILAN YANG DIKENAKAN PPh FINAL
DAN YANG TIDAK TERMASUK OBJEK PAJAK ..…………...………….....…………...………….....…………...………….....…………...…….Ø
PENYESUAIAN FISKAL POSITIF :
a. BIAYA YANG DIBEBANKAN / DIKELUARKAN UNTUK KEPENTINGAN PEMEGANG SAHAM, SEKUTU, ATAU ANGGOTA. ..…………...………….....…………...………….....…………...……………………………Ø
b. PEMBENTUKAN ATAU PEMUPUKAN DANA CADANGAN ..…………...………….....…………...………….....…………...……………..Ø c. PENGGANTIAN ATAU IMBALAN PEKERJAAN ATAU
JASA DALAM BENTUK NATURA DAN KENIKMATAN ..…………...………….....…………...………….....…………...………….....…………Ø
d. JUMLAH YANG MELEBIHI KEWAJARAN YANG DIBAYARKAN KEPADA PEMEGANG SAHAM / PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SEHUBUNGAN DENGAN PEKERJAAN ..…………...………….....…………...………….....…………...………….....…………...……………..Ø
e. HARTA YANG DIHIBAHKAN, BANTUAN ATAU SUMBANGAN ..…………...………….....…………...………….....…………...………..Ø
f. PAJAK PENGHASILAN ..…………...………….....…………...………….....…………...………….....…………...………….....…………...……..Ø g. GAJI YANG DIBAYARKAN KEPADA ANGGOTA PERSEKUTUAN, FIRMA
ATAU CV YANG MODALNYA TIDAK TERBAGI ATAS SAHAM ..…………...………….....…………...………….....…………...………………Ø
h. SANKSI ADMINISTRASI ..…………...………….....…………...………….....…………...………….....…………...………….....…………...…….Ø
i. SELISIH PENYUSUTAN KOMERSIAL DI ATAS PENYUSUTAN FISKAL ..…………...………….....…………...………….....……………Ø
j. SELISIH AMORTISASI KOMERSIAL DI ATAS AMORTISASI FISKAL ..…………...………….....…………...………….....…………...…..Ø
k. BIAYA YANG DITANGGUHKAN PENGAKUANNYA ..…………...………….....…………...………….....…………...………….....………..Ø
l. PENYESUAIAN FISKAL POSITIF LAINNYA ..…………...………….....…………...………….....…………...………….....…………...………Ø
m. JUMLAH 5a s.d. 5l : ..…………...………….....…………...………….....…………...………….....…………...………….....…………...…………..Ø
PENYESUAIAN FISKAL NEGATIF :
a. SELISIH PENYUSUTAN KOMERSIAL DI BAWAH PENYUSUTAN FISKAL ..…………...………….....…………...……………..………..Ø
b. SELISIH AMORTISASI KOMERSIAL DI BAWAH AMORTISASI FISKAL ..…………...………….....…………...………….....…………….Ø
c. PENGHASILAN YANG DITANGGUHKAN PENGAKUANNYA ..…………...………….....…………...………….....…………...……………Ø
d. PENYESUAIAN FISKAL NEGATIF LAINNYA ..…………...………….....…………...………….....…………...………….....…………...…….Ø
e. JUMLAH 6a s.d. 6d ..…………...………….....…………...………….....…………...………….....…………...………….....…………...………………..Ø
FASILITAS PENANAMAN MODAL BERUPA PENGURANGAN PENGHASILAN NETO :
TAHUN KE - 7a (Diisi dari Lampiran Khusus 4B Angka 5b) ..…………...………….…………...………………...………….....…………...…….Ø
CATATAN : Pindahkan jumlah Angka 8 ke Formulir 1771/$ Huruf A Angka 1.D.1.1.32.37
TA
HU
N P
AJ
AK
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
FO
RM
UL
IR
KEMENTERIAN KEUANGAN RIDIREKTORAT JENDERAL PAJAK
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUANDALAM BAHASA INGGRIS DAN MATA UANG DOLLAR AMERIKA SERIKAT
LAMPIRAN - I
1771 - I/$
PENGHITUNGAN PENGHASILAN NETO FISKAL
(3)
s.d.
IDE
NT
ITA
S
URAIAN(1) (2)
US$NO
1.
1g
1h
4.
2.
3.
7.
6.
5.
1e
1f
3
4
2
8. PENGHASILAN NETO FISKAL (3 - 4 + 5m - 6e - 7b) ..…………...………….....…… 8
5h
5i
5j
6c
6d
5k
1a
1b
1c
1d
7b
6b
6e
5m
5e
5g
5a
5c
5b
5f
5l
6a
5d
2 0A A
N P W P : NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
(1)
1. PEMBELIAN BAHAN/BARANG DAGANGAN
2. GAJI, UPAH, BONUS, GRATIFIKASI,HONORARIUM, THR, DSB
3. BIAYA TRANSPORTASI
4. BIAYA PENYUSUTAN DAN AMORTISASI
5. BIAYA SEWA
6. BIAYA BUNGA PINJAMAN
7. BIAYA SEHUBUNGAN DENGAN JASA
8. BIAYA PIUTANG TAK TERTAGIH
9. BIAYA ROYALTI
10. BIAYA PEMASARAN/PROMOSI
11. BIAYA LAINNYA
12. PERSEDIAAN AWAL
13. PERSEDIAAN AKHIR (-/-)
Catatan :• Nomor 1 untuk Perusahaan Dagang diisi pembelian barang dagangan, untuk perusahaan industri diisi pembelian bahan baku, bahan penolong dan barang jadi.• Nomor 7 termasuk management fee, technical assistance fee, dan jasa lainnya• Nomor 11 diisi dengan total biaya yang tidak tertampung dalam perincian 1 s.d. 10.• Nomor 12 dan 13 untuk perusahaan dagang diisi total persediaan awal dan akhir barang dagangan, untuk perusahaan industri diisi total persediaan
awal/akhir bahan baku/bahan penolong ditambah barang setengah jadi ditambah barang jadi.
D.1.1.32.55
14
(2)(US$)
JUMLAH 1 S.D. 12 DIKURANGI 13
PERINCIAN
IDE
NT
ITA
S
NO. (US$)
s.d.
(US$)JUMLAH
FO
RM
UL
IR
1771 - II/$KEMENTERIAN KEUANGAN RI
TA
HU
N P
AJ
AK
DALAM BAHASA INGGRIS DAN MATA UANG DOLLAR AMERIKA SERIKAT
HARGA POKOK PENJUALAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
LAMPIRAN - II
DIREKTORAT JENDERAL PAJAK PERINCIAN HARGA POKOK PENJUALAN, BIAYA USAHA LAINNYA DAN BIAYA DARI LUAR USAHA SECARA KOMERSIAL
BIAYA DARI LUAR USAHABIAYA USAHA LAINNYA
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
(4)(3)(US$)
(6) = (3) + (4) + (5)(5)
2 0 A A
N P W P : NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
(1)
Catatan :
• Diisi dengan rincian per Bukti Pemotongan / Pemungutan Pajak.• Kolom (6) US$ diisi dengan nilai konversi dari angka dalam Kolom (7) Rupiah, dengan menggunakan Kurs Pajak yang berlaku pada tanggal Pemotongan/Pemungutan• Pindahkan hasil penjumlahan PPh Pasal 22, PPh Pasal 23 dan PPh Pasal 26 Kolom (6) ke Formulir 1771/$ Huruf C Angka 8.a.
Halaman ke- dari halaman Lampiran-III
D.1.1.32.39
4.
NOMOR
(8)
2.
3.
NO.
(7)
14.
13.
8.
9.
10.
7.
11.
12.
5.
6.
1.
BUKTI PEMOTONGAN / PEMUNGUTAN/SSP/SSPCP
TANGGAL
(9)
IDE
NT
ITA
SSPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
KREDIT PAJAK DALAM NEGERI
FO
RM
UL
IR 1771 - III/$KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
(6)
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
TA
HU
N P
AJA
K
LAMPIRAN - III
DALAM BAHASA INGGRIS DAN MATA UANG DOLLAR AMERIKA SERIKAT
s.d.
NPWP
(2) (3) (4) (5)
PEMOTONG / PEMUNGUT PAJAK
NAMA
JUMLAH JML
PAJAK PENGHASILANYANG DIPOTONG / DIPUNGUT
(US$) (Rupiah)
OBJEK PEMOTONGAN / PEMUNGUTANJENIS PENGHASILAN /
TRANSAKSI (US$)
2 0A A
N P W P :
NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
BAGIAN A : PPh FINAL
BUNGA DEPOSITO / TABUNGAN DAN DISKONTO SBI / SBN
BUNGA / DISKONTO OBLIGASI
PENGHASILAN PENJUALAN SAHAM YANG DIPERDAGANGKAN DI BURSA EFEK
PENGHASILAN PENJUALAN SAHAM MILIK PERUSAHAAN MODAL VENTURA PENGHASILAN USAHA PENYALUR / DEALER / AGEN PRODUK BBM
PENGHASILAN PENGALIHAN HAK ATAS TANAH / BANGUNAN
PENGHASILAN PERSEWAAN ATAS TANAH / BANGUNAN IMBALAN JASA KONSTRUKSI : a. PELAKSANA KONSTRUKSI
b. PERENCANA KONSTRUKSI
c. PENGAWAS KONSTRUKSI
PERWAKILAN DAGANG ASING
PELAYARAN / PENERBANGAN ASING
PELAYARAN DALAM NEGERI
PENILAIAN KEMBALI AKTIVA TETAP
TRANSAKSI DERIVATIF YANG
DIPERDAGANGKAN DI BURSA
Catatan : Kolom (5) US$ diisi dengan Nilai Konversi dari angka dalam Kolom (6) Rupiah, dengan menggunakan Kurs Pajak yang berlaku pada tanggal Pemotongan/Pembayaran Pajak.
BAGIAN B : PENGHASILAN YANG TIDAK TERMASUK OBJEK PAJAK
DIVIDEN / BAGIAN LABA DARI PENYERTAAN MODAL
PADA BADAN USAHA DI INDONESIA (Pasal 4 Ayat (3) Huruf f UU PPh)
SISA LEBIH YANG DITERIMA ATAU DIPEROLEH BADAN ATAU LEMBAGA NIRLABA YANG BERGERAK DALAM BIDANG PENDIDIKAN DAN/ATAU BIDANG PENELITIAN DAN PENGEMBANGAN, YANG TELAH TERDAFTAR PADA INSTANSI YANG MEMBIDANGINYA, YANG DITANAMKAN KEMBALI DALAM BENTUK SARANA DAN PRASARANA KEGIATAN PENDIDIKAN DAN/ ATAU PENELITIAN DAN PENGEMBANGAN (Pasal 4 Ayat (3) Huruf m UU PPh)
Halaman ke- dari halaman Lampiran-IV
D.1.1.32.40
(3)
Pindahkan ke Formulir 1771/$ huruf F angka 15 butir a
JUMLAH BAGIAN B JBB
JENIS PENGHASILAN
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
JBA
PENGHASILAN BRUTO(US$)
(2)(1)
JUMLAH BAGIAN A
NO
………………………………………………………
…………………………………………………….…………………………………
2.
1.
14.
3.
3.
8.
9.
4.
5.
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
PPh TERUTANG
TA
HU
N P
AJA
K
LAMPIRAN - IV
PPh FINAL DAN PENGHASILAN YANG TIDAK TERMASUK OBJEK PAJAK
s.d.
DALAM BAHASA INGGRIS DAN MATA UANG DOLLAR AMERIKA SERIKAT
(US$)(6)
IDE
NT
ITA
S
(4)
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
DIREKTORAT JENDERAL PAJAK
JENIS PENGHASILAN
(2)
TARIFDASAR PENGENAAN PAJAK(US$)
(3) (5)(RUPIAH)(%)
(1)
FO
RM
UL
IR
2.
1.
1771 - IV/$
KEMENTERIAN KEUANGAN RI
NO.
13.
12.
11.
10.
7.
Pindahkan ke Formulir 1771/$ huruf F angka 15 butir b
6.
2 0 A A
• DAFTAR PEMEGANG SAHAM/PEMILIK MODAL DAN JUMLAH DIVIDEN YANG DIBAGIKAN
• DAFTAR SUSUNAN PENGURUS DAN KOMISARIS
N P W P :
NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
BAGIAN A : DAFTAR PEMEGANG SAHAM / PEMILIK MODAL DAN JUMLAH DIVIDEN YANG DIBAGIKAN
(1)
JBA
BAGIAN B : DAFTAR SUSUNAN PENGURUS DAN KOMISARIS
NO
(1)
Halaman ke- dari halaman Lampiran-V D.1.1.32.41
10.
9.
8.
7.
6.
5.
4.
3.
2.
1.
NAMA ALAMAT NPWP JABATAN
(2) (3) (4) (5)
10.
JUMLAH BAGIAN A
8.
9.
7.
6.
4.
5.
2.
3.
(5)
1.
(2) (3) (4)
NO NAMA ALAMAT NPWPJUMLAH MODAL DISETOR
(US$)
IDE
NT
ITA
S
s.d.
FO
RM
UL
IR
(US$)%DIVIDEN
TA
HU
N P
AJ
AK
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUANDALAM BAHASA INGGRIS DAN MATA UANG DOLLAR AMERIKA SERIKAT
LAMPIRAN - V
KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
1771 - V/$SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
(7)
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
(6)
100%
2 0A A
• DAFTAR PENYERTAAN MODAL PADA PERUSAHAAN AFILIASI
• DAFTAR UTANG DARI PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
• DAFTAR PIUTANG KEPADA PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
N P W P :
NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
BAGIAN A : DAFTAR PENYERTAAN MODAL PADA PERUSAHAAN AFILIASI
(1)
JBA
BAGIAN B : DAFTAR UTANG DARI PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
(1)
1.
2.
3.
4.
5.
6.
7.
8.
9
10.
11.
12.
13.
BAGIAN C : DAFTAR PIUTANG KEPADA PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
(1)
1.
2.
3.
4.
5.
6.
7.
8.
9
10.
11.
12.
13.
Halaman ke- dari halaman Lampiran-VI
D.1.1.32.42
JUMLAH BAGIAN A
NPWPJUMLAH PENYERTAAN MODAL
(US$)(2) (3) (4) (5) (6)
(2) (3) (4) (5) (6)
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
NO NAMA N P W P JUMLAH PINJAMAN TAHUN BUNGA/TH(US$) %
TAHUN BUNGA/TH(US$) %
(2) (3) (4) (5) (6)
NO NAMA N P W P JUMLAH PINJAMAN
4.
5.
2.
3.
1.
IDE
NT
ITA
S
s.d.
NO%
NAMA ALAMAT
LAMPIRAN - VI
TA
HU
N P
AJ
AK
FO
RM
UL
IR 1771 - VI/$SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUANDALAM BAHASA INGGRIS DAN MATA UANG DOLLAR AMERIKA SERIKAT
KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
2 0 A A
1A
FOR TAXABLE YEAR 2 0
T I N : TAXPAYER'S NAME :
TANGIBLE ASSETS
Group 1 :
………………………………………………….
Group 2 :
………………………………………………….
Group 3 :
………………………………………………….
Group 4 :
………………………………………………….
BUILDINGS
Permanent
………………………………………………….
Not Permanent :
………………………………………………….
TOTAL DEPRECIATION (For Tax purpose)……………..……………..……………..……………..……………..……………..……………..……………..……………..……………..…………………………………..…………..………………..……………………………..Ø TOTAL COMMERCIAL DEPRECIATION ……………..……………..……………..……………..……………..……………..……………..……………..……………..………………….………………………….………..…………………………………..Ø DIFFERENCE ( COPY TO FORM 1771-I LINE 5 LETTER i OR LINE 6 LETTER a) ……………..……………..……………..……………..……………….………………………..……………………….. Ø INTANGIBLE ASSETS
Group 1 :
………………………………………………….
Group 2 :
………………………………………………….
Group 3 :
………………………………………………….
Group 4 :
………………………………………………….
Other Group
………………………………………………….
TOTAL AMORTIZATION (For Tax purpose)……………..……………..……………..……………..……………..……………..……………..……………..………………………………...…..……………..……………..………………………………………………….. R TOTAL COMMERCIAL AMORTIZATION ……………..……………..……………..……………..……………..……………..……………..……………..……………………….………………...……………..……………..……………………………………..Ø DIFFERENCE ( COPY TO FORM 1771-I LINE 5 LETTER j OR LINE 6 LETTER b) …………..…...……………..……………..……………..…………………………………………………. Ø
…………………………...…,
TAXPAYER/AUTHORIZED REPRESENTATIVE
(……………………………………………………………)
NOTEYEAR OF
(IDR) (IDR) COMMERCIAL VALUEACQUISITION FISCAL (IDR)
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
LIST OF DEPRECIATION AND AMORTIZATION FISCAL
GROUP / TYPES OF ASSETS
MONTH/COST OF ACQUISITION
DEPRECIATION/ AMORTIZATION
METHOD
FISCAL DEPRECIATION/AMORTIZATION
IN CURRENT YEARBEGINNING BALANCE
1A
TAHUN PAJAK 2 0
NPWP : NAMA WAJIB PAJAK :
HARTA BERWUJUD
Kelompok 1 :
Kelompok 2 :
Kelompok 3 :
Kelompok 4 :
KELOMPOK BANGUNAN
Permanen
Tidak Permanen :
JUMLAH PENYUSUTAN FISKAL ……………..……………..……………..……………..……………..……………..……………..……………..……………..……………..…………………………………..…………..………………..……………………………..Ø JUMLAH PENYUSUTAN KOMERSIAL ……………..……………..……………..……………..……………..……………..……………..……………..……………..………………….………………………….………..…………………………………..Ø SELISIH PENYUSUTAN ( PINDAHKAN KE FORMULIR 1771-I ANGKA 5 HURUF i ATAU ANGKA 6 HURUF a) ……………..……………..……………..……………..……………….………………………..………………………..Ø HARTA TAK BERWUJUD
Kelompok 1 :
Kelompok 2 :
Kelompok 3 :
Kelompok 4 :
Kelompok Lain-lain
JUMLAH AMORTISASI FISKAL ……………..……………..……………..……………..……………..……………..……………..……………..………………………………...…..……………..……………..………………………………………………….. R JUMLAH AMORTISASI KOMERSIAL ……………..……………..……………..……………..……………..……………..……………..……………..……………………….………………...……………..……………..……………………………………..Ø SELISIH AMORTISASI ( PINDAHKAN KE FORMULIR 1771-I ANGKA 5 HURUF j ATAU ANGKA 6 HURUF b) …………..…...……………..……………..……………..…………………………………………………. Ø
…………………………...…,
WAJIB PAJAK / KUASA
(……………………………………………………………)
CATATANTAHUN PEROLEHAN AWAL TAHUN PENYUSUTAN / AMORTISASI FISKAL TAHUN INI
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
DAFTAR PENYUSUTAN DAN AMORTISASI FISKAL
KELOMPOK / JENIS HARTA
BULAN / HARGA
FISKAL (RUPIAH)
NILAI SISA BUKU FISKAL
PEROLEHAN
METODE PENYUSUTAN / AMORTISASI
(RUPIAH) (RUPIAH) KOMERSIAL
1B
FOR TAXABLE YEAR 2 0
T I N : TAXPAYER'S NAME :
TANGIBLE ASSETS
Group 1 :
………………………………………………….
Group 2 :
………………………………………………….
Group 3 :
………………………………………………….
Group 4 :
………………………………………………….
BUILDINGS
Permanent
………………………………………………….
Not Permanent :
………………………………………………….
TOTAL DEPRECIATION (For Tax purpose)……………..……………..……………..……………..……………..……………..……………..……………..……………..……………..…………………………………..…………..………………..……………………………..Ø TOTAL COMMERCIAL DEPRECIATION ……………..……………..……………..……………..……………..……………..……………..……………..……………..………………….………………………….………..…………………………………..Ø DIFFERENCE ( COPY TO FORM 1771-I LINE 5 LETTER i OR LINE 6 LETTER a) ……………..……………..……………..……………..……………….………………………..……………………….. Ø INTANGIBLE ASSETS
Group 1 :
………………………………………………….
Group 2 :
………………………………………………….
Group 3 :
………………………………………………….
Group 4 :
………………………………………………….
Other Group
………………………………………………….
TOTAL AMORTIZATION (For Tax purpose)……………..……………..……………..……………..……………..……………..……………..……………..………………………………...…..……………..……………..………………………………………………….. R TOTAL COMMERCIAL AMORTIZATION ……………..……………..……………..……………..……………..……………..……………..……………..……………………….………………...……………..……………..……………………………………..Ø DIFFERENCE ( COPY TO FORM 1771-I LINE 5 LETTER j OR LINE 6 LETTER b) …………..…...……………..……………..……………..…………………………………………………. Ø
…………………………...…,
TAXPAYER/AUTHORIZED REPRESENTATIVE
(……………………………………………………………)
NOTEYEAR OF
ACQUISITION (US$) (US$) COMMERCIAL VALUE FISCAL (US$)
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
LIST OF DEPRECIATION AND AMORTIZATION FISCAL
GROUP / TYPES OF ASSETS
MONTH/COST OF ACQUISITION BEGINNING BALANCE
DEPRECIATION/ AMORTIZATION
METHOD
FISCAL
DEPRECIATION/AMORTIZATION IN
CURRENT YEAR
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN
ENGLISH LANGUAGE AND US DOLLAR CURRENCY
1B
TAHUN PAJAK 2 0
NPWP : NAMA WAJIB PAJAK :
HARTA BERWUJUD
Kelompok 1 :
………………………………………………….
Kelompok 2 :
………………………………………………….
Kelompok 3 :
………………………………………………….
Kelompok 4 :
………………………………………………….
KELOMPOK BANGUNAN
Permanen
………………………………………………….
Tidak Permanen :
………………………………………………….
JUMLAH PENYUSUTAN FISKAL ……………..……………..……………..……………..……………..……………..……………..……………..……………..……………..…………………………………..…………..………………..……………………………..Ø JUMLAH PENYUSUTAN KOMERSIAL ……………..……………..……………..……………..……………..……………..……………..……………..……………..………………….………………………….………..…………………………………..Ø SELISIH PENYUSUTAN ( PINDAHKAN KE FORMULIR 1771-I /$ ANGKA 5 HURUF i ATAU ANGKA 6 HURUF a) ……………..……………..……………..……………..……………….………………………..………………………..Ø HARTA TAK BERWUJUD
Kelompok 1 :
………………………………………………….
Kelompok 2 :
………………………………………………….
Kelompok 3 :
………………………………………………….
Kelompok 4 :
………………………………………………….
Kelompok Lain-lain
………………………………………………….
JUMLAH AMORTISASI FISKAL ……………..……………..……………..……………..……………..……………..……………..……………..………………………………...…..……………..……………..………………………………………………….. R JUMLAH AMORTISASI KOMERSIAL ……………..……………..……………..……………..……………..……………..……………..……………..……………………….………………...……………..……………..……………………………………..Ø SELISIH AMORTISASI ( PINDAHKAN KE FORMULIR 1771-I/$ ANGKA 5 HURUF j ATAU ANGKA 6 HURUF b) …………..…...……………..……………..……………..…………………………………………………. Ø
…………………………...…,
WAJIB PAJAK / KUASA
(US$)
BULAN / HARGA NILAI SISA BUKU FISKAL
(……………………………………………………………)
PENYUSUTAN / AMORTISASI
CATATANTAHUN PEROLEHAN AWAL TAHUN
(US$) (US$) KOMERSIAL FISKAL
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADANBAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
DAFTAR PENYUSUTAN DAN AMORTISASI FISKAL
KELOMPOK / JENIS HARTA PENYUSUTAN / AMORTISASI FISKAL TAHUN INI
PEROLEHAN
METODE
2A
TAXABLE YEAR 2 0
FOR TAXABLE YEAR AND CURRENT TAXABLE YEAR
T I N : TAXPAYER'S NAME
YEAR. YEAR. YEAR. YEAR. YEAR. YEAR.
(1)
1
2
3
4
5
etc
NOTE: …………………………...…,
*) COPY THE AMOUNT OF THIS COLUMN TO FORM 1771 LETTER A LINE 2
**) COPY THE AMOUNT OF THIS COLUMN TO FORM 1771 LETTER E LINE 14 POINT b TAXPAYER / AUTHORIZED REPRESENTATIVE
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
CALCULATION OF FISCAL LOSS CARRY FORWARD
NO
LOSS AND FISCAL NET INCOME FISCAL LOSS CARRY FORWARD
YEAR IDR(THIS TAXABLE YEAR) (CURRENT TAXABLE YEAR)
(IDR) (IDR) (IDR) (IDR) IDR *) IDR**)
(2) (3) (4) (5) (6) (7) (8) (9)
TOTAL
(……………………………………………………………)
TTL
2A
TAHUN PAJAK 2 0
UNTUK TAHUN PAJAK DAN TAHUN PAJAK BERJALAN
N P W P : NAMA WAJIB PAJAK :
TH. TH. TH. TH. TH. TH.
(1)
1
2
3
4
5
dst
J U M L A H
CATATAN : …………………………...…,
*) PINDAHKAN JUMLAH KOLOM INI KE FORMULIR 1771 HURUF A ANGKA 2
**) PINDAHKAN JUMLAH KOLOM INI KE FORMULIR 1771 HURUF E ANGKA 14 BUTIR b WAJIB PAJAK / KUASA
(……………………………………………………………)
JML
(8) (9)(2) (3) (4) (5) (6) (7)
(TAHUN BERJALAN)
(RUPIAH) (RUPIAH) (RUPIAH) (RUPIAH) RUPIAH *) RUPIAH **)
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
PERHITUNGAN KOMPENSASI KERUGIAN FISKAL
NO
KERUGIAN DAN PENGHASILAN NETO FISKAL KOMPENSASI KERUGIAN FISKAL
TAHUN RUPIAH(TAHUN PAJAK INI)
2B
TAXABLE YEAR 2 0
FOR TAXABLE YEAR AND CURRENT TAXABLE YEAR
T I N : TAXPAYER'S NAME
YEAR. YEAR. YEAR. YEAR. YEAR. YEAR.
(1)
1
2
3
4
5
etc
NOTE: …………………………...…,
*) COPY THE AMOUNT OF THIS COLUMN TO FORM 1771 LETTER A LINE 2
**) COPY THE AMOUNT OF THIS COLUMN TO FORM 1771 LETTER E LINE 14 POINT b TAXPAYER / AUTHORIZED REPRESENTATIVE
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
CALCULATION OF FISCAL LOSS CARRY FORWARD
NO
LOSS AND FISCAL NET INCOME FISCAL LOSS CARRY FORWARD
YEAR US$(THIS TAXABLE YEAR) (CURRENT TAXABLE YEAR)
(US$) (US$) (US$) (US$) US$*) US$**)
(2) (3) (4) (5) (6) (7) (8) (9)
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH
LANGUAGE AND US DOLLAR CURRENCY
(……………………………………………………………)
TOTAL TTL
2B
TAHUN PAJAK 2 0
UNTUK TAHUN PAJAK DAN TAHUN PAJAK BERJALAN
N P W P : NAMA WAJIB PAJAK :
TH. TH. TH. TH. TH. TH.
(1)
1
2
3
4
5
J U M L A H
CATATAN : …………………………...…,
*) PINDAHKAN JUMLAH KOLOM INI KE FORMULIR 1771 /$ HURUF A ANGKA 2
**) PINDAHKAN JUMLAH KOLOM INI KE FORMULIR 1771 /$ HURUF E ANGKA 14 BUTIR b WAJIB PAJAK / KUASA
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADANBAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
PERHITUNGAN KOMPENSASI KERUGIAN FISKAL
NO
KERUGIAN DAN PENGHASILAN NETO FISKAL KOMPENSASI KERUGIAN FISKAL
TAHUN US$(TAHUN PAJAK INI) (TAHUN BERJALAN)
(US$) (US$) (US$) (US$) US$ *) US$ **)
(2) (3) (4) (5) (6) (7) (8) (9)
(……………………………………………………………)
JML
3A
FOR TAXABLE YEAR
T I N:
TAXPAYER'S NAME :
I LIST OF RELATED PARTIES
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
II DETAILS OF TRANSACTION WITH RELATED PARTIES
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
………………………,
TAXPAYER/AUTHORIZED REPRESENTATIVE
5
1
2
3
4
5
ANNUAL INCOME TAX RETURN FOR CORPORATE
SPECIAL ATTACHMENT
NameNo.
Name No.
Types of Relationship with
Taxpayer
1
2
3
4
STATEMENT OF TRANSACTION WITH RELATED PARTIES
Address Tax Identification Number (TIN) Business Activities
Types of Transaction Transaction's Value
(……………………………………………………………)
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
Determination of Price Method
shall be used Determination of Methods
3A
TAHUN PAJAK
NPWP:
Nama :
I DAFTAR PIHAK YANG MEMILIKI HUBUNGAN ISTIMEWA
No
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
II RINCIAN TRANSAKSI DENGAN PIHAK YANG MEMILIKI HUBUNGAN ISTIMEWA
No
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI ………………………,
WAJIB PAJAK / KUASA
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
LAMPIRAN KHUSUS
(……………………………………………………………)
4
5
2
3
Nama Mitra Transaksi Jenis Transaksi Nilai TransaksiMetode Penetapan Harga yang
digunakanAlasan Penggunaan Metode
1
4
5
2
3
Nama Alamat NPWP/ Tax Identification Number Kegiatan UsahaBentuk Hubungan dengan Wajib
Pajak
PERNYATAAN TRANSAKSI DENGAN PIHAK YANG MEMILIKI HUBUNGAN ISTIMEWA
1
3B
FOR TAXABLE YEAR
T I N:
TAXPAYER'S NAME :
I LIST OF RELATED PARTIES
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
II DETAILS OF TRANSACTION WITH RELATED PARTIES
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
………………………,
TAXPAYER/AUTHORIZED REPRESENTATIVE
4
5
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN
ENGLISH LANGUAGE AND US DOLLAR CURRENCY
STATEMENT OF TRANSACTION WITH RELATED PARTIES
No. Name Address Tax Identification Number (TIN) Business Activities Types of Relationship with Taxpayer
1
2
3
4
No. Name Types of Transaction Transaction's Value
5
Determination of Price Method
shall be used Determination of Methods
1
2
3
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
(……………………………………………………………)
3B
NPWP:
Nama :
I DAFTAR PIHAK YANG MEMILIKI HUBUNGAN ISTIMEWA
No
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
II RINCIAN TRANSAKSI DENGAN PIHAK YANG MEMILIKI HUBUNGAN ISTIMEWA
No
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
………………………,
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
WAJIB PAJAK / KUASA
(……………………………………………………………)
4
5
2
3
Metode Penetapan Harga yang
digunakanAlasan Penggunaan Metode
1
5
Nama Mitra Transaksi Jenis Transaksi Nilai Transaksi
3
4
1
2
Nama Alamat NPWP/ Tax Identification Number Kegiatan UsahaBentuk Hubungan dengan Wajib
Pajak
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
TAHUN PAJAK
PERNYATAAN TRANSAKSI DENGAN PIHAK YANG MEMILIKI HUBUNGAN ISTIMEWA
3A-1
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME/PERMANENT ESTABLISHMENT :
Yes
Concerning of Transaction
Yes
Transaction with related parties
Yes
Taxpayer business strategy at the time when carry out the affiliation transaction
Yes
…………………….., …………………………………
TAXPAYER/AUTHORIZED REPRESENTATIVE
____________________________________________
3
That we have made note about :
No
4 Concerning of determination of Fair Price
Functional analysis which is the primary consideration of tax payers' transactions with related parties companies, all risks assumed and assets are being used in those transactions.
The economic conditions when the transactions is happened.
Terms of transactions, including agreement between Taxpayers with related parties from foreign countries
No
Operating aspects of Taxpayers business operations including details of functions which is delivered by units in the Taxpayers organization.
Description of Business Environment in detail.
2That we have made note about :
That we have made note about :
Ownership structure that refer to the dependability between all company in one group of multinational company.
The application of the determination methodology of transfer price and the use of comparing data in the determination of transfer price.
Concerning of Comparation Analysis Result Notes
Characteristic of product (goods, service, loans, finance instrument, etc) which has been transacted.
That we have made note about :
No
Methodology of price determination which applicable by Taxpayer, which shows how the fair price is acquired, and the reasons why this method is chosen, compared to other methods.
Comparing data used by the Taxpayer to determine of transfer price.
Taxpayer's transaction with company which is not influenced by related parties or information about comparing transaction.
Corcerning of company's description in detail
In case of tax payers act as the selling, rendering, or borrowing party as mentioned on the above transactions, we have conducted records as follows :
- Pricing Policy and price list for the last 5 (five) years.
- Details of manufacturing cost or acquisition cost or service preparation cost.
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
STATEMENT OF TRANSACTION IN RELATED PARTIES
Organizational structure of Taxpayer Company.
No
These are some particular notes that we made to support the fact that transactions that have been made with related parties are in accordance with the arm's length principle and the common practice.
1
I DOCUMENTATION OF ARM'S LENGTH TRANSACTION DETERMINATION
3A-1
TAHUN PAJAK
N P W P :
NAMA WAJIB PAJAK / BUT :
Ya
Mengenai Transaksi
Ya
Transaksi Wajib Pajak dengan perusahaan yang mempunyai hubungan istimewa.
-
-
Ya
Strategi bisnis Wajib Pajak pada saat melakukan transaksi affiliasi.
Bahwasannya kami telah membuat catatan tentang :
Ya
…………………….., …………………………………
WAJIB PAJAK/KUASA
____________________________________________
Metodologi penentuan harga yang diterapkan oleh Wajib Pajak, yang menunjukkan bagaimana harga yang wajar diperoleh, dan alasan metode tersebut dipilih
dibandingkan dengan metode-metode lainnya.
Data pembanding yang digunakan oleh Wajib Pajak untuk menentukan harga transfer.
Aplikasi metodologi penentuan harga transfer dan penggunaan data pembanding dalam penentuan harga transfer.
Analisis fungsional yang menjadi dasar pertimbangan dilakukannya transaksi antara Wajib Pajak dengan perusahaan yang mempunyai hubungan istimewa,
semua risiko-risiko diasumsikan dan aktiva-aktiva digunakan dalam transaksi tersebut.
Kondisi-kondisi ekonomi pada saat terjadinya transaksi.
Syarat-syarat transaksi-transaksi (terms of transactions ), termasuk juga perjanjian sesuai kontrak antara Wajib Pajak dengan pihak-pihak yang masih
mempunyai hubungan istimewa di luar negeri.
Transaksi Wajib Pajak dengan perusahaan yang tidak dipengaruhi oleh hubungan istimewa atau informasi mengenai transaksi pembanding.
4 Mengenai Catatan Mengenai Penentuan Harga Wajar
Tidak
3 Mengenai Catatan Hasil Analisis Kesebandingan
Bahwasannya kami telah membuat catatan tentang :
Tidak
Karakteristik dari produk (barang, jasa, pinjaman, instrumen keuangan, dan lain-lain) yang ditransaksikan.
Aspek-aspek operasional kegiatan usaha Wajib Pajak termasuk rincian fungsi-fungsi yang diselenggarakan oleh unit-unit yang berada dalam organisasi
perusahaan Wajib Pajak.
Gambaran Lingkungan Usaha Secara Rinci.
2
Bahwasannya kami telah membuat catatan tentang :
Tidak
Tidak
Struktur kepemilikan yang menunjukkan keterkaitan antara semua perusahaan dalam satu kelompok perusahaan multinasional.
Struktur organisasi perusahaan Wajib Pajak.
Berikut catatan-catatan khusus yang kami buat untuk mendukung bahwa transaksi yang dilakukan dengan pihak yang mempunyai hubungan istimewa telah sesuai dengan
prinsip kewajaran (arm’s length principle ) dan kelaziman.
1 Mengenai Gambaran Perusahaan Secara Rinci Bahwasannya kami telah membuat catatan tentang :
I DOKUMENTASI PENETAPAN HARGA WAJAR TRANSAKSI
Dalam hal Wajib Pajak bertindak sebagai pihak yang menjual, menyerahkan atau meminjamkan dalam transaksi-transaksi sebagaimana disebutkan
di atas, kami telah menyelenggarakan catatan sebagai berikut:
Kebijakan penentuan harga dan daftar harga selama 5 (lima) tahun terakhir
Rincian biaya pabrikasi atau harga perolehan atau biaya penyiapan jasa.
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
PERNYATAAN TRANSAKSI DALAM HUBUNGAN ISTIMEWA
3B-1
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME/PERMANENT ESTABLISHMENT :
Yes
Concerning of Transaction
Yes
Transaction with related parties
Yes
Taxpayer business strategy at the time when carry out the affiliation transaction
Yes
…………………….., …………………………………
TAXPAYER/AUTHORIZED REPRESENTATIVE
____________________________________________
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH
LANGUAGE AND US DOLLAR CURRENCY
STATEMENT OF TRANSACTION IN RELATED PARTIES
I DOCUMENTATION OF ARM'S LENGTH TRANSACTION DETERMINATIONThese are some particular notes that we made to support the fact that transactions that have been made with related parties are in accordance with the arm's length principle and the common practice.
1 Corcerning of company's description in detailThat we have made note about :
No
Ownership structure that refer to the dependability between all company in one group of multinational company.
Organizational structure of Taxpayer Company.
Operating aspects of Taxpayers business operations including details of functions which is delivered by units in the Taxpayers organization.
Description of Business Environment in detail.
2That we have made note about :
No
4 Concerning of determination of Fair Price
Taxpayer's transaction with company which is not influenced by related parties or information about comparing transaction.
In case of tax payers act as the selling, rendering, or borrowing party as mentioned on the above transactions, we have conducted records as follows :
- Pricing Policy and price list for the last 5 (five) years.
- Details of manufacturing cost or acquisition cost or service preparation cost.
3 Concerning of Comparation Analysis Result NotesThat we have made note about :
No
That we have made note about :
No
Methodology of price determination which applicable by Taxpayer, which shows how the fair price is acquired, and the reasons why this method is chosen, compared to other methods.
Comparing data used by the Taxpayer to determine of transfer price.
The application of the determination methodology of transfer price and the use of comparing data in the determination of transfer price.
Characteristic of product (goods, service, loans, finance instrument, etc) which has been transacted.
Functional analysis which is the primary consideration of tax payers' transactions with related parties companies, all risks assumed and assets are being used in those transactions.
The economic conditions when the transactions is happened.
Terms of transactions, including agreement between Taxpayers with related parties from foreign countries
3B-1
N P W P :
NAMA WAJIB PAJAK / BUT :
Ya
Mengenai Transaksi
Ya
Transaksi Wajib Pajak dengan perusahaan yang mempunyai hubungan istimewa.
-
-
Ya
Strategi bisnis Wajib Pajak pada saat melakukan transaksi affiliasi.
Bahwasannya kami telah membuat catatan tentang :
Ya
…………………….., …………………………………
WAJIB PAJAK/KUASA
____________________________________________
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADANBAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
TAHUN PAJAK
PERNYATAAN TRANSAKSI DALAM HUBUNGAN ISTIMEWA
I DOKUMENTASI PENETAPAN HARGA WAJAR TRANSAKSI
Berikut catatan-catatan khusus yang kami buat untuk mendukung bahwa transaksi yang dilakukan dengan pihak yang mempunyai hubungan istimewa telah sesuai dengan
prinsip kewajaran (arm’s length principle ) dan kelaziman.
1 Mengenai Gambaran Perusahaan Secara Rinci Bahwasannya kami telah membuat catatan tentang :
Tidak
Struktur kepemilikan yang menunjukkan keterkaitan antara semua perusahaan dalam satu kelompok perusahaan multinasional.
Struktur organisasi perusahaan Wajib Pajak.
Aspek-aspek operasional kegiatan usaha Wajib Pajak termasuk rincian fungsi-fungsi yang diselenggarakan oleh unit-unit yang berada dalam organisasi
perusahaan Wajib Pajak.
Gambaran Lingkungan Usaha Secara Rinci.
2
Bahwasannya kami telah membuat catatan tentang :
Tidak
4 Mengenai Catatan Mengenai Penentuan Harga Wajar
Transaksi Wajib Pajak dengan perusahaan yang tidak dipengaruhi oleh hubungan istimewa atau informasi mengenai transaksi pembanding.
3 Mengenai Catatan Hasil Analisis Kesebandingan
Bahwasannya kami telah membuat catatan tentang :
Tidak
Dalam hal Wajib Pajak bertindak sebagai pihak yang menjual, menyerahkan atau meminjamkan dalam transaksi-transaksi sebagaimana disebutkan
di atas, kami telah menyelenggarakan catatan sebagai berikut:
Kebijakan penentuan harga dan daftar harga selama 5 (lima) tahun terakhir
Rincian biaya pabrikasi atau harga perolehan atau biaya penyiapan jasa.
Tidak
Metodologi penentuan harga yang diterapkan oleh Wajib Pajak, yang menunjukkan bagaimana harga yang wajar diperoleh, dan alasan metode tersebut dipilih
dibandingkan dengan metode-metode lainnya.
Data pembanding yang digunakan oleh Wajib Pajak untuk menentukan harga transfer.
Aplikasi metodologi penentuan harga transfer dan penggunaan data pembanding dalam penentuan harga transfer.
Karakteristik dari produk (barang, jasa, pinjaman, instrumen keuangan, dan lain-lain) yang ditransaksikan.
Analisis fungsional yang menjadi dasar pertimbangan dilakukannya transaksi antara Wajib Pajak dengan perusahaan yang mempunyai hubungan istimewa,
semua risiko-risiko diasumsikan dan aktiva-aktiva digunakan dalam transaksi tersebut.
Kondisi-kondisi ekonomi pada saat terjadinya transaksi.
Syarat-syarat transaksi-transaksi (terms of transactions ), termasuk juga perjanjian sesuai kontrak antara Wajib Pajak dengan pihak-pihak yang masih
mempunyai hubungan istimewa di luar negeri.
3A-2
FOR TAXABLE YEAR
TIN:
TAXPAYER'S NAME :
I
No
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
II DETERMINATION OF TRANSACTION'S VALUE ABOVE , SHALL BE REFERRED TO THE TERM ARMS LENGTH AND ORDINARY BUSINESS PRINCIPLE
YES NO
……………………….., ………………………
TAXPAYER/AUTHORIZED REPRESENTATIVE
( ………………………… )
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
ANNUAL INCOME TAX RETURN FOR CORPORATE
STATEMENT OF TRANSACTION WITH PARTIES OF TAX HAVEN COUNTRY RESIDENT
5
4
3
2
1
IN CASE OF THE COMPANY HAS MADE TRANSACTIONS WITH PARTIES OF TAX HAVEN COUNTRY RESIDENT IN THIS TAXABLE YEAR
Name of Transaction Colleagues Types of Transaction Country Transaction Value
SPECIAL ATTACHMENT
3A-2
TAHUN PAJAK
NPWP:
Nama :
I
No
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
II PENETAPAN NILAI TRANSAKSI DI ATAS, DITETAPKAN DENGAN MENGGUNAKAN PRINSIP KEWAJARAN DAN KELAZIMAN USAHA
Ya Tidak
……………………….., ………………………
WAJIB PAJAK / KUASA
( ………………………… )
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
PERNYATAAN TRANSAKSI DENGAN PIHAK YANG MERUPAKAN PENDUDUK NEGARA TAX HAVEN COUNTRY
5
4
3
2
1
DALAM HAL WAJIB PAJAK DALAM TAHUN PAJAK INI MELAKUKAN TRANSAKSI DENGAN PIHAK-PIHAK YANG MERUPAKAN PENDUDUK NEGARA TAX HAVEN COUNTRY
Nama Mitra Transaksi Jenis Transaksi Negara Nilai Transaksi
LAMPIRAN KHUSUS
3B-2
FOR TAXABLE YEAR
TIN:
TAXPAYER'S NAME :
I
No
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
II DETERMINATION OF TRANSACTION'S VALUE ABOVE , SHALL BE REFERRED TO THE TERM ARMS LENGTH AND ORDINARY BUSINESS PRINCIPLE
YES NO
……………………….., ………………………
TAXPAYER/AUTHORIZED REPRESENTATIVE
( ………………………… )
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
5
4
3
2
1
STATEMENT OF TRANSACTION WITH PARTIES OF TAX HAVEN COUNTRY RESIDENT
IN CASE OF THE COMPANY HAS MADE TRANSACTIONS WITH PARTIES OF TAX HAVEN COUNTRY RESIDENT IN THIS TAXABLE YEAR
Name of Transaction Colleagues Types of Transaction Country Transaction Value
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF
ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
3B-2
TAHUN PAJAK
NPWP:
Nama :
I
No
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
II PENETAPAN NILAI TRANSAKSI DI ATAS, DITETAPKAN DENGAN MENGGUNAKAN PRINSIP KEWAJARAN DAN KELAZIMAN USAHA
Ya Tidak
……………………….., ………………………
WAJIB PAJAK / KUASA
( ………………………… )
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
4
5
3
2
DALAM HAL WAJIB PAJAK DALAM TAHUN PAJAK INI MELAKUKAN TRANSAKSI DENGAN PIHAK-PIHAK YANG MERUPAKAN PENDUDUK NEGARA TAX HAVEN COUNTRY
Nama Mitra Transaksi Jenis Transaksi Negara Nilai Transaksi
1
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
PERNYATAAN TRANSAKSI DENGAN PIHAK YANG MERUPAKAN PENDUDUK NEGARA TAX HAVEN COUNTRY
4A
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME :
IN CASE OF THE COMPANY HAS BEEN GRANTED TAX FACILITIES ON INVESTMENT, PLEASE EXPLAIN:
a. LETTER OF APPROVAL FROM BKPM b. LETTER OF MINISTER OF FINANCE DECREE
1 NUMBER : ……………………………………………………….. 1 NUMBER : ………………………………………………………..
2 DATE : ……………………………………………………….. 2 DATE : ………………………………………………………..
a. AMOUNT OF INVESTMENT APPROVED: 1. IN FOREX : 2a1
2. EQUIVALENT IDR. : 2a2 *)
3. IN IDR. : 2a3
4. TOTAL IDR. : 2a4
b. INVESTMENT : 1 NEW 2 EXPANSION
c. …………………………………………………………………………………………………………………………
d. FACILITIES GRANTED : 1 INVESTMENT ALLOWANCE
2 ACCELERATED DEPRECIATION/AMORTIZATION
3 LOSS CARRIED FORWARD 4 YEAR
INVESTMENT REALIZATION
a. THIS YEAR : IDR a
b. UP TO THIS YEAR : IDR b
FACILITIES OF INVESTMENT ALLOWANCE : YEAR a b IDR. **)
(5% X REALIZATION OF INVESTMENT UP TO CPS)
NOTE:
*) ……………………………,
**) COPY THE AMOUNT IN LINE 5 b TO FORM 1771-I TAXPAYER/AUTHORIZED REPRESENTATIVE
LINE 7 COLUMN (3)
5.
(……………………………………………………………)
4. TIME WHEN COMMERCIAL PRODUCTION STARTED (CPS), DATE:
PLEASE USE ACTUAL CONVERTION RATE AT THE TIME OF TRANSFER TO THE COMPANY'S ACCOUNT
5
3.
10 % TAX ON DIVIDENDS PAID TO FOREIGN SHAREHOLDERS
FIELD AND/OR REGION OF INVESTMENT:
1.
2.
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
2 0LIST OF INVESTMENT FACILITIES
4A
TAHUN PAJAK
N P W P :
NAMA WAJIB PAJAK :
DALAM HAL PERUSAHAAN MENDAPAT FASILITAS PERPAJAKAN DALAM RANGKA PENANAMAN MODAL, JELASKAN :
a. SURAT PERSETUJUAN KETUA BKPM b. SURAT KEPUTUSAN MENTERI KEUANGAN
1 NOMOR : ……………………………………………………….. 1 NOMOR : ………………………………………………………..
2 TANGGAL : ……………………………………………………….. 2 TANGGAL : ………………………………………………………..
a. JUMLAH PENANAMAN MODAL YANG DISETUJUI : 1. DALAM VALAS : 2a1
2. EQUIVALEN Rp. : 2a2 *)
3. DALAM Rp. : 2a3
4. JUMLAH Rp. : 2a4
b. PENANAMAN MODAL : 1 BARU 2 PERLUASAN
c. DI BIDANG DAN/ ATAU DAERAH : …………………………………………………………………………………………………………………………
d. FASILITAS YANG DIBERIKAN : 1 PENGURANGAN PENGHASILAN NETO
2 PENYUSUTAN / AMORTISASI DIPERCEPAT
3 KOMPENSASI KERUGIAN 4 TAHUN
PENGURANGAN 50 % TARIF PPh ATAS DIVIDEN YANG DIBAYARKAN KEPADA PEMEGANG SAHAM LUAR NEGERI
REALISASI PENANAMAN MODAL
a. TAHUN INI : Rp. a
b. S.D TAHUN INI : Rp. b
SAAT MULAI BERPRODUKSI KOMERSIAL (SMBK) TANGGAL :
FASILITAS PENGURANGAN PENGHASILAN NETO : TAHUN KE a b Rp. **)
(5% X REALISASI PENANAMAN MODAL S.D. SMBK)
CATATAN :
*) DENGAN KURS YANG SEBENARNYA BERLAKU PADA ……………………………,
SAAT TRANSFER DANA KE REKENING PERUSAHAAN
**) PINDAHKAN JUMLAH ANGKA 5 b KE FORMULIR 1771-I WAJIB PAJAK / KUASA
ANGKA 7 KOLOM (3)
5.
(……………………………………………………………)
4.
5
3.
1.
2.
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
2 0
DAFTAR FASILITAS PENANAMAN MODAL
4B
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME :
IN CASE OF THE COMPANY HAS BEEN GRANTED TAX FACILITIES ON INVESTMENT, PLEASE EXPLAIN:
a. LETTER OF APPROVAL FROM BKPM b. LETTER OF MINISTER OF FINANCE DECREE
1 NUMBER : ……………………………………………………….. 1 NUMBER : ………………………………………………………..
2 DATE : ……………………………………………………….. 2 DATE : ………………………………………………………..
a. AMOUNT OF INVESTMENT APPROVED: 1. IN US $ : 2a1
2. IN FOREX :
OTHERS US $
3. EQUIVALENT US $ : 2a3 *)
4. IN IDR 2a4
3. EQUIVALENT US $ : 2a5 *)
4. TOTAL US$. : 2a6
b. INVESTMENT : 1 NEW 2 EXPANSION
c. …………………………………………………………………………………………………………………………
d. FACILITIES GRANTED : 1 INVESTMENT ALLOWANCE
2 ACCELERATED DEPRECIATION/AMORTIZATION
3 LOSS CARRIED FORWARD 4 YEAR
INVESTMENT REALIZATION
a. THIS YEAR : US$. a
b. UP TO THIS YEAR : US$. b
FACILITIES OF INVESTMENT ALLOWANCE : YEAR a b US$. **)
(5% X REALIZATION OF INVESTMENT UP TO CPS)
NOTE:
*) ……………………………,
**) COPY THE AMOUNT IN LINE 5 b TO FORM 1771-I TAXPAYER/AUTHORIZED REPRESENTATIVE
LINE 7 COLUMN (3)
5.
PLEASE USE ACTUAL CONVERTION RATE AT THE TIME OF TRANSFER TO THE COMPANY'S ACCOUNT
(……………………………………………………………)
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
3.
4. TIME WHEN COMMERCIAL PRODUCTION STARTED (CPS), DATE:
FIELD AND/OR REGION OF INVESTMENT:
5 10 % TAX ON DIVIDENDS PAID TO FOREIGN SHAREHOLDERS
1.
2.
2a2
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
2 0LIST OF INVESTMENT FACILITIES
4B
TAHUN PAJAK
N P W P :
NAMA WAJIB PAJAK :
DALAM HAL PERUSAHAAN MENDAPAT FASILITAS PERPAJAKAN DALAM RANGKA PENANAMAN MODAL, JELASKAN :
a. SURAT PERSETUJUAN KETUA BKPM b. SURAT KEPUTUSAN MENTERI KEUANGAN
1 NOMOR : ……………………………………………………….. 1 NOMOR : ………………………………………………………..
2 TANGGAL : ……………………………………………………….. 2 TANGGAL : ………………………………………………………..
a. JUMLAH PENANAMAN MODAL YANG DISETUJUI : 1. DALAM US $ : 2a1
2. DALAM VALAS
SELAIN US $ : 2a2
3. EQUIVALEN US$ : 2a3 *)
4. DALAM RUPIAH : 2a4
5. EQUIVALEN US$ : 2a5 *)
6. JUMLAH US $ : 2a6
b. PENANAMAN MODAL : 1 BARU 2 PERLUASAN
c. DI BIDANG DAN/ATAU DIDAERAH : …………………………………………………………………………………………………………………………
d. FASILITAS YANG DIBERIKAN : 1 PENGURANGAN PENGHASILAN NETO
2 PENYUSUTAN / AMORTISASI DIPERCEPAT
3 KOMPENSASI KERUGIAN 4 TAHUN
PENGURANGAN 50 % TARIF PPh ATAS DIVIDEN YANG DIBAYARKAN KEPADA PEMEGANG SAHAM LUAR NEGERI
REALISASI PENANAMAN MODAL
a. TAHUN INI : US$ 3a
b. S.D TAHUN INI : US$ 3b
SAAT MULAI BERPRODUKSI KOMERSIAL (SMBK) TANGGAL :
FASILITAS PENGURANGAN PENGHASILAN NETO : TAHUN KE a b US$ **)
(5% X REALISASI PENANAMAN MODAL S.D. SMBK)
CATATAN :
*) DENGAN KURS YANG SEBENARNYA BERLAKU PADA ……………………………,
SAAT TRANSFER DANA KE REKENING PERUSAHAAN
**) PINDAHKAN JUMLAH ANGKA 5b KE FORMULIR 1771-I/$ WAJIB PAJAK / KUASA
ANGKA 7 KOLOM (3)
5.
(……………………………………………………………)
3.
4.
5
1.
2.
DAFTAR FASILITAS PENANAMAN MODAL
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADANBAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
2 0
5A
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME :
NOTE: ……………………………,
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
TAXPAYER /AUTHORIZED REPRESENTATIVE
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
2 0LIST OF BRANCH MAJOR
NO ADDRESS OF MAIN BRANCHES OFFICE TIN LOCATIONNUMBER OF MAIN
BRANCHES
(1) (2) (3) (4)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
etc.
(……………………………………………………………)
24
25
5A
TAHUN PAJAK
N P W P :
NAMA WAJIB PAJAK :
CATATAN : ……………………………,
APABILA TIDAK MENCUKUPI DAPAT DIGANDAKAN
WAJIB PAJAK / KUASA
dst.
(……………………………………………………………)
24
25
22
23
20
21
18
19
16
17
14
15
12
13
10
11
8
9
6
7
4
5
2
3
(1) (2) (3) (4)
1
NO ALAMAT CABANG UTAMA NPWP LOKASI
JUMLAH
CABANG
PEMBANTU
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
2 0DAFTAR CABANG UTAMA PERUSAHAAN
5B
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME :
NOTE: ……………………………,
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
TAXPAYER /AUTHORIZED REPRESENTATIVE
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
2 0LIST OF BRANCH MAJOR
NO ADDRESS OF MAIN BRANCHES OFFICE TIN LOCATIONNUMBER OF MAIN
BRANCHES
(1) (2) (3) (4)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
(……………………………………………………………)
19
20
5B
TAHUN PAJAK
N P W P :
NAMA WAJIB PAJAK :
CATATAN : ……………………………,
APABILA TIDAK MENCUKUPI DAPAT DIGANDAKAN
WAJIB PAJAK / KUASA
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADANBAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
2 0
DAFTAR CABANG UTAMA PERUSAHAAN
NO ALAMAT CABANG UTAMA NPWP LOKASI
JUMLAH
CABANG
PEMBANTU
(1) (2) (3) (4)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
(……………………………………………………………)
6A
FOR TAXABLE YEAR
T I N :
:
COMMERCIAL NET INCOME : ……………………………………………………… (BASED ON FINANCIAL STATEMENT)
FISCAL ADJUSTMENTS :
a. POSITIVE : IDR.
b. NEGATIVE : IDR.
c. TOTAL (a – b) : …………………………………………………………………
FISCAL NET INCOME : (1 +/- 2c) ……………………………………………………
CORPORATE INCOME TAX PAYABLE: ……………………………………………….
TAX BASE FOR INCOME TAX ART. 26 PARAGRAPH (4) : (3 - 4) ……………………………………
INCOME TAX ARTICLE 26 PARAGRAPH (4) :
a PAYABLE : …… *) % X AMOUNT IN LINE 5 ………………………………………
b NOT PAYABLE, BECAUSE:
c PROVISIONS OF TAX TREATY INDONESIA - …………………………
d REINVESTED WHOLLY IN INDONESIA IN A NEW LIMITED COMPANY: **)
………………………………………………………………………………………
TIN : e
ADDRESS : f ………………………………………………………………………………………
………………………………………………………………………………………
g CITY : …………………………………… POSTAL CODE : h
NOTE: ……………………,
*) TAX RATE OF 20% RATE STIPULATED IN TAX TREATY
**) PLEASE ATTACH THE DOCUMENTATION OF REINVESTMENT TAXPAYER/AUTHORIZED REPRESENTATIVE
(……………………………………………………………)
5.
6.
3.
4.
IDR
1.
2.
TAXPAYER'S NAME/PERMANENT ESTABLISHMENT
SPECIAL ATTACHMENTANNUAL INCOME TAX RETURN FOR CORPORATE
2 0CALCULATION OF INCOME TAX ARTICLE 26 PARAGRAPH (4)
6A
TAHUN PAJAK
N P W P :
NAMA WAJIB PAJAK / BUT :
PENGHASILAN NETO KOMERSIAL : ………………………………………………………
(BERDASARKAN LAPORAN KEUANGAN)
PENYESUAIAN FISKAL :
a. POSITIF : Rp.
b. NEGATIF : Rp.
c. JUMLAH (a – b) : …………………………………………………………………
PENGHASILAN NETO FISKAL : (1 +/- 2c) ……………………………………………………
PAJAK PENGHASILAN BADAN TERUTANG : ……………………………………………….
DASAR PENGENAAN PPh PASAL 26 AYAT (4) : (3 - 4) ……………………………………
PPh PASAL 26 AYAT (4) :
a TERUTANG : …… *) % X JUMLAH ANGKA 5 ………………………………………
b TIDAK TERUTANG, KARENA :
c KETENTUAN P3B INDONESIA - …………………………
d DITANAMKAN KEMBALI SELURUHNYA DI INDONESIA
PADA PERSEROAN TERBATAS (PT) BARU : **)
………………………………………………………………………………………
NPWP : e
ALAMAT : f ………………………………………………………………………………………
………………………………………………………………………………………
g KOTA : …………………………………… KODE POS : h
CATATAN : ……………………,
*) TARIF 20% ATAU TARIF P3B
**) LAMPIRAN BUKTI REALISASI PENANAMAN KEMBALI WAJIB PAJAK / KUASA
(……………………………………………………………)
5.
6.
3.
4.
RUPIAH PENUH
1.
2.
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
2 0PERHITUNGAN PPh PASAL 26 AYAT (4)
6B
FOR TAXABLE YEAR
T I N :
:
COMMERCIAL NET INCOME : ……………………………………………………… (BASED ON FINANCIAL STATEMENT)
FISCAL ADJUSTMENTS :
a. POSITIVE : US$.
b. NEGATIVE : US$.
c. TOTAL (a – b) : …………………………………………………………………
FISCAL NET INCOME : (1 +/- 2c) ……………………………………………………
CORPORATE INCOME TAX PAYABLE: ……………………………………………….
TAX BASE FOR INCOME TAX ART. 26 PARAGRAPH (4) : (3 - 4) ……………………………………
INCOME TAX ARTICLE 26 PARAGRAPH (4) :
a PAYABLE : …… *) % X AMOUNT IN LINE 5 ………………………………………
b NOT PAYABLE, BECAUSE:
c PROVISIONS OF TAX TREATY INDONESIA - …………………………
d REINVESTED WHOLLY IN INDONESIA IN A NEW LIMITED COMPANY: **)
………………………………………………………………………………………
TIN : e
ADDRESS : f ………………………………………………………………………………………
………………………………………………………………………………………
g CITY : …………………………………… POSTAL CODE : h
NOTE: ……………………,
*) TAX RATE OF 20% RATE STIPULATED IN TAX TREATY
**) PLEASE ATTACH THE DOCUMENTATION OF REINVESTMENT TAXPAYER/AUTHORIZED REPRESENTATIVE
(……………………………………………………………)
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
6.
4.
5.
3.
US$
1.
2.
TAXPAYER'S NAME/PERMANENT ESTABLISHMENT
SPECIAL ATTACHMENTANNUAL INCOME TAX RETURN FOR CORPORATE
2 0CALCULATION OF INCOME TAX ARTICLE 26 PARAGRAPH (4)
6B
TAHUN PAJAK
N P W P :
NAMA WAJIB PAJAK / BUT :
PENGHASILAN NETO KOMERSIAL : ………………………………………………………
(BERDASARKAN LAPORAN KEUANGAN)
PENYESUAIAN FISKAL :
a. POSITIF : US $
b. NEGATIF : US $
c. JUMLAH (a – b) : …………………………………………………………………
PENGHASILAN NETO FISKAL : (1 +/- 2c) ……………………………………………………
PAJAK PENGHASILAN BADAN TERUTANG : ……………………………………………….
DASAR PENGENAAN PPh PASAL 26 AYAT (4) : (3 - 4) ……………………………………
PPh PASAL 26 AYAT (4) :
a TERUTANG : …… *) % X JUMLAH ANGKA 5 ………………………………………
b TIDAK TERUTANG, KARENA :
c KETENTUAN P3B INDONESIA - …………………………
d DITANAMKAN KEMBALI SELURUHNYA DI INDONESIA
PADA PERSEROAN TERBATAS (PT) BARU : **)
………………………………………………………………………………………
NPWP : e
ALAMAT : f ………………………………………………………………………………………
………………………………………………………………………………………
g KOTA : …………………………………… KODE POS : h
CATATAN : ……………………,
*) TARIF 20% ATAU TARIF P3B
**) LAMPIRAN BUKTI REALISASI PENANAMAN KEMBALI WAJIB PAJAK / KUASA
(……………………………………………………………)
4.
5.
6.
3.
US $
1.
2.
PERHITUNGAN PPh PASAL 26 AYAT (4)
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADANBAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
2 0
7A
T I N : TAXPAYER'S NAME :
NOTES : ……………………,
• PLEASE FILL WITH THE DETAIL OF EACH WITHHOLDING RECEIPT/TAX PAYMENT.
• TAXPAYER / AUTHORIZED REPRESENTATIVE
• TAX CREDIT THAT CAN BE CREDITED IN COLUMN (8) SHALL BE CALCULATED BY ORDINARY CREDIT PER COUNTRY BASIS METHOD
• COPY THE TOTAL AMOUNT IN COLUMN (8) TO FORM 1771 LETTER C LINE 8.b.
• COPY THE TOTAL AMOUNT IN COLUMN (5) TO FORM 1771-I line 2.
• IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
SPECIAL ATTACHMENT
TAXABLE YEAR
2 0
(US$)
NO.
WITHHOLDING AGENT
TYPES OF INCOME
NET AMOUNTTAX DUE / PAID
IN FOREIGN COUNTRY
NAME ADDRESS(US$)
US$ FOREIGN EXCHANGE
(1) (2) (3) (4) (5) (6) (7) (8)
1,
2.
3.
4.
5.
6.
7.
8.
9.
10.
(……………………………………………………………)
ANNUAL INCOME TAX RETURN FOR CORPORATE
FOREIGN TAX CREDIT
TAX CREDITABLE
COLUMN (6) IDR FILL WITH CONVERTION VALUE FROM THE NUMBER IN COLUMN (7) FOREIGN EXCHANGE USING EXCHANGE RATE PREVAILING AT
THE TIME OF TAX PAYMENT/TAX DUE IN FOREIGN COUNTRY
TOTAL TTL
7A
N P W P : NAMA WAJIB PAJAK :
CATATAN : ……………………,
• DIISI DENGAN RINCIAN PER BUKTI PEMOTONGAN / PEMBAYARAN PAJAK.
• KOLOM (6) RUPIAH DIISI DENGAN NILAI KONVERSI DARI ANGKA DALAM KOLOM (7) VALAS DENGAN MENGGUNAKAN KURS PAJAK YANG WAJIB PAJAK / KUASA
BERLAKU PADA TANGGAL PEMBAYARAN / TERUTANGNYA PAJAK DI LUAR NEGERI.
• KREDIT PAJAK YANG DAPAT DIPERHITUNGKAN PADA KOLOM (8) DIHITUNG BERDASARKAN METODE ORDINARY CREDIT PER COUNTRY BASIS .
• PINDAHKAN HASIL PENJUMLAHAN KOLOM (8) KE FORMULIR 1771 HURUF C ANGKA 8.b.
• PINDAHKAN HASIL PENJUMLAHAN KOLOM (5) KE FORMULIR 1771-I Nomor 2.
• JIKA FORMULIR INI TIDAK CUKUP, DAPAT DIGANDAKAN SESUAI KEBUTUHAN.
9.
10.
JML
1,
JUMLAH
3.
4.
5.
6.
7.
8.
(4)(3) (5) (6) (7) (8)
ALAMAT NO.
(1)
PEMOTONG PAJAK
NAMA
(2)
VALASRUPIAH
PAJAK YANG TERUTANG / DIBAYAR
DI LUAR NEGERIJENIS PENGHASILAN
JUMLAH NETO
(RUPIAH)
(……………………………………………………………)
2.
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
(RUPIAH)
KREDIT PAJAK YANG
DAPAT DIPERHITUNGKAN
KREDIT PAJAK LUAR NEGERI
LAMPIRAN KHUSUS
TAHUN PAJAK
2 0
7B
T I N : TAXPAYER'S NAME :
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
2.
(7) (8)
1,
(1) (2) (3) (4) (5) (6)
TAX CREDITABLEIN FOREIGN COUNTRYNAME ADDRESS
(US $)US $ FOREIGN EXCHANGE (US $)
FOREIGN TAX CREDIT
NO.WITHHOLDING AGENT
TYPES OF INCOMENET AMOUNT TAX DUE / PAID
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
TAXABLE YEAR2 0
NOTES : ……………………,
TOTAL TTL
10.
9.
8.
7.
6.
5.
4.
3.
• PLEASE FILL WITH THE DETAIL OF EACH WITHHOLDING RECEIPT/TAX PAYMENT.
• TAXPAYER / AUTHORIZED REPRESENTATIVE
• TAX CREDIT THAT CAN BE CREDITED IN COLUMN (8) SHALL BE CALCULATED BY ORDINARY CREDIT PER COUNTRY BASIS METHOD
• COPY THE TOTAL AMOUNT IN COLUMN (8) TO FORM 1771 LETTER C LINE 8.b.
• COPY THE TOTAL AMOUNT IN COLUMN (5) TO FORM 1771-I line 2.
• IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
COLUMN (6) IDR FILL WITH CONVERTION VALUE FROM THE NUMBER IN COLUMN (7) FOREIGN EXCHANGE USING EXCHANGE RATE PREVAILING AT THE TIME OF TAX PAYMENT/TAX DUE IN FOREIGN COUNTRY
(……………………………………………………………)
7B
TAHUN PAJAK
N P W P : NAMA WAJIB PAJAK :
CATATAN : ……………………,
• DIISI DENGAN RINCIAN PER BUKTI PEMOTONGAN / PEMBAYARAN PAJAK.
• KOLOM (6) US $ DIISI DENGAN NILAI KONVERSI DARI ANGKA DALAM KOLOM (7) VALAS DENGAN MENGGUNAKAN KURS PAJAK YANG WAJIB PAJAK / KUASA
BERLAKU PADA TANGGAL PEMBAYARAN / TERUTANGNYA PAJAK DI LUAR NEGERI.
• KREDIT PAJAK YANG DAPAT DIPERHITUNGKAN PADA KOLOM (8) DIHITUNG BERDASARKAN METODE ORDINARY CREDIT PER COUNTRY BASIS .
• PINDAHKAN HASIL PENJUMLAHAN KOLOM (8) KE FORMULIR 1771/$ HURUF C ANGKA 8.b.
• PINDAHKAN HASIL PENJUMLAHAN KOLOM (5) KE FORMULIR 1771-I/$ NOMOR 2.
• JIKA FORMULIR INI TIDAK CUKUP, DAPAT DIGANDAKAN SESUAI KEBUTUHAN.
KREDIT PAJAK LUAR NEGERI
LAMPIRAN KHUSUS
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
2 0
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
NO.
PEMOTONG PAJAK
JENIS PENGHASILAN
JUMLAH NETOPAJAK YANG TERUTANG / DIBAYAR
(1) (2) (3)
4.
2.
(……………………………………………………………)
10.
9.
KREDIT PAJAK YANGDI LUAR NEGERI
NAMA ALAMAT (US$) DAPAT DIPERHITUNGKAN
US$ VALAS (US$)
(4) (5) (6) (7) (8)
1,
3.
5.
6.
7.
8.
JUMLAH JML
INDUSTRIAL COMPANIES 8A-1
TIN :
TAXPAYER'S NAME :
I. ELEMENTS FROM BALANCE SHEET
NO. NO.
1. CASH AND EQUIVALENT 1. ACCOUNT PAYABLE - THIRD PARTIES
2. TEMPORARY INVESTMENTS 2.
3. ACCOUNT RECEIVABLE - THIRD PARTIES 3. INTEREST PAYABLE
4. 4. TAXES PAYABLE
5. OTHER RECEIVABLE - THIRD PARTIES 5. DIVIDENDS PAYABLE
6. 6. ACCRUED EXPENSES
7. ALLOWANCE FOR DOUBTFUL ACCOUNTS 7. SHORT - TERM BANK LOANS
8. INVENTORIES 8.
9. PREPAID EXPENSES 9. ADVANCES
10. ADVANCES 10. OTHER CURRENT LIABILITIES
11. OTHER CURRENT ASSETS 11. LONG - TERM DEBT - BANK LOANS
12. LONG-TERM RECEIVABLES 12.
13. LAND AND BUILDINGS 13.
14. OTHER FIXED ASSETS 14. DEFFERED TAX LIABILITIES
15. LESS: ACCUMULATED DEPRECIATION 15. OTHER NON-CURRENT LIABILITIES
16. INVESMENT IN ASSOCIATES 16. CAPITAL STOCK
17. OTHER LONG-TERM INVESTMENTS 17.
18. INTANGIBLE ASSETS 18.
19. DEFERRED TAX ASSET 19. RETAINED EARNINGS
20. OTHER NON - CURRENT ASSETS 20. OTHER EQUITY
TOTAL ASSETS
II. ELEMENTS FROM INCOME STATEMENT
NO.
1. NET SALES
2. MATERIALS
3. DIRECT LABOUR
4. FACTORY OVERHEAD
5. MANUFACTURING COST (2 + 3 + 4)
6. WORK IN PROCESS - BEGINNING
7. WORK IN PROCESS - ENDING
8. COST OF GOOD MANUFACTURE (5 + 6 - 7)
9. FINISHED GOODS - BEGINNING
10. FINISHED GOODS - ENDING
11. COST OF GOOD SOLD (8 + 9 - 10)
12. GROSS PROFIT (1 - 11)
13. SELLING EXPENSES
14. GENERAL AND ADMINISTRATIVE EXPENSES
15. PROFIT (12 - 13 - 14)
16. OTHERS INCOME (EXPENSES)
17. NET EARNINGS OF ASSOCIATES
18. INCOME BEFORE INCOME TAX BENEFIT/ (EXPENSE) (15 + 16 + 17)
19. INCOME TAX BENEFIT / (EXPENSE)
20. NET EARNINGS FROM NORMAL ACTIVITIES (18 - 19)
21. EXTRA ORDINARY ITEMS
22. INCOME BEFORE MINORITY INTEREST IN NET EARNINGS OF SUBSIDIARIES (20 + 21)
23. MINORITY INTEREST IN NET EARNINGS OF SUBSIDIARIES
24. NET PROFIT (22 - 23)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
2 0a. ….…………………………………,
(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIVE
c. FULL NAME OF MANAGEMENT/REPRESENTATIVE
TAXABLE YEAR8A-1 CORPORATE ANNUAL INCOME TAX RETURN
SPECIAL ATTACHMENT
2
DESCRIPTION
0
PARTIES TYPES OF TRANSACTION TRANSACTION VALUE (IDR)
DECLARATION
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
TOTAL LIABILITIES AND OWNERS' EQUITY
VALUE (IDR)
ACCOUNT RECEIVABLE - RELATED PARTIES
OTHER RECEIVABLE - RELATED PARTIES
VALUE (IDR)DESCRIPTION DESCRIPTION
ACCOUNT PAYABLE - RELATED PARTIES
LONG-TERM DEBT-RELATED PARTIES
LONG - TERM DEBTS-CURRENT MATURITIES
VALUE (IDR)
LONG-TERM DEBT-THIRD PARTIES
ADDITONAL PAID - IN CAPITAL
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT
(d. Signature and Company Seal)
(year)(date) (month)
RETAINED EARNINGS FROM PREVIOUS YEARS
PERUSAHAAN INDUSTRI 8A-1 MANUFAKTUR TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
1. KAS DAN SETARA KAS 1. HUTANG USAHA PIHAK KETIGA
2. INVESTASI SEMENTARA 2.
3. PIUTANG USAHA PIHAK KETIGA 3. HUTANG BUNGA
4. 4. HUTANG PAJAK
5. PIUTANG LAIN-LAIN PIHAK KETIGA 5. HUTANG DIVIDEN
6. 6. BIAYA YANG MASIH HARUS DIBAYAR
7. PENYISIHAN PIUTANG RAGU-RAGU 7. HUTANG BANK
8. PERSEDIAAN 8.
9. BEBAN DIBAYAR DI MUKA 9. UANG MUKA PELANGGAN
10. UANG MUKA PEMBELIAN 10. KEWAJIBAN LANCAR LAINNYA
11. AKTIVA LANCAR LAINNYA 11. HUTANG BANK JANGKA PANJANG
12. PIUTANG JANGKA PANJANG 12.
13. TANAH DAN BANGUNAN 13.
14. AKTIVA TETAP LAINNYA 14. KEWAJIBAN PAJAK TANGGUHAN
15. DIKURANGI: AKUMULASI PENYUSUTAN 15. KEWAJIBAN TIDAK LANCAR LAINNYA
16. INVESTASI PADA PERUSAHAAN ASOSIASI 16. MODAL SAHAM
17. INVESTASI JANGKA PANJANG LAINNYA 17.
18. HARTA TIDAK BERWUJUD 18.
19. AKTIVA PAJAK TANGGUHAN 19. LABA DITAHAN TAHUN INI
20. AKTIVA TIDAK LANCAR LAINNYA 20. EKUITAS LAIN-LAIN
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
1. PENJUALAN BERSIH
2. BAHAN BAKU YANG DIGUNAKAN
3. UPAH BURUH LANGSUNG
4. BIAYA PABRIKASI
5. JUMLAH BIAYA PRODUKSI (2 + 3 + 4)
6. SALDO BARANG DALAM PROSES - AWAL
7. SALDO BARANG DALAM PROSES - AKHIR
8. HARGA POKOK PRODUKSI (5 + 6 - 7)
9. SALDO BARANG JADI - AWAL
10. SALDO BARANG JADI - AKHIR
11. HARGA POKOK PENJUALAN (8 + 9 - 10)
12. LABA KOTOR (1 - 11)
13. BEBAN PENJUALAN
14. BEBAN UMUM DAN ADMINISTRASI
15. LABA USAHA (12 - 13 - 14)
16. PENGHASILAN/(BEBAN) LAIN
17. BAGIAN LABA (RUGI) PERUSAHAAN ASOSIASI
18. LABA/RUGI SEBELUM PAJAK PENGHASILAN (15 + 16 + 17)
19. BEBAN (MANFAAT) PAJAK PENGHASILAN
20. LABA (RUGI) DARI AKTIVITAS NORMAL (18 - 19)
21. POS LUAR BIASA
22. LABA/RUGI SEBELUM HAK MINORITAS (20 + 21)
23. HAK MINORITAS ATAS LABA (RUGI) BERSIH ANAK PERUSAHAAN
24. LABA BERSIH (22 - 23)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
(d. Tanda Tangan dan Cap Perusahaan)
(thn)(tgl) (bln)
LABA DITAHAN TAHUN-TAHUN SEBELUMNYA
NILAI (RUPIAH)URAIAN
HUTANG USAHA JANGKA PANJANG PIHAK LAIN
AGIO SAHAM (TAMBAHAN MODAL DISETOR)
HUTANG USAHA JANGKA PANJANG PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA
BAGIAN HUTANG JANGKA PANJANG YANG JATUH TEMPO DALAM TAHUN BERJALAN
PIUTANG USAHA PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA
PIUTANG LAIN-LAIN PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA
NILAI (RUPIAH)URAIAN URAIAN
HUTANG USAHA PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA
NILAI (RUPIAH)
JUMLAH KEWAJIBAN DAN EKUITAS
JENIS TRANSAKSI NILAI TRANSAKSI (RUPIAH)
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah saya beritahukan di atas adalah benar, lengkap dan jelas.
PERNYATAAN
PIHAK-PIHAK
8A-1 SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
TRANSKRIP KUTIPAN ELEMEN-ELEMEN 2 0
LAMPIRAN KHUSUS
DARI LAPORAN KEUANGAN
INDUSTRIAL COMPANIES 8B-1
TIN :
TAXPAYER'S NAME :
I. ELEMENTS FROM BALANCE SHEET
NO. NO.
1. CASH AND EQUIVALENT 1. ACCOUNT PAYABLE - THIRD PARTIES
2. TEMPORARY INVESTMENTS 2.
3. ACCOUNT RECEIVABLE - THIRD PARTIES 3. INTEREST PAYABLE
4. 4. TAXES PAYABLE
5. OTHER RECEIVABLE - THIRD PARTIES 5. DIVIDENDS PAYABLE
6. 6. ACCRUED EXPENSES
7. ALLOWANCE FOR DOUBTFUL ACCOUNTS 7. SHORT - TERM BANK LOANS
8. INVENTORIES 8.
9. PREPAID EXPENSES 9. ADVANCES
10. ADVANCES 10. OTHER CURRENT LIABILITIES
11. OTHER CURRENT ASSETS 11. LONG - TERM DEBT - BANK LOANS
12. LONG-TERM RECEIVABLES 12.
13. LAND AND BUILDINGS 13.
14. OTHER FIXED ASSETS 14. DEFFERED TAX LIABILITIES
15. LESS: ACCUMULATED DEPRECIATION 15. OTHER NON-CURRENT LIABILITIES
16. INVESMENT IN ASSOCIATES 16. CAPITAL STOCK
17. OTHER LONG-TERM INVESTMENTS 17.
18. INTANGIBLE ASSETS 18.
19. DEFERRED TAX ASSET 19. RETAINED EARNINGS
20. OTHER NON - CURRENT ASSETS 20. OTHER EQUITY
TOTAL ASSETS
II. ELEMENTS FROM INCOME STATEMENT
NO.
1. NET SALES
2. MATERIALS
3. DIRECT LABOUR
4. FACTORY OVERHEAD
5. MANUFACTURING COST (2 + 3 + 4)
6. WORK IN PROCESS - BEGINNING
7. WORK IN PROCESS - ENDING
8. COST OF GOOD MANUFACTURE (5 + 6 - 7)
9. FINISHED GOODS - BEGINNING
10. FINISHED GOODS - ENDING
11. COST OF GOOD SOLD (8 + 9 - 10)
12. GROSS PROFIT (1 - 11)
13. SELLING EXPENSES
14. GENERAL AND ADMINISTRATIVE EXPENSES
15. PROFIT (12 - 13 - 14)
16. OTHERS INCOME (EXPENSES)
17. NET EARNINGS OF ASSOCIATES
18. INCOME BEFORE INCOME TAX BENEFIT/ (EXPENSE) (15 + 16 + 17)
19. INCOME TAX BENEFIT / (EXPENSE)
20. NET EARNINGS FROM NORMAL ACTIVITIES (18 - 19)
21. EXTRA ORDINARY ITEMS
22. INCOME BEFORE MINORITY INTEREST IN NET EARNINGS OF SUBSIDIARIES (20 + 21)
23. MINORITY INTEREST IN NET EARNINGS OF SUBSIDIARIES
24. NET PROFIT (22 - 23)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
2 0a. ….…………………………………,
(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIVE
c. FULL NAME OF MANAGEMENT/REPRESENTATIVE
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND UNITED STATES DOLLAR CURRENCY
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT
(d. Signature and Company Seal)
(year)(date) (month)
RETAINED EARNINGS FROM PREVIOUS YEARS
VALUE (US$)
LONG-TERM DEBT-THIRD PARTIES
ADDITONAL PAID - IN CAPITAL
LONG-TERM DEBT-RELATED PARTIES
LONG - TERM DEBTS-CURRENT MATURITIES
ACCOUNT RECEIVABLE - RELATED PARTIES
OTHER RECEIVABLE - RELATED PARTIES
VALUE (US$)DESCRIPTION DESCRIPTION
ACCOUNT PAYABLE - RELATED PARTIES
VALUE (US$)
TOTAL LIABILITIES AND OWNERS' EQUITY
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
DECLARATION
TYPES OF TRANSACTION TRANSACTION VALUE (US$)PARTIES
TAXABLE YEAR8B-1 CORPORATE ANNUAL INCOME TAX RETURN
SPECIAL ATTACHMENT
2
DESCRIPTION
0
PERUSAHAAN INDUSTRI 8B-1
MANUFAKTUR TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
1. KAS DAN SETARA KAS 1. HUTANG USAHA PIHAK KETIGA
2. INVESTASI SEMENTARA 2.
3. PIUTANG USAHA PIHAK KETIGA 3. HUTANG BUNGA
4. 4. HUTANG PAJAK
5. PIUTANG LAIN-LAIN PIHAK KETIGA 5. HUTANG DIVIDEN
6. 6. BIAYA YANG MASIH HARUS DIBAYAR
7. PENYISIHAN PIUTANG RAGU-RAGU 7. HUTANG BANK
8. PERSEDIAAN 8.
9. BEBAN DIBAYAR DI MUKA 9. UANG MUKA PELANGGAN
10. UANG MUKA PEMBELIAN 10. KEWAJIBAN LANCAR LAINNYA
11. AKTIVA LANCAR LAINNYA 11. HUTANG BANK JANGKA PANJANG
12. PIUTANG JANGKA PANJANG 12.
13. TANAH DAN BANGUNAN 13.
14. AKTIVA TETAP LAINNYA 14. KEWAJIBAN PAJAK TANGGUHAN
15. DIKURANGI: AKUMULASI PENYUSUTAN 15. KEWAJIBAN TIDAK LANCAR LAINNYA
16. INVESTASI PADA PERUSAHAAN ASOSIASI 16. MODAL SAHAM
17. INVESTASI JANGKA PANJANG LAINNYA 17.
18. HARTA TIDAK BERWUJUD 18.
19. AKTIVA PAJAK TANGGUHAN 19. LABA DITAHAN TAHUN INI
20. AKTIVA TIDAK LANCAR LAINNYA 20. EKUITAS LAIN-LAIN
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
1. PENJUALAN BERSIH
2. BAHAN BAKU YANG DIGUNAKAN
3. UPAH BURUH LANGSUNG
4. BIAYA PABRIKASI
5. JUMLAH BIAYA PRODUKSI (2 + 3 + 4)
6. SALDO BARANG DALAM PROSES - AWAL
7. SALDO BARANG DALAM PROSES - AKHIR
8. HARGA POKOK PRODUKSI (5 + 6 - 7)
9. SALDO BARANG JADI - AWAL
10. SALDO BARANG JADI - AKHIR
11. HARGA POKOK PENJUALAN (8 + 9 - 10)
12. LABA KOTOR (1 - 11)
13. BEBAN PENJUALAN
14. BEBAN UMUM DAN ADMINISTRASI
15. LABA USAHA (12 - 13 - 14)
16. PENGHASILAN/(BEBAN) LAIN
17. BAGIAN LABA (RUGI) PERUSAHAAN ASOSIASI
18. LABA/RUGI SEBELUM PAJAK PENGHASILAN (15 + 16 + 17)
19. BEBAN (MANFAAT) PAJAK PENGHASILAN
20. LABA (RUGI) DARI AKTIVITAS NORMAL (18 - 19)
21. POS LUAR BIASA
22. LABA/RUGI SEBELUM HAK MINORITAS (20 + 21)
23. HAK MINORITAS ATAS LABA (RUGI) BERSIH ANAK PERUSAHAAN
24. LABA BERSIH (22 - 23)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
(d. Tanda Tangan dan Cap Perusahaan)
(thn)(tgl) (bln)
LABA DITAHAN TAHUN-TAHUN SEBELUMNYA
URAIAN
AGIO SAHAM (TAMBAHAN MODAL DISETOR)
HUTANG USAHA JANGKA PANJANG PIHAK YANG
MEMPUNYAI HUBUNGAN ISTIMEWA
NILAI (US$)
PIUTANG USAHA PIHAK YANG MEMPUNYAI HUBUNGAN
ISTIMEWA
PIUTANG LAIN-LAIN PIHAK YANG MEMPUNYAI HUBUNGAN
ISTIMEWA
BAGIAN HUTANG JANGKA PANJANG YANG JATUH
TEMPO DALAM TAHUN BERJALAN
HUTANG USAHA JANGKA PANJANG PIHAK LAIN
NILAI (US$)URAIAN URAIAN
HUTANG USAHA PIHAK YANG MEMPUNYAI
HUBUNGAN ISTIMEWA
NILAI (US$)
JUMLAH KEWAJIBAN DAN EKUITAS
JENIS TRANSAKSI NILAI TRANSAKSI (US$)
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah
saya beritahukan di atas adalah benar, lengkap dan jelas.
PERNYATAAN
PIHAK-PIHAK
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN8B-1
LAMPIRAN KHUSUS
02TRANSKRIP KUTIPAN ELEMEN-ELEMEN
DARI LAPORAN KEUANGAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
8A-2TRADING COMPANIES
TIN :
TAXPAYER'S NAME :
I. ELEMENT FROM BALANCE SHEET
NO. NO.
1. CASH AND EQUIVALENT 1. ACCOUNT PAYABLE -THIRD PARTIES
2. TEMPORARY INVESTMENTS 2.
3. ACCOUNT RECEIVABLE - THIRD PARTIES 3. INTEREST PAYABLE
4. 4. TAXES PAYABLE
5. OTHER RECEIVABLE - THIRD PARTIES 5. DIVIDEND PAYABLE
6. 6. ACCRUED EXPENSES
7. ALLOWANCE FOR DOUBTFUL ACCOUNTS 7. SHORT - TERM BANK LOANS
8. INVENTORIES 8.
9. PREPAID EXPENSES 9. ADVANCES
10. ADVANCES 10. OTHER CURRENT LIABILITIES
11. OTHER CURRENT ASSET 11. LONG - TERM DEBT - BANK LOANS
12. LONG - TERM RECEIVABLES 12.
13. LAND AND BUILDINGS 13.
14. OTHER FIXED ASSETS 14. DEFFERED TAX LIABILITIES
15. LESS: ACCUMULATED DEPRECIATION 15. OTHER LONG - TERM LIABILITIES
16. INVESTMENTS IN ASOCIATES 16. CAPITAL STOCK
17. OTHER LONG - TERM INVESTMENTS 17.
18. INTANGIBLE ASSETS 18.
19. DEFERRED TAX ASSET 19. RETAINED EARNINGS
20. OTHER NON - CURRENT ASSET 20. OTHER EQUITY
TOTAL ASSETS
II. ELEMENTS FROM INCOME STATEMENT
NO.
1. NET SALES
2. PURCHASE
3. MERCHANDISE INVENTORY- BEGINNING
4. MERCHANDISE INVENTORY- ENDING
5. COST OF GOOD SOLD (2 + 3 - 4)
6. GROSS PROFIT (1 - 5)
7. SALES EXPENSE
8. GENERAL AND ADMINISTRATIVE EXPENSES
9. PROFIT (6 - 7 - 8)
10. INCOME/(EXPENSE) OTHER
11. NET EARNINGS OF ASSOCIATES
12. INCOME BEFORE INCOME TAX (9 + 10 + 11)
13. INCOME TAX BENEFIT (EXPENSE)
14. NET EARNINGS FROM NORMAL ACTIVITIES (12 - 13)
15. EXTRAORDINARY ITEMS
16. GAIN/LOSS BEFORE MINORITY INTEREST (14 + 15)
17. MINORITY INTEREST IN NET EARNIGS OF SUBSIDIARIES
18. NET PROFIT (16 - 17)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
a. ….…………………………………, 2 0(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIVE
c. FULL NAME OF MANAGEMENT/REPRESENTATIVE
2 0
ACCOUNT PAYABLE - RELATED PARTIES
LONG - TERM DEBTS-CURRENT MATURITIES
LONG - TERM DEBT - THIRD PARTIES
LONG -TERM DEBT - RELATED PARTIES
RETAINED EARNINGS FROM PREVIOUS YEARS
TOTAL LIABILITIES AND OWNERS' EQUITY
ADDITIONAL PAID-IN CAPITAL
DESCRIPTION VALUE (IDR)
ACCOUNT RECEIVABLE - RELATED PARTIES
OTHER RECEIVABLE - RELATED PARTIES
SPECIAL ATTACHMENT
DESCRIPTION VALUE (IDR) DESCRIPTION VALUE (IDR)
8A-2 CORPORATE ANNUAL INCOME TAX RETURN
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT
TAXABLE YEAR
TYPES OF TRANSACTION TRANSACTION VALUE (IDR)
DECLARATION
(d. Signature and Company Seal)
(date) (month) (year)
PARTIES
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
PERUSAHAAN 8A-2 DAGANG TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
1. KAS DAN SETARA KAS 1. HUTANG USAHA PIHAK KETIGA
2. INVESTASI SEMENTARA 2.
3. PIUTANG USAHA PIHAK KETIGA 3. HUTANG BUNGA
4. 4. HUTANG PAJAK
5. PIUTANG LAIN-LAIN PIHAK KETIGA 5. HUTANG DIVIDEN
6. 6. BIAYA YANG MASIH HARUS DIBAYAR
7. PENYISIHAN PIUTANG RAGU-RAGU 7. HUTANG BANK
8. PERSEDIAAN 8.
9. BEBAN DIBAYAR DI MUKA 9. UANG MUKA PELANGGAN
10. UANG MUKA PEMBELIAN 10. KEWAJIBAN LANCAR LAINNYA
11. AKTIVA LANCAR LAINNYA 11. HUTANG BANK JANGKA PANJANG
12. PIUTANG JANGKA PANJANG 12.
13. TANAH DAN BANGUNAN 13.
14. AKTIVA TETAP LAINNYA 14. KEWAJIBAN PAJAK TANGGUHAN
15. DIKURANGI: AKUMULASI PENYUSUTAN 15. KEWAJIBAN TIDAK LANCAR LAINNYA
16. INVESTASI PADA PERUSAHAAN ASOSIASI 16. MODAL SAHAM
17. INVESTASI JANGKA PANJANG LAINNYA 17.
18. HARTA TIDAK BERWUJUD 18.
19. AKTIVA PAJAK TANGGUHAN 19. LABA DITAHAN TAHUN INI
20. AKTIVA TIDAK LANCAR LAINNYA 20. EKUITAS LAIN-LAIN
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
1. PENJUALAN BERSIH
2. PEMBELIAN
3. SALDO BARANG DAGANGAN - AWAL
4. SALDO BARANG DAGANGAN - AKHIR
5. HARGA POKOK PENJUALAN (2 + 3 - 4)
6. LABA KOTOR (1 - 5)
7. BEBAN PENJUALAN
8. BEBAN UMUM DAN ADMINISTRASI
9. LABA USAHA (6 - 7 - 8)
10. PENGHASILAN/(BEBAN) LAIN
11. BAGIAN LABA (RUGI) PERUSAHAAN ASOSIASI
12. LABA/RUGI SEBELUM PAJAK PENGHASILAN (9 + 10 + 11)
13. BEBAN (MANFAAT) PAJAK PENGHASILAN
14. LABA (RUGI) DARI AKTIVITAS NORMAL (12 - 13)
15. POS LUAR BIASA
16. LABA/RUGI SEBELUM HAK MINORITAS (14 + 15)
17. HAK MINORITAS ATAS LABA (RUGI) BERSIH ANAK PERUSAHAAN
18. LABA BERSIH (16 - 17)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
JENIS TRANSAKSI NILAI TRANSAKSI (RUPIAH)
PERNYATAAN
(d. Tanda Tangan dan Cap Perusahaan)
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah saya beritahukan di atas adalah benar, lengkap dan jelas.
(tgl) (bln) (thn)
PIHAK-PIHAK
LAMPIRAN KHUSUS
URAIAN NILAI (RUPIAH) URAIAN NILAI (RUPIAH)
DARI LAPORAN KEUANGAN
8A-2 SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
TRANSKRIP KUTIPAN ELEMEN-ELEMEN 2
HUTANG USAHA PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA
PIUTANG USAHA PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA
PIUTANG LAIN-LAIN PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA
BAGIAN HUTANG JANGKA PANJANG YANG JATUH TEMPO DALAM TAHUN BERJALAN
HUTANG USAHA JANGKA PANJANG PIHAK LAIN
HUTANG USAHA JANGKA PANJANG PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA
AGIO SAHAM (TAMBAHAN MODAL DISETOR)
LABA DITAHAN TAHUN-TAHUN SEBELUMNYA
URAIAN NILAI (RUPIAH)
JUMLAH KEWAJIBAN DAN EKUITAS
0
8B-2TRADING COMPANIES
TIN :
TAXPAYER'S NAME :
I. ELEMENT FROM BALANCE SHEET
NO. NO.
1. CASH AND EQUIVALENT 1. ACCOUNT PAYABLE -THIRD PARTIES
2. TEMPORARY INVESTMENTS 2.
3. ACCOUNT RECEIVABLE - THIRD PARTIES 3. INTEREST PAYABLE
4. 4. TAXES PAYABLE
5. OTHER RECEIVABLE - THIRD PARTIES 5. DIVIDEND PAYABLE
6. 6. ACCRUED EXPENSES
7. ALLOWANCE FOR DOUBTFUL ACCOUNTS 7. SHORT - TERM BANK LOANS
8. INVENTORIES 8.
9. PREPAID EXPENSES 9. ADVANCES
10. ADVANCES 10. OTHER CURRENT LIABILITIES
11. OTHER CURRENT ASSET 11. LONG - TERM DEBT - BANK LOANS
12. LONG - TERM RECEIVABLES 12.
13. LAND AND BUILDINGS 13.
14. OTHER FIXED ASSETS 14. DEFFERED TAX LIABILITIES
15. LESS: ACCUMULATED DEPRECIATION 15. OTHER LONG - TERM LIABILITIES
16. INVESTMENTS IN ASOCIATES 16. CAPITAL STOCK
17. OTHER LONG - TERM INVESTMENTS 17.
18. INTANGIBLE ASSETS 18.
19. DEFERRED TAX ASSET 19. RETAINED EARNINGS
20. OTHER NON - CURRENT ASSET 20. OTHER EQUITY
TOTAL ASSETS
II. ELEMENTS FROM INCOME STATEMENT
NO.
1. NET SALES
2. PURCHASE
3. MERCHANDISE INVENTORY- BEGINNING
4. MERCHANDISE INVENTORY- ENDING
5. COST OF GOOD SOLD (2 + 3 - 4)
6. GROSS PROFIT (1 - 5)
7. SALES EXPENSE
8. GENERAL AND ADMINISTRATIVE EXPENSES
9. PROFIT (6 - 7 - 8)
10. INCOME/(EXPENSE) OTHER
11. NET EARNINGS OF ASSOCIATES
12. INCOME BEFORE INCOME TAX (9 + 10 + 11)
13. INCOME TAX BENEFIT (EXPENSE)
14. NET EARNINGS FROM NORMAL ACTIVITIES (12 - 13)
15. EXTRAORDINARY ITEMS
16. GAIN/LOSS BEFORE MINORITY INTEREST (14 + 15)
17. MINORITY INTEREST IN NET EARNIGS OF SUBSIDIARIES
18. NET PROFIT (16 - 17)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
a. ….…………………………………, 2 0(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIVE
c. FULL NAME OF MANAGEMENT/REPRESENTATIVE
TYPES OF TRANSACTION TRANSACTION VALUE (US$)
DECLARATION
(d. Signature and Company Seal)
(date) (month) (year)
PARTIES
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
SPECIAL ATTACHMENT
DESCRIPTION VALUE (US$) DESCRIPTION VALUE (US$)
8B-2 CORPORATE ANNUAL INCOME TAX RETURN
FOR CORPORATION PERMITTED TO MAINTAIN BOOKKEEPING IN ENGLISH LANGUAGE AND UNITED STATE DOLLAR CURRENCY
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT
TAXABLE YEAR
ACCOUNT RECEIVABLE - RELATED PARTIES
OTHER RECEIVABLE - RELATED PARTIES
DESCRIPTION VALUE (US$)
ADDITIONAL PAID-IN CAPITAL
TOTAL LIABILITIES AND OWNERS' EQUITY
ACCOUNT PAYABLE - RELATED PARTIES
LONG - TERM DEBTS-CURRENT MATURITIES
LONG - TERM DEBT - THIRD PARTIES
LONG -TERM DEBT - RELATED PARTIES
RETAINED EARNINGS FROM PREVIOUS YEARS
2 0
PERUSAHAAN 8B-2
DAGANG TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
1. KAS DAN SETARA KAS 1. HUTANG USAHA PIHAK KETIGA
2. INVESTASI SEMENTARA 2.
3. PIUTANG USAHA PIHAK KETIGA 3. HUTANG BUNGA
4. 4. HUTANG PAJAK
5. PIUTANG LAIN-LAIN PIHAK KETIGA 5. HUTANG DIVIDEN
6. 6. BIAYA YANG MASIH HARUS DIBAYAR
7. PENYISIHAN PIUTANG RAGU-RAGU 7. HUTANG BANK
8. PERSEDIAAN 8.
9. BEBAN DIBAYAR DI MUKA 9. UANG MUKA PELANGGAN
10. UANG MUKA PEMBELIAN 10. KEWAJIBAN LANCAR LAINNYA
11. AKTIVA LANCAR LAINNYA 11. HUTANG BANK JANGKA PANJANG
12. PIUTANG JANGKA PANJANG 12.
13. TANAH DAN BANGUNAN 13.
14. AKTIVA TETAP LAINNYA 14. KEWAJIBAN PAJAK TANGGUHAN
15. DIKURANGI: AKUMULASI PENYUSUTAN 15. KEWAJIBAN TIDAK LANCAR LAINNYA
16. INVESTASI PADA PERUSAHAAN ASOSIASI 16. MODAL SAHAM
17. INVESTASI JANGKA PANJANG LAINNYA 17.
18. HARTA TIDAK BERWUJUD 18.
19. AKTIVA PAJAK TANGGUHAN 19. LABA DITAHAN TAHUN INI
20. AKTIVA TIDAK LANCAR LAINNYA 20. EKUITAS LAIN-LAIN
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
1. PENJUALAN BERSIH
2. PEMBELIAN
3. SALDO BARANG DAGANGAN - AWAL
4. SALDO BARANG DAGANGAN - AKHIR
5. HARGA POKOK PENJUALAN (2 + 3 - 4)
6. LABA KOTOR (1 - 5)
7. BEBAN PENJUALAN
8. BEBAN UMUM DAN ADMINISTRASI
9. LABA USAHA (6 - 7 - 8)
10. PENGHASILAN/(BEBAN) LAIN
11. BAGIAN LABA (RUGI) PERUSAHAAN ASOSIASI
12. LABA/RUGI SEBELUM PAJAK PENGHASILAN (9 + 10 + 11)
13. BEBAN (MANFAAT) PAJAK PENGHASILAN
14. LABA (RUGI) DARI AKTIVITAS NORMAL (12 - 13)
15. POS LUAR BIASA
16. LABA/RUGI SEBELUM HAK MINORITAS (14 + 15)
17. HAK MINORITAS ATAS LABA (RUGI) BERSIH ANAK PERUSAHAAN
18. LABA BERSIH (16 - 17)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
JENIS TRANSAKSI NILAI TRANSAKSI (US$)
PERNYATAAN
(d. Tanda Tangan dan Cap Perusahaan)
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah
saya beritahukan di atas adalah benar, lengkap dan jelas.
(tgl) (bln) (thn)
PIHAK-PIHAK
URAIAN NILAI (US$) URAIAN NILAI (US$)
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
TRANSKRIP KUTIPAN ELEMEN-ELEMEN
DARI LAPORAN KEUANGAN
HUTANG USAHA PIHAK YANG MEMPUNYAI
HUBUNGAN ISTIMEWA
PIUTANG USAHA PIHAK YANG MEMPUNYAI HUBUNGAN
ISTIMEWA
PIUTANG LAIN-LAIN PIHAK YANG MEMPUNYAI HUBUNGAN
ISTIMEWA
BAGIAN HUTANG JANGKA PANJANG YANG JATUH
TEMPO DALAM TAHUN BERJALAN
HUTANG USAHA JANGKA PANJANG PIHAK LAIN
HUTANG USAHA JANGKA PANJANG PIHAK YANG
MEMPUNYAI HUBUNGAN ISTIMEWA
AGIO SAHAM (TAMBAHAN MODAL DISETOR)
LABA DITAHAN TAHUN-TAHUN SEBELUMNYA
JUMLAH KEWAJIBAN DAN EKUITAS
URAIAN NILAI (US$)
8B-2
2 0
LAMPIRAN KHUSUS
8A-3 CONVENTIONAL BANKS
TAXABLE YEAR
TIN :
TAXPAYER'S NAME :
I. ELEMENTS FROM BALANCE SHEET
NO. NO.
1. CASH 1. OBLIGATION DUE IMMEDIATELY
2. GIRO AT CENTRAL BANK 2.
3. GIRO AT OTHER BANK - NET 3.
4. 4. DEPOSITS FROM OTHER BANKS
5. 5.
6. 6. DERIVATIVE PAYABLES
7. 7. ACCEPTANCE PAYABLES
8. 8. TAXES PAYABLE
9. DERIVATIVE RECEIVABLES, NET OF ALLOWANCE 9. MARKETABLE SECURITIES ISSUED
10. LOANS, NET OF ALLOWANCE 10. LOAN RECEIVED
11. 11.
12. ACCEPTANCE RECEIVABLES, NET OF ALLOWANCE 12. DEFFERED TAX LIABILITIES
13. GOVERNMENT BONDS 13. ACCRUALS LIABILITIES
14. INVESTMENTS, NET OF ALLOWANCE 14. OTHER LIABILITIES
15. GOODWILL - NET OF ACCUMULATED AMORTIZATION 15. SUBORDINATED DEBTS
16. FIXED ASSET 16. CAPITAL STOCK
17. LESS: ACCUMULATED DEPRECIATION 17.
18. DEFFERED TAX ASSET 18.
19. PREPAID EXPENSES 19. RETAINED EARNINGS
20. OTHER ASSETS 20. OTHER EQUITY
TOTAL ASSETS
II. ELEMENTS FROM INCOME STATEMENT
NO.
1. INTEREST INCOME
2. INTEREST EXPENSE
3. NET INTEREST INCOME (1 - 2)
4. OTHER OPERATING INCOME
5. OTHER OPERATING EXPENSES
6. INCOME FROM OPERATIONS (3 + 4 - 5)
7. NON-OPERATING INCOME
8. NON-OPERATING EXPENSES
9. NON-OPERATING INCOME - NET (7 - 8)
10. NET EARNINGS OF ASSOCIATES
11. INCOME BEFORE INCOME TAX (3 + 6 + 9 + 10)
12. INCOME TAX BENEFIT (EXPENSE)
13. NET EARNINGS FROM NORMAL ACTIVITIES ( 11 - 12)
14. EXTRAORDINARY ITEMS
15. INCOME BEFORE MINORITY INTEREST IN NET EARNIGS OF SUBSIDIARIES (13-14)
16. MINORITY INTEREST IN NET EARNIGS OF SUBSIDIARIES
17. NET PROFIT (15 - 16)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
2 0a. ….…………………………………,
(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIVE
c. FULL NAME OF MANAGEMENT/REPRESENTATIVE
2 0
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT
8A-3 CORPORATE ANNUAL INCOME TAX RETURNSPECIAL ATTACHMENT
RETAINED EARNINGS FROM PREVIOUS YEARS
DEPOSITS FROM CUSTOMERS - THIRD PARTIES
DEPOSITS FROM CUSTOMERS - RELATED PARTIES
MARKETABLE SECURITIES SOLD UNDER REPURCHASE AGREEMENTS, NET OF ALLOWANCE
ESTIMATED LOSSES ON COMMITMENTS AND CONTIGENCIES
TOTAL LIABILITIES AND OWNERS' EQUITY
DESCRIPTION VALUE (IDR) DESCRIPTION VALUE (IDR)
PLACEMENTS ON CENTRAL BANK - NET
PLACEMENTS ON OTHER BANKS - NET
MARKETABLE SECURITIES - RELATED PARTIES
MARKETABLE SECURITIES - THIRD PARTIES
MARKETABLE SECURITIES PURCHASED UNDER RESALE AGREEMENT, NET OF ALLOWANCE
CONSUMER FINANCING RECEIVABLES, NET OF ALLOWANCE
ADDITIONAL PAID - IN CAPITAL
(d. Signature and Company Seal)
PARTIES TYPES OF TRANSACTION TRANSACTION VALUE (IDR)
DECLARATION
(date) (month) (year)
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
DESCRIPTION VALUE (IDR)
BANK 8A-3
KONVENSIONAL TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
1. KAS 1. KEWAJIBAN SEGERA
2. GIRO PADA BANK INDONESIA 2.
3. GIRO PADA BANK LAIN - BERSIH 3. SIMPANAN NASABAH PIHAK KETIGA
4. 4. SIMPANAN DARI BANK LAIN
5. 5.
6. 6. KEWAJIBAN DERIVATIF
7. SURAT BERHARGA PIHAK KETIGA - BERSIH 7. KEWAJIBAN AKSEPTASI
8. 8. HUTANG PAJAK
9. TAGIHAN DERIVATIF - BERSIH 9. SURAT BERHARGA YANG DITERBITKAN
10. PINJAMAN YANG DIBERIKAN - BERSIH 10. PINJAMAN YANG DITERIMA
11. 11.
12. TAGIHAN AKSEPTASI - BERSIH 12. KEWAJIBAN PAJAK TANGGUHAN
13. OBLIGASI PEMERINTAH 13. BEBAN YANG MASIH HARUS DIBAYAR
14. PENYERTAAN SAHAM - BERSIH 14. KEWAJIBAN LAIN-LAIN
15. GOODWIL - BERSIH 15. PINJAMAN SUBORDINASI
16. AKTIVA TETAP 16. MODAL SAHAM
17. DIKURANGI: AKUMULASI PENYUSUTAN 17.
18. AKTIVA PAJAK TANGGUHAN 18.
19. BIAYA DIBAYAR DI MUKA 19. LABA DITAHAN TAHUN INI
20. AKTIVA LAIN-LAIN BERSIH 20. EKUITAS LAIN-LAIN
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
1. PENDAPATAN BUNGA
2. BEBAN BUNGA
3. PENDAPATAN BUNGA - BERSIH (1 - 2)
4. PENDAPATAN OPERASI LAINNYA
5. BEBAN OPERASIONAL LAINNYA
6. PENDAPATAN/(BEBAN) OPERASIONAL LAINNYA - BERSIH (4 - 5)
7. PENDAPATAN BUKAN OPERASIONAL
8. BEBAN BUKAN OPERASIONAL
9. PENDAPATAN NON OPERASIONAL - BERSIH (7 - 8)
10. BAGIAN LABA (RUGI) PERUSAHAAN ASOSIASI
11. LABA/RUGI SEBELUM PAJAK PENGHASILAN (3 + 6 + 9 + 10)
12. BEBAN (MANFAAT) PAJAK PENGHASILAN
13. LABA (RUGI) DARI AKTIVITAS NORMAL (11 - 12)
14. POS LUAR BIASA
15. LABA/RUGI SEBELUM HAK MINORITAS (13 + 14)
16. HAK MINORITAS ATAS LABA (RUGI) BERSIH ANAK PERUSAHAAN
17. LABA BERSIH (15 - 16)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
SIMPANAN NASABAH PIHAK YANG MEMPUNYAI
HUBUNGAN ISTIMEWA
PENEMPATAN PADA BANK INDONESIA - BERSIH
SURAT BERHARGA PIHAK YANG MEMPUNYAI HUBUNGAN
ISTIMEWA - BERSIH
(bln) (thn)
AGIO SAHAM (TAMBAHAN MODAL DISETOR)
LABA DITAHAN TAHUN-TAHUN SEBELUMNYA
JUMLAH KEWAJIBAN DAN EKUITAS
URAIAN NILAI (RUPIAH)
(d. Tanda Tangan dan Cap Perusahaan)
PIHAK-PIHAK JENIS TRANSAKSI NILAI TRANSAKSI (RUPIAH)
PERNYATAAN
PENEMPATAN PADA BANK LAIN - BERSIH
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah
saya beritahukan di atas adalah benar, lengkap dan jelas.
(tgl)
PIUTANG PEMBIAYAAN KONSUMEN - BERSIH
SURAT BERHARGA YANG DIJUAL DENGAN JANJI
DIBELI KEMBALI - BERSIH
URAIAN NILAI (RUPIAH) URAIAN NILAI (RUPIAH)
SURAT BERHARGA YANG DIBELI DENGAN JANJI DIJUAL
KEMBALI - BERSIH
ESTIMASI KERUGIAN KOMITMEN DAN KONTIJENSI
8A-3SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
TRANSKRIP KUTIPAN ELEMEN-ELEMEN 2 0
DARI LAPORAN KEUANGAN
LAMPIRAN KHUSUS
8B-3 CONVENTIONAL BANKS
TAXABLE YEAR
TIN :
TAXPAYER'S NAME :
I. ELEMENTS FROM BALANCE SHEET
NO. NO.
1. CASH 1. OBLIGATION DUE IMMEDIATELY
2. GIRO AT CENTRAL BANK 2.
3. GIRO AT OTHER BANK - NET 3.
4. 4. DEPOSITS FROM OTHER BANKS
5. 5.
6. 6. DERIVATIVE PAYABLES
7. 7. ACCEPTANCE PAYABLES
8. 8. TAXES PAYABLE
9. DERIVATIVE RECEIVABLES, NET OF ALLOWANCE 9. MARKETABLE SECURITIES ISSUED
10. LOANS, NET OF ALLOWANCE 10. LOAN RECEIVED
11. 11.
12. ACCEPTANCE RECEIVABLES, NET OF ALLOWANCE 12. DEFFERED TAX LIABILITIES
13. GOVERNMENT BONDS 13. ACCRUALS LIABILITIES
14. INVESTMENTS, NET OF ALLOWANCE 14. OTHER LIABILITIES
15. GOODWILL - NET OF ACCUMULATED AMORTIZATION 15. SUBORDINATED DEBTS
16. FIXED ASSET 16. CAPITAL STOCK
17. LESS: ACCUMULATED DEPRECIATION 17.
18. DEFFERED TAX ASSET 18.
19. PREPAID EXPENSES 19. RETAINED EARNINGS
20. OTHER ASSETS 20. OTHER EQUITY
TOTAL ASSETS
II. ELEMENTS FROM INCOME STATEMENT
NO.
1. INTEREST INCOME
2. INTEREST EXPENSE
3. NET INTEREST INCOME (1 - 2)
4. OTHER OPERATING INCOME
5. OTHER OPERATING EXPENSES
6. INCOME FROM OPERATIONS (3 + 4 - 5)
7. NON-OPERATING INCOME
8. NON-OPERATING EXPENSES
9. NON-OPERATING INCOME - NET (7 - 8)
10. NET EARNINGS OF ASSOCIATES
11. INCOME BEFORE INCOME TAX (3 + 6 + 9 + 10)
12. INCOME TAX BENEFIT (EXPENSE)
13. NET EARNINGS FROM NORMAL ACTIVITIES ( 11 - 12)
14. EXTRAORDINARY ITEMS
15. INCOME BEFORE MINORITY INTEREST IN NET EARNIGS OF SUBSIDIARIES (13-14)
16. MINORITY INTEREST IN NET EARNIGS OF SUBSIDIARIES
17. NET PROFIT (15 - 16)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
2 0a. ….…………………………………,
(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIVE
c. FULL NAME OF MANAGEMENT/REPRESENTATIVE
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
DESCRIPTION VALUE (US$)
(d. Signature and Company Seal)
PARTIES TYPES OF TRANSACTION TRANSACTION VALUE (US$)
DECLARATION
(date) (month) (year)
ADDITIONAL PAID - IN CAPITAL
MARKETABLE SECURITIES - THIRD PARTIES
MARKETABLE SECURITIES PURCHASED UNDER RESALE AGREEMENT, NET OF ALLOWANCE
CONSUMER FINANCING RECEIVABLES, NET OF ALLOWANCE
DESCRIPTION VALUE (US$) DESCRIPTION VALUE (US$)
PLACEMENTS ON CENTRAL BANK - NET
PLACEMENTS ON OTHER BANKS - NET
MARKETABLE SECURITIES - RELATED PARTIES
MARKETABLE SECURITIES SOLD UNDER REPURCHASE AGREEMENTS, NET OF ALLOWANCE
ESTIMATED LOSSES ON COMMITMENTS AND CONTIGENCIES
TOTAL LIABILITIES AND OWNERS' EQUITY
8B-3 CORPORATE ANNUAL INCOME TAX RETURNSPECIAL ATTACHMENT
RETAINED EARNINGS FROM PREVIOUS YEARS
DEPOSITS FROM CUSTOMERS - THIRD PARTIES
DEPOSITS FROM CUSTOMERS - RELATED PARTIES
2 0FOR CORPORATION PERMITTED TO MAINTAIN BOOKKEEPING IN ENGLISH LANGUAGE AND UNITED STATE DOLLAR CURRENCY
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT
BANK 8B-3
KONVENSIONAL TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
1. KAS 1. KEWAJIBAN SEGERA
2. GIRO PADA BANK INDONESIA 2.
3. GIRO PADA BANK LAIN - BERSIH 3. SIMPANAN NASABAH PIHAK KETIGA
4. 4. SIMPANAN DARI BANK LAIN
5. 5.
6. 6. KEWAJIBAN DERIVATIF
7. SURAT BERHARGA PIHAK KETIGA - BERSIH 7. KEWAJIBAN AKSEPTASI
8. 8. HUTANG PAJAK
9. TAGIHAN DERIVATIF - BERSIH 9. SURAT BERHARGA YANG DITERBITKAN
10. PINJAMAN YANG DIBERIKAN - BERSIH 10. PINJAMAN YANG DITERIMA
11. 11.
12. TAGIHAN AKSEPTASI - BERSIH 12. KEWAJIBAN PAJAK TANGGUHAN
13. OBLIGASI PEMERINTAH 13. BEBAN YANG MASIH HARUS DIBAYAR
14. PENYERTAAN SAHAM - BERSIH 14. KEWAJIBAN LAIN-LAIN
15. GOODWIL - BERSIH 15. PINJAMAN SUBORDINASI
16. AKTIVA TETAP 16. MODAL SAHAM
17. DIKURANGI: AKUMULASI PENYUSUTAN 17.
18. AKTIVA PAJAK TANGGUHAN 18.
19. BIAYA DIBAYAR DI MUKA 19. LABA DITAHAN TAHUN INI
20. AKTIVA LAIN-LAIN BERSIH 20. EKUITAS LAIN-LAIN
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
1. PENDAPATAN BUNGA
2. BEBAN BUNGA
3. PENDAPATAN BUNGA - BERSIH (1 - 2)
4. PENDAPATAN OPERASI LAINNYA
5. BEBAN OPERASIONAL LAINNYA
6. PENDAPATAN/(BEBAN) OPERASIONAL LAINNYA - BERSIH (4 - 5)
7. PENDAPATAN BUKAN OPERASIONAL
8. BEBAN BUKAN OPERASIONAL
9. PENDAPATAN NON OPERASIONAL - BERSIH (7 - 8)
10. BAGIAN LABA (RUGI) PERUSAHAAN ASOSIASI
11. LABA/RUGI SEBELUM PAJAK PENGHASILAN (3 + 6 + 9 + 10)
12. BEBAN (MANFAAT) PAJAK PENGHASILAN
13. LABA (RUGI) DARI AKTIVITAS NORMAL (11 - 12)
14. POS LUAR BIASA
15. LABA/RUGI SEBELUM HAK MINORITAS (13 + 14)
16. HAK MINORITAS ATAS LABA (RUGI) BERSIH ANAK PERUSAHAAN
17. LABA BERSIH (15 - 16)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
02
SIMPANAN NASABAH PIHAK YANG MEMPUNYAI
HUBUNGAN ISTIMEWA
PENEMPATAN PADA BANK INDONESIA - BERSIH
SURAT BERHARGA PIHAK YANG MEMPUNYAI HUBUNGAN
ISTIMEWA - BERSIH
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah
saya beritahukan di atas adalah benar, lengkap dan jelas.
(tgl) (bln) (thn)
AGIO SAHAM (TAMBAHAN MODAL DISETOR)
LABA DITAHAN TAHUN-TAHUN SEBELUMNYA
JUMLAH KEWAJIBAN DAN EKUITAS
URAIAN NILAI (US$)
(d. Tanda Tangan dan Cap Perusahaan)
PIHAK-PIHAK JENIS TRANSAKSI NILAI TRANSAKSI (US$)
PERNYATAAN
PENEMPATAN PADA BANK LAIN - BERSIH
URAIAN NILAI (US$) URAIAN NILAI (US$)
LAMPIRAN KHUSUS
TRANSKRIP KUTIPAN ELEMEN-ELEMEN
DARI LAPORAN KEUANGAN
8B-3SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
SURAT BERHARGA YANG DIBELI DENGAN JANJI DIJUAL
KEMBALI - BERSIH
ESTIMASI KERUGIAN KOMITMEN DAN KONTIJENSIPIUTANG PEMBIAYAAN KONSUMEN - BERSIH
SURAT BERHARGA YANG DIJUAL DENGAN JANJI
DIBELI KEMBALI - BERSIH
SHARIA 8A-4BANKS
TIN :
TAXPAYER'S NAME :
I. ELEMENTS FROM BALANCE SHEET
NO. NO.
1. CASH AND EQUIVALENT 1. OBLIGATION DUE IMMEDIATELY
2. PLACEMENTS ON CENTRAL BANK 2.
3. GIRO ON OTHER BANKS - NET 3.
4. 4. LIABILITIY TO OTHER BANK
5. 5.
6. 6.
7. 7. ZAKAT PAYABLE
8. 8. TAX PAYABLE
9. INVENTORIES (ASSET FOR RESALES) 9. DEFERRED TAX LIABILITIES
10. ASSETS ACQUIRED FOR IJARAH 10. OTHER PAYABLE
11. ASSET OF ISTISHNA IN COMPLETION 11.
12. INVESTMENT 12.
13. FIXED ASSET 13. CAPITAL STOCK
14. LESS: ACCUMULATED DEPRECIATION 14.
15. DEFERRED TAX ASSETS 15.
16. PREPAID EXPENSES 16. RETAINED EARNING FOR THIS YEAR
17. OTHER ASSETS 17. OTHER EQUITY
TOTAL ASSETS
II. ELEMENTS FROM INCOME STATEMENT
NO.
1. OPERATING REVENUE
2. RIGHT OF THIRD PARTIES ON THE UNRELATED INVESTMENT RETURN
3. MAJOR OPERATIONS INCOME - NET (1 - 2)
4. OTHER OPERATING REVENUES
5. OTHER OPERATING EXPENSES
6. INCOME FROM OPERATIONS (3 + 4 - 5)
7. NON-OPERATING REVENUE
8. NON OPERATING EXPENSES
9. NET EARNINGS OF ASSOCIATES
10. INCOME BEFORE INCOME TAX (6 + 7 - 8 + 9)
11. INCOME TAX BENEFIT (EXPENSE)
12. NET EARNINGS FROM NORMAL ACTIVITIES (10 - 11)
13. EXTRAORDINARY ITEMS
14. INCOME BEFORE MINORITY INTEREST IN NET EARNIGS OF SUBSIDIARIES (12-13)
15. MINORITY INTEREST IN NET EARNIGS OF SUBSIDIARIES
16. NET PROFIT (14 - 15)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
2 0
a. ….…………………………………,(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIVE
c. FULL NAME OF MANAGEMENT/REPRESENTATIVE
TAXABLE YEAR
CORPORATE ANNUAL INCOME TAX RETURN
TOTAL LIABILITIES AND OWNER'S EQUITY
MUSYAROKAH FINANCING
VALUE (IDR)DESCRIPTION
ADDITIONAL PAID-IN CAPITAL
PREVIOUS RETAINED EARNING
(MUDHARABAH DEPOSIT AND SAVING) BANK
(d. Signature and Company Seal)
DECLARATION
(date)
(MUDAROBAH DEPOSIT AND SAVING) NON BANK
(month) (year)
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
UNDISTRIBUTED OF PROFIT ANNOUNCED
PARTIES TYPES OF TRANSACTION TRANSACTION VALUE (IDR)
DESCRIPTION
DEPOSIT (WADIAH SAVING AND GIRO)
OTHER LIABILITY (SALAM LIABILITY AND ISTISHNA LIABILITY)
SECURITIES RECEIVED FINANCING
SPECIAL ATTACHMENT8A-4
VALUE (IDR)DESCRIPTION
RECEIVABLES (MURABAHAH, SALAM, ISTISHNA, IJAROH, ETC)
VALUE (IDR)
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT 2 0
MUDHARABAH FINANCING
PLACEMENT ON OTHER BANK - NET
BANK 8A-4
SYARIAH TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
1. KAS DAN SETARA KAS 1. KEWAJIBAN SEGERA
2. PENEMPATAN PADA BANK INDONESIA 2.
3. GIRO PADA BANK LAIN - BERSIH 3.
4. 4. KEWAJIBAN PADA BANK LAIN
5. 5.
6. 6.
7. 7. HUTANG ZAKAT
8. 8. HUTANG PAJAK
9. PERSEDIAAN (AKTIVA UNTUK DIJUAL KEMBALI) 9. KEWAJIBAN PAJAK TANGGUHAN
10. AKTIVA YANG DIPEROLEH UNTUK IJAROH 10. HUTANG LAINNYA
11. AKTIVA ISTISHNA DALAM PENYELESAIAN 11.
12. PENYERTAAN 12.
13. AKTIVA TETAP 13. MODAL SAHAM
14. DIKURANGI: AKUMULASI PENYUSUTAN 14.
15. AKTIVA PAJAK TANGGUHAN 15.
16. BIAYA DIBAYAR DIMUKA 16. LABA DITAHAN TAHUN INI
17. AKTIVA LAIN-LAIN 17. EKUITAS LAIN-LAIN
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
1. PENDAPATAN OPERASI UTAMA
2. HAK PIHAK KETIGA ATAS BAGI HASIL INVESTASI TIDAK TERIKAT
3. PENDAPATAN OPERASI UTAMA - BERSIH (1 - 2)
4. PENDAPATAN OPERASIONAL LAINNYA
5. BEBAN OPERASIONAL LAINNYA
6. LABA OPERASIONAL (3 + 4 - 5)
7. PENDAPATAN BUKAN OPERASIONAL
8. BEBAN BUKAN OPERASIONAL
9. BAGIAN LABA (RUGI) PERUSAHAAN ASOSIASI
10. LABA SEBELUM PAJAK PENGHASILAN (6 + 7 - 8 + 9)
11. BEBAN (MANFAAT) PAJAK PENGHASILAN
12. LABA (RUGI) DARI AKTIVITAS NORMAL (10 - 11)
13. POS LUAR BIASA
14. LABA/RUGI SEBELUM HAK MINORITAS (12 - 13)
15. HAK MINORITAS ATAS LABA (RUGI) BERSIH ANAK PERUSAHAAN
16. LABA BERSIH (14 - 15)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
PENEMPATAN PADA BANK LAIN - BERSIH
LAMPIRAN KHUSUS8A-4
SIMPANAN (GIRO DAN TABUNGAN WADIAH)
KEWAJIBAN LAIN (HUTANG SALAM DAN HUTANG
ISTISHNA)
INVESTASI TIDAK TERIKAT BUKAN BANK (TABUNGAN
DAN DEPOSITO MUDHARABAH)
PIHAK-PIHAK JENIS TRANSAKSI NILAI TRANSAKSI (RUPIAH)
PERNYATAAN
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah
saya beritahukan di atas adalah benar, lengkap dan jelas.
(tgl) (bln) (thn)
(d. Tanda Tangan dan Cap Perusahaan)
NILAI (RUPIAH)URAIAN URAIAN NILAI (RUPIAH)
EFEK - EFEK
AGIO SAHAM (TAMBAHAN MODAL DISETOR)
LABA DITAHAN TAHUN-TAHUN SEBELUMNYA
JUMLAH KEWAJIBAN, ITT DAN EKUITAS
NILAI (RUPIAH)URAIAN
PIUTANG (MURABAHAH, SALAM, ISTISHNA, IJAROH DLL)
PEMBIAYAAN MUDHARABAH
PEMBIAYAAN MUSYAROKAH
PEMBIAYAAN YANG DITERIMA
KEUNTUNGAN YANG SUDAH DIUMUMKAN BELUM
DIBAGI
INVESTASI TIDAK TERIKAT BANK (TABUNGAN DAN
DEPOSITO MUDHARABAH)
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
TRANSKRIP KUTIPAN ELEMEN-ELEMEN 2 0
DARI LAPORAN KEUANGAN
SHARIA 8B-4BANKS
TIN :
TAXPAYER'S NAME :
I. ELEMENTS FROM BALANCE SHEET
NO. NO.
1. CASH AND EQUIVALENT 1. OBLIGATION DUE IMMEDIATELY
2. PLACEMENTS ON CENTRAL BANK 2.
3. GIRO ON OTHER BANKS - NET 3.
4. 4. LIABILITIY TO OTHER BANK
5. 5.
6. 6.
7. 7. ZAKAT PAYABLE
8. 8. TAX PAYABLE
9. INVENTORIES (ASSET FOR RESALES) 9. DEFERRED TAX LIABILITIES
10. ASSETS ACQUIRED FOR IJARAH 10. OTHER PAYABLE
11. ASSET OF ISTISHNA IN COMPLETION 11.
12. INVESTMENT 12.
13. FIXED ASSET 13. CAPITAL STOCK
14. LESS: ACCUMULATED DEPRECIATION 14.
15. DEFERRED TAX ASSETS 15.
16. PREPAID EXPENSES 16. RETAINED EARNING FOR THIS YEAR
17. OTHER ASSETS 17. OTHER EQUITY
TOTAL ASSETS
II. ELEMENTS FROM INCOME STATEMENT
NO.
1. OPERATING REVENUE
2. RIGHT OF THIRD PARTIES ON THE UNRELATED INVESTMENT RETURN
3. MAJOR OPERATIONS INCOME - NET (1 - 2)
4. OTHER OPERATING REVENUES
5. OTHER OPERATING EXPENSES
6. INCOME FROM OPERATIONS (3 + 4 - 5)
7. NON-OPERATING REVENUE
8. NON OPERATING EXPENSES
9. NET EARNINGS OF ASSOCIATES
10. INCOME BEFORE INCOME TAX (6 + 7 - 8 + 9)
11. INCOME TAX BENEFIT (EXPENSE)
12. NET EARNINGS FROM NORMAL ACTIVITIES (10 - 11)
13. EXTRAORDINARY ITEMS
14. INCOME BEFORE MINORITY INTEREST IN NET EARNIGS OF SUBSIDIARIES (12-13)
15. MINORITY INTEREST IN NET EARNIGS OF SUBSIDIARIES
16. NET PROFIT (14 - 15)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
2 0
a. ….…………………………………,(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIVE
c. FULL NAME OF MANAGEMENT/REPRESENTATIVE
RECEIVABLES (MURABAHAH, SALAM, ISTISHNA, IJAROH, ETC)
VALUE (US$)
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT 2 0
MUDHARABAH FINANCING
PLACEMENT ON OTHER BANK - NET
SECURITIES RECEIVED FINANCING
SPECIAL ATTACHMENT8B-4
VALUE (US$)DESCRIPTION DESCRIPTION
DEPOSIT (WADIAH SAVING AND GIRO)
OTHER LIABILITY (SALAM LIABILITY AND ISTISHNA LIABILITY)
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
UNDISTRIBUTED OF PROFIT ANNOUNCED
PARTIES TYPES OF TRANSACTION TRANSACTION VALUE (US$)
(MUDAROBAH DEPOSIT AND SAVING) NON BANK
(month) (year)
(d. Signature and Company Seal)
DECLARATION
(date)
ADDITIONAL PAID-IN CAPITAL
PREVIOUS RETAINED EARNING
(MUDHARABAH DEPOSIT AND SAVING) BANK
MUSYAROKAH FINANCING
VALUE (US$)DESCRIPTION
TAXABLE YEAR
FOR CORPORATION PERMITTED TO MAINTAIN BOOKKEEPING IN ENGLISH LANGUAGE AND UNITED STATE DOLLAR CURRENCY
CORPORATE ANNUAL INCOME TAX RETURN
TOTAL LIABILITIES AND OWNER'S EQUITY
BANK 8B-4
SYARIAH TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
1. KAS DAN SETARA KAS 1. KEWAJIBAN SEGERA
2. PENEMPATAN PADA BANK INDONESIA 2.
3. GIRO PADA BANK LAIN - BERSIH 3.
4. 4. KEWAJIBAN PADA BANK LAIN
5. 5.
6. 6.
7. 7. HUTANG ZAKAT
8. 8. HUTANG PAJAK
9. PERSEDIAAN (AKTIVA UNTUK DIJUAL KEMBALI) 9. KEWAJIBAN PAJAK TANGGUHAN
10. AKTIVA YANG DIPEROLEH UNTUK IJAROH 10. HUTANG LAINNYA
11. AKTIVA ISTISHNA DALAM PENYELESAIAN 11.
12. PENYERTAAN 12.
13. AKTIVA TETAP 13. MODAL SAHAM
14. DIKURANGI: AKUMULASI PENYUSUTAN 14.
15. AKTIVA PAJAK TANGGUHAN 15.
16. BIAYA DIBAYAR DIMUKA 16. LABA DITAHAN TAHUN INI
17. AKTIVA LAIN-LAIN 17. EKUITAS LAIN-LAIN
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
1. PENDAPATAN OPERASI UTAMA
2. HAK PIHAK KETIGA ATAS BAGI HASIL INVESTASI TIDAK TERIKAT
3. PENDAPATAN OPERASI UTAMA - BERSIH (1 - 2)
4. PENDAPATAN OPERASIONAL LAINNYA
5. BEBAN OPERASIONAL LAINNYA
6. LABA OPERASIONAL (3 + 4 - 5)
7. PENDAPATAN BUKAN OPERASIONAL
8. BEBAN BUKAN OPERASIONAL
9. BAGIAN LABA (RUGI) PERUSAHAAN ASOSIASI
10. LABA SEBELUM PAJAK PENGHASILAN (6 + 7 - 8 + 9)
11. BEBAN (MANFAAT) PAJAK PENGHASILAN
12. LABA (RUGI) DARI AKTIVITAS NORMAL (10 - 11)
13. POS LUAR BIASA
14. LABA/RUGI SEBELUM HAK MINORITAS (12 - 13)
15. HAK MINORITAS ATAS LABA (RUGI) BERSIH ANAK PERUSAHAAN
16. LABA BERSIH (14 - 15)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
PENEMPATAN PADA BANK LAIN - BERSIH
LAMPIRAN KHUSUS8B-4
SIMPANAN (GIRO DAN TABUNGAN WADIAH)
KEWAJIBAN LAIN (HUTANG SALAM DAN HUTANG
ISTISHNA)
INVESTASI TIDAK TERIKAT BUKAN BANK (TABUNGAN
DAN DEPOSITO MUDHARABAH)
PIHAK-PIHAK JENIS TRANSAKSI NILAI TRANSAKSI (US$)
PERNYATAAN
URAIAN
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah
saya beritahukan di atas adalah benar, lengkap dan jelas.
(tgl) (bln) (thn)
(d. Tanda Tangan dan Cap Perusahaan)
NILAI (US$)URAIAN URAIAN NILAI (US$)
EFEK - EFEK
PIUTANG (MURABAHAH, SALAM, ISTISHNA, IJAROH DLL)
PEMBIAYAAN MUDHARABAH
PEMBIAYAAN MUSYAROKAH
PEMBIAYAAN YANG DITERIMA
KEUNTUNGAN YANG SUDAH DIUMUMKAN BELUM
DIBAGI
INVESTASI TIDAK TERIKAT BANK (TABUNGAN DAN
DEPOSITO MUDHARABAH)
AGIO SAHAM (TAMBAHAN MODAL DISETOR)
LABA DITAHAN TAHUN-TAHUN SEBELUMNYA
JUMLAH KEWAJIBAN, ITT DAN EKUITAS
NILAI (US$)
DARI LAPORAN KEUANGAN
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
TRANSKRIP KUTIPAN ELEMEN-ELEMEN
2 0DALAM MATA UANG DOLLAR AMERIKA SERIKAT
INSURANCE COMPANY 8A-5
TAXABLE YEAR
TIN :
TAXPAYER'S NAME :
I. ELEMENTS FROM BALANCE SHEET
NO. NO.
1. INVESTMENTS - TIME DEPOSITS 1. OBLIGATION TO POLICYHOLDER
2. INVESTMENTS IN SHARES OF STOCK 2. OBLIGATION FOR FUTURE POLICY BENEFITS
3. INVESTMENTS - BONDS 3. ESTIMATED OWN RETENTION CLAIMS
4. INVESTMENTS - TRADING SECURITIES 4. CLAIMS PAYABLE
5. INVESMENTS-DIRECT SHARE 5.
6. INVESTMENTS- LAND AND BUILDING 6.
7. INVESTMENTS- MORTGAGES LOAN 7. DEPOSIT PREMIUMS
8. INVESTMENTS- INSURANCE POLICY LOANS 8. COMMISION PAYABLES
9. OTHER INVESTMENTS 9. RE-INSURANCE PAYABLES
10. CASH ON HAND AND IN BANKS 10. ACCRUED EXPENSES
11. PREMIUM RECEIVABLES 11. TAXES PAYABLE
12. RE-INSURANCE RECEIVABLES 12. DEFFERED TAX LIABILITIES
13. INVESTMENT RETURN RECEIVABLES 13. OTHER LIABILITIES
14. OTHER ACCOUNT RECEIVABLES 14. CAPITAL STOCK
15. PREPAID EXPENSES 15. ADDITIONAL PAID-IN CAPITAL
16. DEFFERED TAX ASSETS 16.
17. FIXED ASSETS 17.
18. LESS: ACCUMULATED DEPRECIATION 18.
19. DEFERRED ACQUISITION COST – NET 19. RETAINED EARNINGS
20. OTHER ASSETS 20. OTHER EQUITY
TOTAL ASSETS
II. ELEMENTS FROM INCOME STATEMENT
NO.
1. GROSS PREMIUMS
2. REINSURANCE PREMIUMS
3. DECREASE (INCREASE) IN UNEARNED PREMIUMS
4. TOTAL PREMIUMS INCOME (1 + 2 + 3)
5. NET INCOME FROM INVESTMENTS
6. OTHERS
7. TOTAL INCOME (4 + 5 + 6)
8. CLAIMS AND BENEFITS
9. RE-INSURANCE CLAIMS
10. INCREASE IN FUTURE POLICYHOLDER BENEFIT LIABILITIES AND ESTIMATED CLAIMS LIABILITIES
11. ACQUISITION COST
12. OPERATING EXPENSES
13. SELLING EXPENSES
14. GENERAL AND ADMINISTRATIVE EXPENSE
15. OTHER EXPENSES
16. TOTAL EXPENSES (TOTAL 8 TO 15)
17. INCOME FROM OPERATIONS (7 - 16)
18. NET EARNINGS OF ASSOCIATES
19. INCOME BEFORE INCOME TAX BENEFIT/(EXPENSE)(17+ 18)
20. INCOME TAX BENEFIT / (EXPENSE)
21. GAINS (LOSSES) FROM NORMAL ACTIVITIES (19 - 20)
22. EXTRA ORDINARY ITEMS
23. INCOME BEFORE MINORITY INTEREST IN NET EARNIGS OF SUBSIDIARIES (21 + 22)
24. MINORITY INTEREST IN NET EARNIGSSOF SUBSIDIARIES
25. NET PROFIT (23 - 24)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
2 0a. ….…………………………………,
(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIVE
c. FULL NAME OF MANAGEMENT/REPRESENTATIVE
8A-5 CORPORATE ANNUAL INCOME TAX RETURN
2 0
VALUE (IDR)
VALUE (IDR)
DESCRIPTION VALUE (IDR)
(d. Signature and Company Seal)
(date) (month) (year)
PARTIES TYPES OF TRANSACTION TRANSACTION VALUE (IDR)
DECLARATION
DESCRIPTION
TOTAL LIABILITIES AND OWNERS' EQUITY
NET UNREALIZED GAIN (LOSS) ON INCREASE (DECREASE) IN FAIR VALUE OF AVAILABLE FOR SALE SECURITIES
DIFFERENCE ON REVALUATION OF FIXED ASSET
DIFFERENCE IN VALUE RESULTING FROM RESTUCTURING TRANSACTION WITH ENTITIES UNDER COMMON CONTROL
TOTAL OBLIGATION TO POLICYHOLDER
DESCRIPTION
UNEARNED PREMIUMS
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
SPECIAL ATTACHMENT
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT
PERUSAHAAN 8A-5
ASURANSI TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
1. INVESTASI DEPOSITO 1. KEWAJIBAN KEPADA PEMEGANG POLIS
2. INVESTASI SAHAM 2. KEWAJIBAN MANFAAT POLIS MASA DEPAN
3. INVESTASI OBLIGASI 3. ESTIMASI KEWAJIBAN KLAIM
4. INVESTASI SURAT BERHARGA PASAR UANG 4. HUTANG KLAIM
5. INVESTASI PENYERTAAN LANGSUNG 5.
6. INVESTASI TANAH DAN BANGUNAN 6.
7. INVESTASI PINJAMAN HIPOTIK 7. TITIPAN PREMI
8. INVESTASI PINJAMAN POLIS 8. HUTANG KOMISI
9. INVESTASI LAINNYA 9. HUTANG REASURANSI
10. KAS DAN BANK 10. BIAYA MASIH HARUS DIBAYAR
11. PIUTANG PREMI 11. HUTANG PAJAK
12. PIUTANG REASURANSI 12. KEWAJIBAN PAJAK TANGGUHAN
13. PIUTANG HASIL INVESTASI 13. KEWAJIBAN LAIN-LAIN
14. PIUTANG LAIN-LAIN 14. MODAL SAHAM
15. BIAYA DIBAYAR DI MUKA 15. TAMBAHAN MODAL DISETOR
16. AKTIVA PAJAK TANGGUHAN 16.
17. AKTIVA TETAP 17.
18. DIKURANGI: AKUMULASI PENYUSUTAN 18.
19. BIAYA AKUISISI DITANGGUHKAN – BERSIH 19. SALDO LABA
20. AKTIVA LAIN-LAIN 20. EKUITAS LAIN-LAIN
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
1. PREMI BRUTO
2. PREMI REASURANSI
3. PENURUNAN (KENAIKAN) PREMI YANG BELUM MERUPAKAN PENDAPATAN
4. JUMLAH PENDAPATAN PREMI (1 + 2 + 3)
5. HASIL INVESTASI - BERSIH
6. LAIN-LAIN
7. JUMLAH PENDAPATAN (4 + 5 + 6)
8. KLAIM DAN MANFAAT
9. KLAIM REASURANSI
10. KENAIKAN KEWAJIBAN MANFAAT POLIS MASA DEPAN DAN ESTIMASI KEWAJIBAN KLAIM
11. BIAYA AKUISISI
12. BEBAN USAHA
13. PEMASARAN
14. UMUM DAN ADMINISTRASI
15. LAIN-LAIN
16. JUMLAH BEBAN (JUMLAH 8 S.D. 15)
17. LABA/RUGI USAHA (7 - 16)
18. BAGIAN LABA (RUGI) PERUSAHAAN ASOSIASI
19. LABA/RUGI SEBELUM PAJAK PENGHASILAN (17 + 18)
20. BEBAN (MANFAAT) PAJAK PENGHASILAN
21. LABA (RUGI) DARI AKTIVITAS NORMAL (19 - 20)
22. POS LUAR BIASA
23. LABA/RUGI SEBELUM HAK MINORITAS (21 + 22)
24. HAK MINORITAS ATAS LABA (RUGI) BERSIH ANAK PERUSAHAAN
25. LABA BERSIH (23 - 24)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
DARI LAPORAN KEUANGAN
LAMPIRAN KHUSUS
JUMLAH KEWAJIBAN KEPADA PEMEGANG POLIS
SELISIH PENILAIAN KEMBALI AKTIVA TETAP
SELISIH NILAI TRANSAKSI RESTRUKTURISASI
ENTITAS SEPENGENDALI
LABA BELUM DIREALISASI DARI EFEK TERSEDIA
UNTUK DIJUAL
JUMLAH KEWAJIBAN DAN EKUITAS
URAIAN
PERNYATAAN
(d. Tanda Tangan dan Cap Perusahaan)
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah
saya beritahukan di atas adalah benar, lengkap dan jelas.
(tgl) (bln) (thn)
PIHAK-PIHAK JENIS TRANSAKSI NILAI TRANSAKSI (RUPIAH)
URAIAN NILAI (RUPIAH)
NILAI (RUPIAH)
URAIAN NILAI (RUPIAH)
PREMI YANG BELUM MERUPAKAN
PENDAPATAN
8A-5SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
TRANSKRIP KUTIPAN ELEMEN-ELEMEN 2 0
INSURANCE COMPANY 8B-5
TAXABLE YEAR
TIN :
TAXPAYER'S NAME :
I. ELEMENTS FROM BALANCE SHEET
NO. NO.
1. INVESTMENTS - TIME DEPOSITS 1. OBLIGATION TO POLICYHOLDER
2. INVESTMENTS IN SHARES OF STOCK 2. OBLIGATION FOR FUTURE POLICY BENEFITS
3. INVESTMENTS - BONDS 3. ESTIMATED OWN RETENTION CLAIMS
4. INVESTMENTS - TRADING SECURITIES 4. CLAIMS PAYABLE
5. INVESMENTS-DIRECT SHARE 5.
6. INVESTMENTS- LAND AND BUILDING 6.
7. INVESTMENTS- MORTGAGES LOAN 7. DEPOSIT PREMIUMS
8. INVESTMENTS- INSURANCE POLICY LOANS 8. COMMISION PAYABLES
9. OTHER INVESTMENTS 9. RE-INSURANCE PAYABLES
10. CASH ON HAND AND IN BANKS 10. ACCRUED EXPENSES
11. PREMIUM RECEIVABLES 11. TAXES PAYABLE
12. RE-INSURANCE RECEIVABLES 12. DEFFERED TAX LIABILITIES
13. INVESTMENT RETURN RECEIVABLES 13. OTHER LIABILITIES
14. OTHER ACCOUNT RECEIVABLES 14. CAPITAL STOCK
15. PREPAID EXPENSES 15. ADDITIONAL PAID-IN CAPITAL
16. DEFFERED TAX ASSETS 16.
17. FIXED ASSETS 17.
18. LESS: ACCUMULATED DEPRECIATION 18.
19. DEFERRED ACQUISITION COST – NET 19. RETAINED EARNINGS
20. OTHER ASSETS 20. OTHER EQUITY
TOTAL ASSETS
II. ELEMENTS FROM INCOME STATEMENT
NO.
1. GROSS PREMIUMS
2. REINSURANCE PREMIUMS
3. DECREASE (INCREASE) IN UNEARNED PREMIUMS
4. TOTAL PREMIUMS INCOME (1 + 2 + 3)
5. NET INCOME FROM INVESTMENTS
6. OTHERS
7. TOTAL INCOME (4 + 5 + 6)
8. CLAIMS AND BENEFITS
9. RE-INSURANCE CLAIMS
10. INCREASE IN FUTURE POLICYHOLDER BENEFIT LIABILITIES AND ESTIMATED CLAIMS LIABILITIES
11. ACQUISITION COST
12. OPERATING EXPENSES
13. SELLING EXPENSES
14. GENERAL AND ADMINISTRATIVE EXPENSE
15. OTHER EXPENSES
16. TOTAL EXPENSES (TOTAL 8 TO 15)
17. INCOME FROM OPERATIONS (7 - 16)
18. NET EARNINGS OF ASSOCIATES
19. INCOME BEFORE INCOME TAX BENEFIT/(EXPENSE)(17+ 18)
20. INCOME TAX BENEFIT / (EXPENSE)
21. GAINS (LOSSES) FROM NORMAL ACTIVITIES (19 - 20)
22. EXTRA ORDINARY ITEMS
23. INCOME BEFORE MINORITY INTEREST IN NET EARNIGS OF SUBSIDIARIES (21 + 22)
24. MINORITY INTEREST IN NET EARNIGSSOF SUBSIDIARIES
25. NET PROFIT (23 - 24)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
2 0a. ….…………………………………,
(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIVE
c. FULL NAME OF MANAGEMENT/REPRESENTATIVE
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
SPECIAL ATTACHMENT
FOR CORPORATION PERMITTED TO MAINTAIN BOOKKEEPING IN ENGLISH LANGUAGE AND UNITED STATE DOLLAR CURRENCY
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT
DESCRIPTION
UNEARNED PREMIUMS
TOTAL OBLIGATION TO POLICYHOLDER
DIFFERENCE ON REVALUATION OF FIXED ASSET
DIFFERENCE IN VALUE RESULTING FROM RESTUCTURING TRANSACTION WITH ENTITIES UNDER COMMON CONTROL
NET UNREALIZED GAIN (LOSS) ON INCREASE (DECREASE) IN FAIR VALUE OF AVAILABLE FOR SALE SECURITIES
DESCRIPTION
TOTAL LIABILITIES AND OWNERS' EQUITY
PARTIES TYPES OF TRANSACTION TRANSACTION VALUE (US$)
DECLARATION
DESCRIPTION VALUE (US$)
(d. Signature and Company Seal)
(date) (month) (year)
8B-5 CORPORATE ANNUAL INCOME TAX RETURN
2 0
VALUE (US$)
VALUE (US$)
PERUSAHAAN 8B-5
ASURANSI TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
1. INVESTASI DEPOSITO 1. KEWAJIBAN KEPADA PEMEGANG POLIS
2. INVESTASI SAHAM 2. KEWAJIBAN MANFAAT POLIS MASA DEPAN
3. INVESTASI OBLIGASI 3. ESTIMASI KEWAJIBAN KLAIM
4. INVESTASI SURAT BERHARGA PASAR UANG 4. HUTANG KLAIM
5. INVESTASI PENYERTAAN LANGSUNG 5.
6. INVESTASI TANAH DAN BANGUNAN 6.
7. INVESTASI PINJAMAN HIPOTIK 7. TITIPAN PREMI
8. INVESTASI PINJAMAN POLIS 8. HUTANG KOMISI
9. INVESTASI LAINNYA 9. HUTANG REASURANSI
10. KAS DAN BANK 10. BIAYA MASIH HARUS DIBAYAR
11. PIUTANG PREMI 11. HUTANG PAJAK
12. PIUTANG REASURANSI 12. KEWAJIBAN PAJAK TANGGUHAN
13. PIUTANG HASIL INVESTASI 13. KEWAJIBAN LAIN-LAIN
14. PIUTANG LAIN-LAIN 14. MODAL SAHAM
15. BIAYA DIBAYAR DI MUKA 15. TAMBAHAN MODAL DISETOR
16. AKTIVA PAJAK TANGGUHAN 16.
17. AKTIVA TETAP 17.
18. DIKURANGI: AKUMULASI PENYUSUTAN 18.
19. BIAYA AKUISISI DITANGGUHKAN – BERSIH 19. SALDO LABA
20. AKTIVA LAIN-LAIN 20. EKUITAS LAIN-LAIN
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
1. PREMI BRUTO
2. PREMI REASURANSI
3. PENURUNAN (KENAIKAN) PREMI YANG BELUM MERUPAKAN PENDAPATAN
4. JUMLAH PENDAPATAN PREMI (1 + 2 + 3)
5. HASIL INVESTASI - BERSIH
6. LAIN-LAIN
7. JUMLAH PENDAPATAN (4 + 5 + 6)
8. KLAIM DAN MANFAAT
9. KLAIM REASURANSI
10. KENAIKAN KEWAJIBAN MANFAAT POLIS MASA DEPAN DAN ESTIMASI KEWAJIBAN KLAIM
11. BIAYA AKUISISI
12. BEBAN USAHA
13. PEMASARAN
14. UMUM DAN ADMINISTRASI
15. LAIN-LAIN
16. JUMLAH BEBAN (JUMLAH 8 S.D. 15)
17. LABA/RUGI USAHA (7 - 16)
18. BAGIAN LABA (RUGI) PERUSAHAAN ASOSIASI
19. LABA/RUGI SEBELUM PAJAK PENGHASILAN (17 + 18)
20. BEBAN (MANFAAT) PAJAK PENGHASILAN
21. LABA (RUGI) DARI AKTIVITAS NORMAL (19 - 20)
22. POS LUAR BIASA
23. LABA/RUGI SEBELUM HAK MINORITAS (21 + 22)
24. HAK MINORITAS ATAS LABA (RUGI) BERSIH ANAK PERUSAHAAN
25. LABA BERSIH (23 - 24)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
LAMPIRAN KHUSUS
TRANSKRIP KUTIPAN ELEMEN-ELEMEN
DARI LAPORAN KEUANGAN
JUMLAH KEWAJIBAN KEPADA PEMEGANG POLIS
SELISIH PENILAIAN KEMBALI AKTIVA TETAP
SELISIH NILAI TRANSAKSI RESTRUKTURISASI
ENTITAS SEPENGENDALI
LABA BELUM DIREALISASI DARI EFEK TERSEDIA
UNTUK DIJUAL
JUMLAH KEWAJIBAN DAN EKUITAS
URAIAN
PERNYATAAN
(d. Tanda Tangan dan Cap Perusahaan)
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah
saya beritahukan di atas adalah benar, lengkap dan jelas.
(tgl) (bln) (thn)
PIHAK-PIHAK JENIS TRANSAKSI NILAI TRANSAKSI (US$)
8B-5SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN 2 0
URAIAN NILAI (US$)
PREMI YANG BELUM MERUPAKAN
PENDAPATAN
URAIAN NILAI (US$)
NILAI (US$)
NON- 8A-6 QUALIFICATION
TAXABLE YEAR
TIN :
TAXPAYER'S NAME :
I. ELEMENTS FROM BALANCE SHEET
NO. NO.
1. CASH AND EQUIVALENT 1. ACCOUNT PAYABLE - THIRD PARTY
2. TEMPORARY INVESTMENT 2.
3. ACCOUNT RECEIVABLE - THIRD PARTIES 3. INTEREST PAYABLE
4. 4. INTEREST TAXES
5. OTHER ACCOUNT RECEIVABLE - THIRD PARTIES 5. DIVIDEND PAYABLE
6. 6. ACCRUED EXPENSES
7. ALLOWANCE FOR DOUBTFUL ACCOUNTS 7. BANK PAYABLES
8. INVENTORIES 8.
9. PREPAID EXPENSES 9. ADVANCES
10. PURCHASING DOWN PAYMENT 10. OTHER CURRENT LIABILITIES
11. OTHER CURRENT ASSETS 11. LONG - TERM DEBT-BANK LOANS
12. LONG - TERM RECEIVABLE 12.
13. LAND AND BUILDING 13.
14. OTHER FIXED ASSETS 14. DEFERRED TAX LIABILITIES
15. ACCUMULATED DEPRECIATION 15. OTHER NON CURRENT LIABILITIES
16. INVESTMENT IN ASSOCIATION COMPANIES 16. CAPITAL STOCK
17. OTHER LONG - TERM INVESTMENTS 17.
18. INTANGIBLE ASSETS 18.
19. DEFERRED TAX ASSETS 19. RETAINED EARNINGS
20. OTHER NON CURRENT ASSETS 20. OTHER EQUITY
TOTAL ASSETS
II. ELEMENTS FROM INCOME STATEMENT
NO.
1. NET SALES
2. BEGINNING INVENTORY
3. PURCHASE
4. ENDING INVENTORY
5. COST OF GOOD SOLD (2 + 3 - 4)
6. GROSS PROFIT (1 - 5)
7. SALES EXPENSE
8. GENERAL AND ADMINISTRATION EXPENSE
9. PROFIT (6 - 7 - 8)
10. INCOME/ (EXPENSE) OTHER
11. NET EARNINGS FROM ASSOCIATES
12. INCOME BEFORE INCOME TAX (9 + 10 + 11)
13. INCOME TAX BENEFIT( EXPENSE)
14. GAIN (LOSS) FROM NORMAL ACTIVITIES (12 - 13)
15. EXTRAORDINARY ITEMS
16. GAIN/LOSS BEFORE MINORITY INTEREST (14 + 15)
17. MINORITY INTEREST IN NET EARNING OF SUBSIDIARIES
18. NET PROFIT (16 - 17)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
2 0a. ….…………………………………,
(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIVE
c. FULL NAME OF MANAGEMENT/REPRESENTATIVE
8A-6 CORPORATE ANNUAL INCOME TAX RETURN
2 0TRANSCRIPT OF ELEMENTS CITATION OF
FINANCIAL STATEMENT
SPECIAL ATTACHMENT
DESCRIPTION
VALUE (IDR)
TOTAL LIABILITY AND OWNER'S EQUITY
DESCRIPTION
ADDITIONAL PAID-IN CAPITAL
RETAINED EARNING FROM PREVIOUS YEAR
DESCRIPTION VALUE (IDR) VALUE (IDR)
ACCOUNT PAYABLE - RELATED PARTIES
ACCOUNT RECEIVABLE - RELATED PARTIES
OTHER RECEIVABLE WITH RELATED PARTIES
LONG -TERM DEBT-RELATED PARTIES
LONG - TERM DEBTS-CURRENT MATURITIES
DECLARATION
(date) (month) (year)
(d. Signature and Company Seal)
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
PARTIES TYPES OF TRANSACTION TRANSACTION VALUE (IDR)
LONG - TERM DEBT-THIRD PARTIES
NON- 8A-6
KUALIFIKASI TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
1. KAS DAN SETARA KAS 1. HUTANG USAHA PIHAK KETIGA
2. INVESTASI SEMENTARA 2.
3. PIUTANG USAHA PIHAK KETIGA 3. HUTANG BUNGA
4. 4. HUTANG PAJAK
5. PIUTANG LAIN-LAIN PIHAK KETIGA 5. HUTANG DIVIDEN
6. 6. BIAYA YANG MASIH HARUS DIBAYAR
7. PENYISIHAN PIUTANG RAGU-RAGU 7. HUTANG BANK
8. PERSEDIAAN 8.
9. BEBAN DIBAYAR DI MUKA 9. UANG MUKA PELANGGAN
10. UANG MUKA PEMBELIAN 10. KEWAJIBAN LANCAR LAINNYA
11. AKTIVA LANCAR LAINNYA 11. HUTANG BANK JANGKA PANJANG
12. PIUTANG JANGKA PANJANG 12.
13. TANAH DAN BANGUNAN 13.
14. AKTIVA TETAP LAINNYA 14. KEWAJIBAN PAJAK TANGGUHAN
15. AKUMULASI PENYUSUTAN 15. KEWAJIBAN TIDAK LANCAR LAINNYA
16. INVESTASI PADA PERUSAHAAN ASOSIASI 16. MODAL SAHAM
17. INVESTASI JANGKA PANJANG LAINNYA 17.
18. HARTA TIDAK BERWUJUD 18.
19. AKTIVA PAJAK TANGGUHAN 19. LABA DITAHAN TAHUN INI
20. AKTIVA TIDAK LANCAR LAINNYA 20. EKUITAS LAIN-LAIN
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
1. PENJUALAN BERSIH
2. PERSEDIAAN AWAL
3. PEMBELIAN
4. PERSEDIAAN AKHIR
5. HARGA POKOK PENJUALAN (2 + 3 - 4)
6. LABA KOTOR (1 - 5)
7. BEBAN PENJUALAN
8. BEBAN UMUM DAN ADMINISTRASI
9. LABA USAHA (6 - 7 - 8)
10. PENGHASILAN/(BEBAN) LAIN
11. BAGIAN LABA (RUGI) PERUSAHAAN ASOSIASI
12. LABA/RUGI SEBELUM PAJAK PENGHASILAN (9 + 10 + 11)
13. BEBAN (MANFAAT) PAJAK PENGHASILAN
14. LABA (RUGI) DARI AKTIVITAS NORMAL (12 - 13)
15. POS LUAR BIASA
16. LABA/RUGI SEBELUM HAK MINORITAS (14 + 15)
17. HAK MINORITAS ATAS LABA (RUGI) BERSIH ANAK PERUSAHAAN
18. LABA BERSIH (16 - 17)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
PIHAK-PIHAK JENIS TRANSAKSI NILAI TRANSAKSI (RUPIAH)
DARI LAPORAN KEUANGAN
PERNYATAAN
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah
saya beritahukan di atas adalah benar, lengkap dan jelas.
(tgl) (bln) (thn)
(d. Tanda Tangan dan Cap Perusahaan)
HUTANG USAHA JANGKA PANJANG PIHAK LAIN
BAGIAN HUTANG JANGKA PANJANG YANG JATUH
TEMPO DALAM TAHUN BERJALAN
PIUTANG USAHA PIHAK YANG MEMPUNYAI HUBUNGAN
ISTIMEWA
PIUTANG LAIN-LAIN PIHAK YANG MEMPUNYAI HUBUNGAN
ISTIMEWA
URAIAN NILAI (RUPIAH) NILAI (RUPIAH)
HUTANG USAHA PIHAK YANG MEMPUNYAI
HUBUNGAN ISTIMEWA
HUTANG USAHA JANGKA PANJANG PIHAK YANG
MEMPUNYAI HUBUNGAN ISTIMEWA
AGIO SAHAM (TAMBAHAN MODAL DISETOR)
LABA DITAHAN TAHUN-TAHUN SEBELUMNYA
JUMLAH KEWAJIBAN DAN EKUITAS
URAIAN NILAI (RUPIAH)
LAMPIRAN KHUSUS
URAIAN
8A-6SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
TRANSKRIP KUTIPAN ELEMEN-ELEMEN 2 0
NON- 8B-6 QUALIFICATION
TAXABLE YEAR
TIN :
TAXPAYER'S NAME :
I. ELEMENTS FROM BALANCE SHEET
NO. NO.
1. CASH AND EQUIVALENT 1. ACCOUNT PAYABLE - THIRD PARTY
2. TEMPORARY INVESTMENT 2.
3. ACCOUNT RECEIVABLE - THIRD PARTIES 3. INTEREST PAYABLE
4. 4. INTEREST TAXES
5. OTHER ACCOUNT RECEIVABLE - THIRD PARTIES 5. DIVIDEND PAYABLE
6. 6. ACCRUED EXPENSES
7. ALLOWANCE FOR DOUBTFUL ACCOUNTS 7. BANK PAYABLES
8. INVENTORIES 8.
9. PREPAID EXPENSES 9. ADVANCES
10. PURCHASING DOWN PAYMENT 10. OTHER CURRENT LIABILITIES
11. OTHER CURRENT ASSETS 11. LONG - TERM DEBT-BANK LOANS
12. LONG - TERM RECEIVABLE 12.
13. LAND AND BUILDING 13.
14. OTHER FIXED ASSETS 14. DEFERRED TAX LIABILITIES
15. ACCUMULATED DEPRECIATION 15. OTHER NON CURRENT LIABILITIES
16. INVESTMENT IN ASSOCIATION COMPANIES 16. CAPITAL STOCK
17. OTHER LONG - TERM INVESTMENTS 17.
18. INTANGIBLE ASSETS 18.
19. DEFERRED TAX ASSETS 19. RETAINED EARNINGS
20. OTHER NON CURRENT ASSETS 20. OTHER EQUITY
TOTAL ASSETS
II. ELEMENTS FROM INCOME STATEMENT
NO.
1. NET SALES
2. BEGINNING INVENTORY
3. PURCHASE
4. ENDING INVENTORY
5. COST OF GOOD SOLD (2 + 3 - 4)
6. GROSS PROFIT (1 - 5)
7. SALES EXPENSE
8. GENERAL AND ADMINISTRATION EXPENSE
9. PROFIT (6 - 7 - 8)
10. INCOME/ (EXPENSE) OTHER
11. NET EARNINGS FROM ASSOCIATES
12. INCOME BEFORE INCOME TAX (9 + 10 + 11)
13. INCOME TAX BENEFIT( EXPENSE)
14. GAIN (LOSS) FROM NORMAL ACTIVITIES (12 - 13)
15. EXTRAORDINARY ITEMS
16. GAIN/LOSS BEFORE MINORITY INTEREST (14 + 15)
17. MINORITY INTEREST IN NET EARNING OF SUBSIDIARIES
18. NET PROFIT (16 - 17)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
2 0a. ….…………………………………,
(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIVE
c. FULL NAME OF MANAGEMENT/REPRESENTATIVE
PARTIES TYPES OF TRANSACTION TRANSACTION VALUE (US$)
LONG - TERM DEBT-THIRD PARTIES
DECLARATION
(date) (month) (year)
(d. Signature and Company Seal)
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
LONG -TERM DEBT-RELATED PARTIES
LONG - TERM DEBTS-CURRENT MATURITIES
ACCOUNT RECEIVABLE - RELATED PARTIES
OTHER RECEIVABLE WITH RELATED PARTIES
DESCRIPTION VALUE (US$) VALUE (US$)
ACCOUNT PAYABLE - RELATED PARTIES
ADDITIONAL PAID-IN CAPITAL
RETAINED EARNING FROM PREVIOUS YEAR
TOTAL LIABILITY AND OWNER'S EQUITY
DESCRIPTION VALUE (US$)
SPECIAL ATTACHMENT
DESCRIPTION
8B-6 CORPORATE ANNUAL INCOME TAX RETURN
2 0FOR CORPORATION PERMITTED TO MAINTAIN BOOKKEEPING IN ENGLISH LANGUAGE AND UNITED STATE DOLLAR CURRENCY
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT
NON- 8B-6
KUALIFIKASI TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
1. KAS DAN SETARA KAS 1. HUTANG USAHA PIHAK KETIGA
2. INVESTASI SEMENTARA 2.
3. PIUTANG USAHA PIHAK KETIGA 3. HUTANG BUNGA
4. 4. HUTANG PAJAK
5. PIUTANG LAIN-LAIN PIHAK KETIGA 5. HUTANG DIVIDEN
6. 6. BIAYA YANG MASIH HARUS DIBAYAR
7. PENYISIHAN PIUTANG RAGU-RAGU 7. HUTANG BANK
8. PERSEDIAAN 8.
9. BEBAN DIBAYAR DI MUKA 9. UANG MUKA PELANGGAN
10. UANG MUKA PEMBELIAN 10. KEWAJIBAN LANCAR LAINNYA
11. AKTIVA LANCAR LAINNYA 11. HUTANG BANK JANGKA PANJANG
12. PIUTANG JANGKA PANJANG 12.
13. TANAH DAN BANGUNAN 13.
14. AKTIVA TETAP LAINNYA 14. KEWAJIBAN PAJAK TANGGUHAN
15. AKUMULASI PENYUSUTAN 15. KEWAJIBAN TIDAK LANCAR LAINNYA
16. INVESTASI PADA PERUSAHAAN ASOSIASI 16. MODAL SAHAM
17. INVESTASI JANGKA PANJANG LAINNYA 17.
18. HARTA TIDAK BERWUJUD 18.
19. AKTIVA PAJAK TANGGUHAN 19. LABA DITAHAN TAHUN INI
20. AKTIVA TIDAK LANCAR LAINNYA 20. EKUITAS LAIN-LAIN
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
1. PENJUALAN BERSIH
2. PERSEDIAAN AWAL
3. PEMBELIAN
4. PERSEDIAAN AKHIR
5. HARGA POKOK PENJUALAN (2 + 3 - 4)
6. LABA KOTOR (1 - 5)
7. BEBAN PENJUALAN
8. BEBAN UMUM DAN ADMINISTRASI
9. LABA USAHA (6 - 7 - 8)
10. PENGHASILAN/(BEBAN) LAIN
11. BAGIAN LABA (RUGI) PERUSAHAAN ASOSIASI
12. LABA/RUGI SEBELUM PAJAK PENGHASILAN (9 + 10 + 11)
13. BEBAN (MANFAAT) PAJAK PENGHASILAN
14. LABA (RUGI) DARI AKTIVITAS NORMAL (12 - 13)
15. POS LUAR BIASA
16. LABA/RUGI SEBELUM HAK MINORITAS (14 + 15)
17. HAK MINORITAS ATAS LABA (RUGI) BERSIH ANAK PERUSAHAAN
18. LABA BERSIH (16 - 17)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
PIHAK-PIHAK JENIS TRANSAKSI NILAI TRANSAKSI (US$)
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
PERNYATAAN
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah
saya beritahukan di atas adalah benar, lengkap dan jelas.
(tgl) (bln) (thn)
(d. Tanda Tangan dan Cap Perusahaan)
HUTANG USAHA JANGKA PANJANG PIHAK LAIN
BAGIAN HUTANG JANGKA PANJANG YANG JATUH
TEMPO DALAM TAHUN BERJALAN
PIUTANG USAHA PIHAK YANG MEMPUNYAI HUBUNGAN
ISTIMEWA
PIUTANG LAIN-LAIN PIHAK YANG MEMPUNYAI HUBUNGAN
ISTIMEWA
URAIAN NILAI (US$) NILAI (US$)
HUTANG USAHA PIHAK YANG MEMPUNYAI
HUBUNGAN ISTIMEWA
HUTANG USAHA JANGKA PANJANG PIHAK YANG
MEMPUNYAI HUBUNGAN ISTIMEWA
AGIO SAHAM (TAMBAHAN MODAL DISETOR)
LABA DITAHAN TAHUN-TAHUN SEBELUMNYA
JUMLAH KEWAJIBAN DAN EKUITAS
URAIAN NILAI (US$)
LAMPIRAN KHUSUS
URAIAN
TRANSKRIP KUTIPAN ELEMEN-ELEMEN
DARI LAPORAN KEUANGAN
8B-6SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN 2 0
8A-7
TAXABLE YEAR
TIN :
TAXPAYER'S NAME :
I. ELEMENT FROM BALANCE SHEET
NO. NO.
INVESTMENT (Acquisition Cost) 1. ACTUARIAL LIABILITIES
1. DEPOSIT ON CALL 2.
2. TIME DEPOSIT NON ACTUARIAL LIABILITIES
3. 3. MATURE PENSION BENEFIT DEBTS
4. CERTIFICATES OF CENTRAL BANK 4. INVESTMENT PAYABLE
5. 5. PREPAID INCOME
6. BOND 6. ACCRUED EXPENSE
7. INVESTMENT IN MUTUAL FUND UNIT 7.
8. GOVERNMENT SECURITIES
9. COLLECTIVE INVESTMENT UNIT
10. DIRECT PLACEMENT
11. LETTER OF DEBT
12. LAND AND BUILDING (Net)
13. OTHER ALLOWED INVESTMENT
14. DIFFRENCE ON INVESTMENT CURRENT ASSETS
NON INVESTMENT CURRENT ASSETS
15. CASH AND BANK
16. CONTRIBUTIONS - NORMAL EMPLOYEE
17. CONTRIBUTIONS - NORMAL PARTICIPANT
18. CONTRIBUTIONS - ADDITIONAL PARTICIPANT
19. LATE PREMIUM INTEREST RECEIVABLE
20. PREPAID EXPENSE
21. INVESTMENT RECEIVABLE
22. INVESTMENT REVENUE RECEIVABLE
23. OTHER RECEIVABLE
OPERATING ASSETS
24. LAND AND BUILDING (Net)
25. OTHER OPERATING ASSETS (Net)
TOTAL ASSETS
II. ELEMENT FROM INCOME STATEMENT
NO.
1. INVESTMENT EARNING
2. INVESTMENT EXPENSE
3. RETURN ON INVESTMENT (1 - 2)
OPERATING EXPENSES :
4. SALARY/HONORARIUM OF EMPLOYEE , MANAGEMENT AND SUPERVISORY BOARD
5. OFFICE EXPENSES
6. MAINTENANCE EXPENSES
7. DEPRECIATION EXPENSES
8. EXPENSES OF THIRD PARTY'S SERVICE
9. OTHER OPERATING EXPENSES
10. TOTAL OPERATING EXPENSES (4 + 5 + 6 + 7 + 8 + 9)
11. OTHER INCOMES
12. OTHER EXPENSES
13. NET PROFIT (3 - 10 + 11 - 12)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
a. ….…………………………………, 2 0(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIF
c. FULL NAME OF MANAGEMENT/REPRESENTATIF
8A-7 PENSION FUNDSPECIAL ATTACHMENT
CORPORATE ANNUAL INCOME TAX RETURN
2 0
DESCRIPTION VALUE (IDR) DESCRIPTION VALUE(IDR)
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT
CERTIFICATE ON DEPOSIT
DIFFERENCE ON ACTUARIAL LIABILITIS
SHARE
OTHER NON ACTUARIAL LIABILITIES
TOTAL LIABILITES AND EQUITIES
DESCRIPTON VALUE (IDR)
(d. Signature and Company Seal)
PARTIES TYPES OF TRANSACTION TRANSACTION VALUE (IDR)
DECLARATION
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
(date) (month) (year)
8A-7
TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
INVESTASI (Harga Perolehan) 1. KEWAJIBAN AKTUARIA
1. DEPOSITO ON CALL 2.
2. DEPOSITO BERJANGKA KEWAJIBAN DILUAR KEWAJIBAN AKTUARIA
3. 3. HUTANG MANFAAT PENSIUN JATUH TEMPO
4. SERTIFIKAT BANK INDONESIA (SBI) 4. UTANG INVESTASI
5. 5. PENDAPATAN DITERIMA DIMUKA
6. OBLIGASI 6. BEBAN YANG MASIH HARUS DIBAYAR
7. UNIT PENYERTAAN REKSADANA 7.
8. SURAT BERHARGA PEMERINTAH
9. UNIT PENYERTAAN INVESTASI KOLEKTIF
10. PENEMPATAN LANGSUNG
11. SURAT PENGAKUAN UTANG
12. TANAH DAN BANGUNAN (Neto)
13. INVESTASI LAIN YANG DIPERKENANKAN
14. SELISIH PENELAIAN INVESTASI
AKTIVA LANCAR DILUAR INVESTASI
15. KAS & BANK
16. PIUTANG - IURAN NORMAL PEMBERI KERJA
17. PIUTANG - IURANG NORMAL PESERTA
18. PIUTANG - IURAN TAMBAHAN
19. PIUTANG BUNGA KETERLAMBATAN IURAN
20. BEBAN DIBAYAR DIMUKA
21. PIUTANG INVESTASI
22. PIUTANG HASIL INVESTASI
23. PIUTANG LAIN-LAIN
AKTIVA OPERASIONAL
24. TANAH DAN BANGUNAN (Neto)
25. AKTIVA OPERASIONAL LAIN (Neto)
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
1. PENDAPATAN INVESTASI
2. BEBAN INVESTASI
3. HASIL USAHA INVESTASI (1 - 2)
BEBAN OPERASIONAL :
4. GAJI/HONOR KARYAWAN, PENGURUS DAN DEWAN PENGAWAS
5. BEBAN KANTOR
6. BEBAN PEMELIHARAAN
7. BEBAN PENYUSUTAN
8. BEBAN JASA PIHAK KETIGA
9. BEBAN OPERASIONAL LAIN
10. TOTAL BEBAN OPERASIONAL (4 + 5 + 6 + 7 + 8 + 9)
11. PENDAPATAN LAIN-LAIN
12. BEBAN LAIN-LAIN
13. LABA BERSIH (3 - 10 + 11 - 12)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
8A-7 DANA PENSIUNLAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
TRANSKRIP KUTIPAN ELEMEN-ELEMEN 2 0
DARI LAPORAN KEUANGAN
URAIAN NILAI (RUPIAH) URAIAN NILAI (RUPIAH)
SELISIH KEWAJIBAN AKTUARIA
SERTIFIKAT DEPOSITO
SAHAM
KEWAJIBAN DILUAR KEWAJIBAN AKTUARIA LAIN
JUMLAH KEWAJIBAN DAN EKUITAS
URAIAN NILAI (RUPIAH)
PIHAK-PIHAK JENIS TRANSAKSI NILAI TRANSAKSI (RUPIAH)
PERNYATAAN
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah
saya beritahukan di atas adalah benar, lengkap dan jelas.
(tgl) (bln) (thn)
(d. Tanda Tangan dan Cap Perusahaan)
8B-7
TAXABLE YEAR
TIN :
TAXPAYER'S NAME :
I. ELEMENT FROM BALANCE SHEET
NO. NO.
INVESTMENT (Acquisition Cost) 1. ACTUARIAL LIABILITIES
1. DEPOSIT ON CALL 2.
2. TIME DEPOSIT NON ACTUARIAL LIABILITIES
3. 3. MATURE PENSION BENEFIT DEBTS
4. CERTIFICATES OF CENTRAL BANK 4. INVESTMENT PAYABLE
5. 5. PREPAID INCOME
6. BOND 6. ACCRUED EXPENSE
7. INVESTMENT IN MUTUAL FUND UNIT 7.
8. GOVERNMENT SECURITIES
9. COLLECTIVE INVESTMENT UNIT
10. DIRECT PLACEMENT
11. LETTER OF DEBT
12. LAND AND BUILDING (Net)
13. OTHER ALLOWED INVESTMENT
14. DIFFRENCE ON INVESTMENT APPRAISAL
NON INVESTMENT CURRENT ASSETS
15. CASH AND BANK
16. CONTRIBUTIONS - NORMAL EMPLOYEE
17. CONTRIBUTIONS - NORMAL PARTICIPANT
18. CONTRIBUTIONS - ADDITIONAL PARTICIPANT
19. LATE PREMIUM INTEREST RECEIVABLE
20. PREPAID EXPENSE
21. INVESTMENT RECEIVABLE
22. INVESTMENT REVENUE RECEIVABLE
23. OTHER RECEIVABLE
OPERATING ASSETS
24. LAND AND BUILDING (Net)
25. OTHER OPERATING ASSETS (Net)
TOTAL ASSETSTOTA
II. ELEMENT FROM INCOME STATEMENT
NO.
1. INVESTMENT EARNING
2. INVESTMENT EXPENSE
3. RETURN ON INVESTMENT (1 - 2)
OPERATING EXPENSES :
4. SALARY/HONORARIUM OF EMPLOYEE , MANAGEMENT AND SUPERVISORY BOARD
5. OFFICE EXPENSES
6. MAINTENANCE EXPENSES
7. DEPRECIATION EXPENSES
8. EXPENSES OF THIRD PARTY'S SERVICE
9. OTHER OPERATING EXPENSES
10. TOTAL OPERATING EXPENSES (4 + 5 + 6 + 7 + 8 + 9)
11. OTHER INCOMES
12. OTHER EXPENSES
13. NET PROFIT (3 - 10 + 11 - 12)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
a. ….…………………………………, 2 0(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIF
c. FULL NAME OF MANAGEMENT/REPRESENTATIF
(date) (month) (year)
(d. Signature and Company Seal)
PARTIES TYPES OF TRANSACTION TRANSACTION VALUE (US$)
DECLARATION
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
DESCRIPTON VALUE (RUPIAH)
OTHER NON ACTUARIAL LIABILITIES
CERTIFICATE ON DEPOSIT
SHARE
DIFFERENCE ON ACTUARIAL LIABILITIES
DESCRIPTION VALUE (US$) DESCRIPTION VALUE(US$)
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT
8B-7 PENSION FUNDSPECIAL ATTACHMENT
CORPORATE ANNUAL INCOME TAX RETURN
2 0
FOR TAXPAYER PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND UNITED STATED DOLLAR CURRENCY
8B-7
TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
INVESTASI (Harga Perolehan) 1. KEWAJIBAN AKTUARIA
1. DEPOSITO ON CALL 2.
2. DEPOSITO BERJANGKA KEWAJIBAN DILUAR KEWAJIBAN AKTUARIA
3. 3. HUTANG MANFAAT PENSIUN JATUH TEMPO
4. SERTIFIKAT BANK INDONESIA (SBI) 4. UTANG INVESTASI
5. 5. PENDAPATAN DITERIMA DIMUKA
6. OBLIGASI 6. BEBAN YANG MASIH HARUS DIBAYAR
7. UNIT PENYERTAAN REKSADANA 7.
8. SURAT BERHARGA PEMERINTAH
9. UNIT PENYERTAAN INVESTASI KOLEKTIF
10. PENEMPATAN LANGSUNG
11. SURAT PENGAKUAN UTANG
12. TANAH DAN BANGUNAN (Neto)
13. INVESTASI LAIN YANG DIPERKENANKAN
14. SELISIH PENELAIAN INVESTASI
AKTIVA LANCAR DILUAR INVESTASI
15. KAS & BANK
16. PIUTANG - IURAN NORMAL PEMBERI KERJA
17. PIUTANG - IURANG NORMAL PESERTA
18. PIUTANG - IURAN TAMBAHAN
19. PIUTANG BUNGA KETERLAMBATAN IURAN
20. BEBAN DIBAYAR DIMUKA
21. PIUTANG INVESTASI
22. PIUTANG HASIL INVESTASI
23. PIUTANG LAIN-LAIN
AKTIVA OPERASIONAL
24. TANAH DAN BANGUNAN (Neto)
25. AKTIVA OPERASIONAL LAIN (Neto)
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
1. PENADAPATAN INVESTASI
2. BEBAN INVESTASI
3. HASIL USAHA INVESTASI (1 - 2)
BEBAN OPERASIONAL :
4. GAJI/HONOR KARYAWAN, PENGURUS DAN DEWAN PENGAWAS
5. BEBAN KANTOR
6. BEBAN PEMELIHARAAN
7. BEBAN PENYUSUTAN
8. BEBAN JASA PIHAK KETIGA
9. BEBAN OPERASIONAL LAIN
10. TOTAL BEBAN OPERASIONAL (4 + 5 + 6 + 7 + 8 + 9)
11. PENDAPATAN LAIN-LAIN
12. BEBAN LAIN-LAIN
13. LABA BERSIH (3 - 10 + 11 - 12)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
DARI LAPORAN KEUANGAN
URAIAN
8B-7LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN DALAM MATA UANG DOLLAR AMERIKA
SERIKAT
DANA PENSIUN
KEWAJIBAN DILUAR KEWAJIBAN AKTUARIA LAIN
JUMLAH KEWAJIBAN DAN EKUITAS
URAIAN NILAI (RUPIAH)
SAHAM
2 0TRANSKRIP KUTIPAN ELEMEN-ELEMEN
PIHAK-PIHAK JENIS TRANSAKSI NILAI TRANSAKSI (RUPIAH)
NILAI (US$) URAIAN NILAI (US$)
SELISIH KEWAJIBAN AKTUARIA
SERTIFIKAT DEPOSITO
(d. Tanda Tangan dan Cap Perusahaan)
PERNYATAAN
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah
saya beritahukan di atas adalah benar, lengkap dan jelas.
(tgl) (bln) (thn)
FINANCING 8A-8
COMPANY TAXABLE YEAR
TIN :
TAXPAYER'S NAME :
I. ELEMENT FROM BALANCE SHEET
NO. NO.
CASH AND EQUIVALENT 1. LIABILITIES PAID IMMEDIATELY
1. CASH 2.
2. DOMESTIC BANK LOANS
3. 3. DOMESTIC
4. SHORT-TERM INVESTMENT IN SECURITIES 4. FOREIGN
5. SECURITIES ISSUED
5. LEASING 6. LIABILITIES OF DEFERRED TAX
6. FACTORING
7. CREDIT CARD 7. DOMESTIC
8. CONSUMEN FINANCE 8. FOREIGN
CAPITAL INVESTMENTS 9. OTHER LIABILITIES
9. BANK
10. OTHER FINANCE SERVICE COMPANY 10.
11. LONG-TERM INVESMENT IN SECURITIES 11. PREMIUM
12. OPERATING LEASE - NET 12. DISAGIO
FIXED ASSET AND INVENTORY - NET 13. COMMERCIAL RESERVE
13. LAND AND BUILDING 14.
14. FIXED ASSET OTHER THAN LAND AND BUILDING 15.
15. DEFFERED TAX ASSET 16. BALANCE- GAIN (LOSS)
16. OTHER ASSETS 17. GAIN (LOSSI) IN CURRENT YEAR
TOTAL ASSETS
II. ELEMENT FROM INCOME STATEMENT
NO.
OPERATING INCOME :
1. LEASING
2. FACTORING
3. CREDIT CARD
4. CONSUMEN FINANCING
5. INCOME FROM FINANCING DISTRIBUTION
6. TOTAL OPERATING INCOME (1 + 2 + 3 + 4 + 5)
OPERATING EXPENSES :
7. INTEREST
8. SWAP PREMIUMS
9. INSURANCE PREMIUMS
10. MANPOWER
11. DEPRECIATION
12. RECEIVABLE WRITE OFF ON FINANCING
13. RENT
14. OTHER OPERATING EXPENSES
15. TOTAL OPERATING EXPENSES (7 + 8 + 9 + 10 + 11 + 12 + 13 + 14)
16. NON OPERATING INCOME
17. NON OPERATING EXPENSE
13. NET PROFIT (3 - 10 + 11 - 12)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
a. ….…………………………………, 2 0(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIF
c. FULL NAME OF MANAGEMENT/REPRESENTATIF
8A-8SPECIAL ATTACHMENT
CORPORATE ANNUAL INCOME TAX RETURN
2
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
TAX PAYABLE
0
DESCRIPTION VALUE (IDR) DESCRIPTION VALUE (IDR)
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT
BANK-OVERSEAS
FINANCING RECEIVABLE - NET
SUBORDINATED DEBT
CAPITAL
PAID IN CAPITAL
APPROPRIATED RESERVE
REVALUATION RESERVE
TOTAL LIABILITES AND EQUITIES
DESCRIPTION VALUE (IDR)
(date) (month) (year)
(d. Signature and Company Seal)
TYPES OF TRANSACTION TRANSACTION VALUE (IDR)
DECLARATION
PARTIES
PERUSAHAAN 8A-8
PEMBIAYAAN TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
KAS DAN SETARA KAS 1. KEWAJIBAN YANG SEGERA DIBAYAR
1. KAS 2.
2. BANK DALAM NEGERI PINJAMAN YANG DITERIMA
3. 3. DALAM NEGERI
4. INVESTASI JANGKA PENDEK DALAM SURAT BERHARGA 4. LUAR NEGERI
5. SURAT BERHARGA YANG DITERBITKAN
5. SEWA GUNA USAHA 6. KEWAJIBAN PAJAK TANGUHAN
6. ANJAK PIUTANG
7. KARTU KREDIT 7. DALAM NEGERI
8. PEMBIAYAAN KONSUMEN 8. LUAR NEGERI
PENYERTAAN MODAL 9. KEWAJIBAN LAINNYA
9. BANK
10. PERUSAHAAN JASA KEUANGAN LAINNYA 10.
11. INVESTASI JANGKA PANAJANG DALAM SURAT BERHARGA 11. AGIO
12. AKTIVA TETAP YANG DISEWAGUNAUSAHAKAN - NETO 12. DISAGIO
AKTIIVA TETAP DAN INVENTARIS - NETO 13. CADANGAN UMUM
13. TANAH DAN BANGUNAN 14.
14. AKTIVA TETAP SELAIN TANAH DAN BANGUNAN 15.
15. AKTIVA PAJAK TANGGUHAN 16. SALDO LABA (RUGI)
16. AKTIVA LAIN-LAIN 17. LABA (RUGI) TAHUN BERJALAN
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
PENDAPATAN OPERASIONAL :
1. SEWA GUNA USAHA
2. ANJAK PIUTANG
3. KARTU KREDIT
4. PEMBIAYAAN KONSUMEN
5. PENDAPATAN DARI PENYALURAN PEMBIAAN
6. TOTAL PENDAPATAN OPERASIONAL (1 + 2 + 3 + 4 + 5)
BEBAN OPERASIONAL :
7. BUNGA
8. PREMI SWAP
9. PREMI ASURANSI
10. TENAGA KERJA
11. PENYUSUTAN
12. PENGHAPUSAN PIUTANG PEMBIAYAAN
13. SEWA
14. BIAYA OPERASIONAL LAIN
15. TOTAL BEBAN OPERASIONAL (7 + 8 + 9 + 10 + 11 + 12 + 13 + 14)
16. PENDAPATAN NON OPERASIONAL
17. BEBAN NON OPERASIONAL
13. LABA BERSIH (6 - 15 + 16 - 17)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
8A-8LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
TRANSKRIP KUTIPAN ELEMEN-ELEMEN 2 0
DARI LAPORAN KEUANGAN
URAIAN NILAI (RUPIAH) URAIAN NILAI (RUPIAH)
UTANG PAJAK
BANK LUAR NEGERI
PIUTANG PEMBIAYAAN - NETO
PINJAMAN SUBORDINASI
MODAL
MODAL DISETOR
CADANGAN TUJUAN
CADANGAN REVALUASI AKTIVA TETAP
JUMLAH KEWAJIBAN DAN EKUITAS
URAIAN NILAI (RUPIAH)
PERNYATAAN
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah
saya beritahukan di atas adalah benar, lengkap dan jelas.
(tgl) (bln) (thn)
(d. Tanda Tangan dan Cap Perusahaan)
PIHAK-PIHAK JENIS TRANSAKSI NILAI TRANSAKSI (RUPIAH)
FINANCING 8B-8
COMPANY
TAXABLE YEAR
TIN :
TAXPAYER'S NAME :
I. ELEMENT FROM BALANCE SHEET
NO. NO.
CASH AND EQUIVALENT 1. LIABILITIES PAID IMMEDIATELY
1. CASH 2.
2. DOMESTIC BANK LOANS
3. 3. DOMESTIC
4. SHORT-TERM INVESTMENT IN SECURITIES 4. FOREIGN
5. SECURITIES ISSUED
5. LEASING 6. LIABILITIES OF DEFERRED TAX
6. FACTORING
7. CREDIT CARD 7. DOMESTIC
8. CONSUMEN FINANCE 8. FOREIGN
CAPITAL INVESTMENTS 9. OTHER LIABILITIES
9. BANK
10. OTHER FINANCE SERVICE COMPANY 10.
11. LONG-TERM INVESMENT IN SECURITIES 11. PREMIUM
12. OPERATING LEASE - NET 12. DISAGIO
FIXED ASSET AND INVENTORY - NET 13. COMMERCIAL RESERVE
13. LAND AND BUILDING 14.
14. FIXED ASSET OTHER THAN LAND AND BUILDING 15.
15. DEFFERED TAX ASSET 16. BALANCE- GAIN (LOSS)
16. OTHER ASSETS 17. GAIN (LOSSI) IN CURRENT YEAR
TOTAL ASSETS
II. ELEMEN DARI LAPORAN ELEMENT FROM INCOME STATEMENT
NO.
OPERATING INCOME :
1. LEASING
2. FACTORING
3. CREDIT CARD
4. CONSUMEN FINANCING
5. INCOME FROM FINANCING DISTRIBUTION
6. TOTAL OPERATING INCOME (1 + 2 + 3 + 4 + 5)
OPERATING EXPENSES :
7. INTEREST
8. SWAP PREMIUMS
9. INSURANCE PREMIUMS
10. MANPOWER
11. DEPRECIATION
12. RECEIVABLE WRITE OFF ON FINANCING
13. RENT
14. OTHER OPERATING EXPENSES
15. TOTAL OPERATING EXPENSES (7 + 8 + 9 + 10 + 11 + 12 + 13 + 14)
16. NON OPERATING INCOME
17. NON OPERATING EXPENSE
13. NET PROFIT (3 - 10 + 11 - 12)
III. TRANSACTION WITH RELATED PARTIES UNDER FINANCIAL ACCOUNTING STANDARD GUIDELINES (PSAK) NUMBER 7
NO.
a. ….…………………………………, 2 0(Place)
b. TAXPAYER AUTHORIZED/REPRESENTATIF
c. FULL NAME OF MANAGEMENT/REPRESENTATIF
(date) (month) (year)
(d. Signature and Company Seal)
TYPES OF TRANSACTION TRANSACTION VALUE (US$)
DECLARATION
PARTIES
TOTAL LIABILITES AND EQUITIES
DESCRIPTION VALUE (US $)
APPROPRIATED RESERVE
REVALUATION RESERVE
CAPITAL
PAID IN CAPITAL
SUBORDINATED DEBT
FINANCING RECEIVABLE - NET
BANK-OVERSEAS
0
DESCRIPTION VALUE (US$) DESCRIPTION VALUE (US$)
TRANSCRIPT OF ELEMENTS CITATION OF FINANCIAL STATEMENT
8B-8SPECIAL ATTACHMENT
CORPORATE ANNUAL INCOME TAX RETURNFOR TAXPAYER PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND UNITED STATED
DOLLAR CURRENCY
2
Understanding All The Sanctions Provided by The Law and Regulations, I Hereby Declare that The Information Stated in this Return, Including All Attachments Provided, are True, Complete, Clear, and Under No Circumstances Whatsoever.
TAX PAYABLE
PERUSAHAAN 8B-8
PEMBIAYAAN
TAHUN PAJAK
NPWP :
NAMA WAJIB PAJAK :
I. ELEMEN DARI NERACA
NO. NO.
KAS DAN SETARA KAS 1. KEWAJIBAN YANG SEGERA DIBAYAR
1. KAS 2.
2. BANK DALAM NEGERI PINJAMAN YANG DITERIMA
3. 3. DALAM NEGERI
4. INVESTASI JANGKA PENDEK DALAM SURAT BERHARGA 4. LUAR NEGERI
5. SURAT BERHARGA YANG DITERBITKAN
5. SEWA GUNA USAHA 6. KEWAJIBAN PAJAK TANGUHAN
6. ANJAK PIUTANG
7. KARTU KREDIT 7. DALAM NEGERI
8. PEMBIAYAAN KONSUMEN 8. LUAR NEGERI
PENYERTAAN MODAL 9. KEWAJIBAN LAINNYA
9. BANK
10. PERUSAHAAN JASA KEUANGAN LAINNYA 10.
11. INVESTASI JANGKA PANAJANG DALAM SURAT BERHARGA 11. AGIO
12. AKTIVA TETAP YANG DISEWAGUNAUSAHAKAN - NETO 12. DISAGIO
AKTIIVA TETAP DAN INVENTARIS - NETO 13. CADANGAN UMUM
13. TANAH DAN BANGUNAN 14.
14. AKTIVA TETAP SELAIN TANAH DAN BANGUNAN 15.
15. AKTIVA PAJAK TANGGUHAN 16. SALDO LABA (RUGI)
16. AKTIVA LAIN-LAIN 17. LABA (RUGI) TAHUN BERJALAN
JUMLAH AKTIVA
II. ELEMEN DARI LAPORAN LABA/RUGI
NO.
PENDAPATAN OPERASIONAL :
1. SEWA GUNA USAHA
2. ANJAK PIUTANG
3. KARTU KREDIT
4. PEMBIAYAAN KONSUMEN
5. PENDAPATAN DARI PENYALURAN PEMBIAAN
6. TOTAL PENDAPATAN OPERASIONAL (1 + 2 + 3 + 4 + 5)
BEBAN OPERASIONAL :
7. BUNGA
8. PREMI SWAP
9. PREMI ASURANSI
10. TENAGA KERJA
11. PENYUSUTAN
12. PENGHAPUSAN PIUTANG PEMBIAYAAN
13. SEWA
14. BIAYA OPERASIONAL LAIN
15. TOTAL BEBAN OPERASIONAL (7 + 8 + 9 + 10 + 11 + 12 + 13 + 14)
16. PENDAPATAN NON OPERASIONAL
17. BEBAN NON OPERASIONAL
13. LABA BERSIH (3 - 10 + 11 - 12)
III. ELEMEN TRANSAKSI DENGAN PIHAK-PIHAK YANG MEMPUNYAI HUBUNGAN ISTIMEWA SESUAI DENGAN PSAK NOMOR 7
NO.
a. ….…………………………………, 2 0(Tempat)
b. WAJIB PAJAK KUASA
c. NAMA LENGKAP PENGURUS/KUASA
8B-8LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN DALAM MATA UANG DOLLAR AMERIKA
SERIKAT
TRANSKRIP KUTIPAN ELEMEN-ELEMEN 2 0
DARI LAPORAN KEUANGAN
URAIAN NILAI (US$) URAIAN NILAI (US$)
UTANG PAJAK
BANK LUAR NEGERI
PIUTANG PEMBIAYAAN - NETO
PINJAMAN SUBORDINASI
MODAL
MODAL DISETOR
CADANGAN TUJUAN
CADANGAN REVALUASI AKTIVA TETAP
JUMLAH KEWAJIBAN DAN EKUITAS
URAIAN NILAI (RUPIAH)
PERNYATAAN
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah
saya beritahukan di atas adalah benar, lengkap dan jelas.
(tgl) (bln) (thn)
(d. Tanda Tangan dan Cap Perusahaan)
PIHAK-PIHAK JENIS TRANSAKSI NILAI TRANSAKSI (RUPIAH)
T I N : TAXPAYER'S NAME:
BOOKS OF ACCOUNT PERIOD :
NO.
(1)
TOTAL
Notes:
• Filled with calculation of each Withholding Tax Receipt.
• Copy of Total Income Tax Article 22, Income Tax Article 23 and Income Tax Article 26 column (6) to Form 1771 Letter C Line 8.a.
Page- from page Attachment-III
D.1.1.32.32
WITHHOLDING AGENT
NAME
(2) (3)
TIN
(5)
(IDR)
(4)
WITHHOLDING OBJECT
TYPES OF INCOME/
TRANSACTION
1771 - III
DIRECTORATE GENERAL OF TAXES
IF NEEDED. ADDITIONAL PAGES MAY BE ADDEED
TTL
(7)(6) (8)
ANNUAL INCOME TAX RETURN FOR CORPORATE
DATE
TA
XA
BL
E Y
EA
R
WITHHOLDING RECEIPT/TAX PAYMENT SLIP (SSP)/SSPCP
MINISTRY OF FINANCE OF THE REPUBLIC OF
INDONESIA
(IDR)
INCOME TAX WITHHELD
FO
RM
FOREIGN TAX CREDIT
to
IDE
NT
ITY
ATTACHMENT - III
NUMBER
2 0A A
N P W P : NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
(1)
JUMLAH
Catatan :
• Diisi dengan rincian per Bukti Pemotongan / Pemungutan Pajak.
• Pindahkan hasil penjumlahan PPh Pasal 22, PPh Pasal 23 dan PPh Pasal 26 Kolom (6) ke Formulir 1771 Huruf C Angka 8.a.
Halaman ke- dari halaman Lampiran-III
D.1.1.32.32
s.d.
IDE
NT
ITA
S
LAMPIRAN - III
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADANKEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
JML
TA
HU
N P
AJA
K
FO
RM
UL
IR 1771 - III
KREDIT PAJAK DALAM NEGERI
NO.
(3)
OBJEK PEMOTONGAN / PEMUNGUTAN
JENIS PENGHASILAN /TANGGAL
PEMOTONG / PEMUNGUT PAJAK
NAMA NPWP
PAJAK PENGHASILAN
(2) (6)
BUKTI PEMOTONGAN / PEMUNGUTAN/SSP/SSPCP
NOMOR
(7) (8)
TRANSAKSI(Rupiah)
(4) (5)
YANG DIPOTONG / DIPUNGUT
(Rupiah)
2 0 A A
T I N : TAXPAYER'S NAME :
ACCOUNTING PERIOD :
(1)
Notes:
• Filled with calculation of each Withholding Tax Receipt.• Column (6) US$ filed with convertion value from the number in column (7) Rupiah, using Tax Rates which prevailing at the date of withholding• Copy of Total Income Tax Article 22, Income Tax Article 23 and Income Tax Article 26 column (6) to Form 1771/$ Letter C Line 8.a.
Pages- from page attachment-III
D.1.1.32.39
NAME TIN
WITHHOLDING AGENTNO.
TOTAL TTL
(5)
DIRECTORATE GENERAL OF TAXES FOREIGN TAX CREDIT
INCOME TAX WITHHELD
IF NEEDED. ADDITIONAL PAGES MAY BE ADDEED
NUMBER
(2) (3)
WITHHOLDING OBJECT
(US$)TYPES OF INCOME/
(4)
WITHHOLDING RECEIPT/TAX PAYMENT SLIP (SSP/SPPCP)
FO
RM
IDE
NT
ITY
TA
XA
BL
E Y
EA
R
ATTACHMENT - IIICORPORATE ANNUAL INCOME TAX RETURN
to
FOR CORPORATE PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
1771 - III/$MINISTRY OF FINANCE OF THE REPUBLIC
OF INDONESIA
DATE
(9)(US$) (IDR)
(6) (7) (8)
2 0 A A
N P W P : NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
(1)
Catatan :
• Diisi dengan rincian per Bukti Pemotongan / Pemungutan Pajak.• Kolom (6) US$ diisi dengan nilai konversi dari angka dalam Kolom (7) Rupiah, dengan menggunakan Kurs Pajak yang berlaku pada tanggal Pemotongan/Pemungutan• Pindahkan hasil penjumlahan PPh Pasal 22, PPh Pasal 23 dan PPh Pasal 26 Kolom (6) ke Formulir 1771/$ Huruf C Angka 8.a.
Halaman ke- dari halaman Lampiran-III
D.1.1.32.39
4.
NOMOR
(8)
2.
3.
NO.
(7)
14.
13.
8.
9.
10.
7.
11.
12.
5.
6.
1.
BUKTI PEMOTONGAN / PEMUNGUTAN/SSP/SSPCP
TANGGAL
(9)
IDE
NT
ITA
SSPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
KREDIT PAJAK DALAM NEGERI
FO
RM
UL
IR 1771 - III/$KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
(6)
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
TA
HU
N P
AJA
K
LAMPIRAN - III
DALAM BAHASA INGGRIS DAN MATA UANG DOLLAR AMERIKA SERIKAT
s.d.
NPWP
(2) (3) (4) (5)
PEMOTONG / PEMUNGUT PAJAK
NAMA
JUMLAH JML
PAJAK PENGHASILANYANG DIPOTONG / DIPUNGUT
(US$) (Rupiah)
OBJEK PEMOTONGAN / PEMUNGUTANJENIS PENGHASILAN /
TRANSAKSI (US$)
2 0A A
• LIST OF SHAREHOLDERS/CAPITAL OWNERS AND TOTAL DIVIDENDS DISTRIBUTED
• LIST OF DIRECTORS AND COMMISSIONERS
T I N :
TAXPAYER'S NAME :
BOOKS OF ACCOUNT PERIOD :
PART A: LIST OF SHAREHOLDERS/CAPITAL OWNERS AND TOTAL DIVIDENDS DISTRIBUTED
PART B: LIST OF DIRECTORS AND COMMISSIONERS
Page page Attachment-V
D.1.1.32.35
MINISTRY OF FINANCE OF THE REPUBLIC OF INDONESIA
T I NNAME ADDRESS
(2) (3) (4)
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
TA
XA
BL
E Y
EA
R
(1)
FO
RM 1771 - V
ATTACHMENT - V ANNUAL INCOME TAX RETURN FOR CORPORATE
to
IDE
NT
ITY
NO%
(2)
NAME ADDRESS T I N
(3) (4)
NO
(1)
DIVIDENDTOTAL PAID IN SHARES
(5)(IDR)
(7)(IDR)
(6)
(5)
POSITION
TPA
from
DIRECTORATE GENERAL OF TAXES
100%TOTAL PART A
2 0 A A
• DAFTAR PEMEGANG SAHAM/PEMILIK MODAL DAN JUMLAH DIVIDEN YANG DIBAGIKAN
• DAFTAR SUSUNAN PENGURUS DAN KOMISARIS
N P W P :
NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
BAGIAN A : DAFTAR PEMEGANG SAHAM / PEMILIK MODAL DAN JUMLAH DIVIDEN YANG DIBAGIKAN
(1)
JBA
BAGIAN B : DAFTAR SUSUNAN PENGURUS DAN KOMISARIS
NO
(1)
Halaman ke- dari halaman Lampiran-V
D.1.1.32.35
TA
HU
N P
AJ
AK
LAMPIRAN - V
KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
1771 - VF
OR
MU
LIR
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
s.d.
IDE
NT
ITA
S
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
100%
NO NAMA ALAMAT NPWPJUMLAH MODAL DISETOR
(Rupiah) %
DIVIDEN
(Rupiah)
(2) (3) (4) (5) (6) (7)
JUMLAH BAGIAN A
(2) (4) (5)
ALAMAT
(3)
NPWP JABATANNAMA
2 0A A
• LIST OF SHAREHOLDERS/CAPITAL OWNERS AND TOTAL DIVIDENDS DISTRIBUTED
• LIST OF DIRECTORS AND COMMISSIONERS
T I N :
TAXPAYER'S NAME :
ACCOUNTING PERIOD :
PART A: LIST OF SHAREHOLDERS/CAPITAL OWNERS AND TOTAL DIVIDENDS DISTRIBUTED
(3) (4)
PART B: LIST OF DIRECTORS AND COMMISSIONERS
(3) (4)
Page page Attachment-V
D.1.1.32.41
DIRECTORATE GENERAL OF TAXES
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
(6)
100%TPATOTAL PART A
CORPORATE ANNUAL INCOME TAX RETURN
to
TA
XA
BL
E Y
EA
R
(7)(US$)%
DIVIDEND
FO
RM
T I N
(2)
NAME ADDRESS
1771 - V/$MINISTRY OF FINANCE OF THE
REPUBLIC ON INDONESIA
NO
(1)
ATTACHMENT - V
TOTAL PAID IN SHARES(US$)
from
FOR CORPORATE PERMITTED TO MAINTAIN BOOKS IN ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
IDE
NT
ITY
NO
(1)
(5)
POSITIONT I NNAME ADDRESS(2) (5)
2 0 A A
• DAFTAR PEMEGANG SAHAM/PEMILIK MODAL DAN JUMLAH DIVIDEN YANG DIBAGIKAN
• DAFTAR SUSUNAN PENGURUS DAN KOMISARIS
N P W P :
NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
BAGIAN A : DAFTAR PEMEGANG SAHAM / PEMILIK MODAL DAN JUMLAH DIVIDEN YANG DIBAGIKAN
(1)
JBA
BAGIAN B : DAFTAR SUSUNAN PENGURUS DAN KOMISARIS
NO
(1)
Halaman ke- dari halaman Lampiran-V
D.1.1.32.41
10.
9.
8.
7.
6.
5.
4.
3.
2.
1.
NAMA ALAMAT NPWP JABATAN
(2) (3) (4) (5)
JUMLAH BAGIAN A
(5)(2) (3) (4)
NO NAMA ALAMAT NPWPJUMLAH MODAL DISETOR
(US$)
IDE
NT
ITA
S
s.d.
FO
RM
UL
IR
(US$)%
DIVIDEN
TA
HU
N P
AJ
AK
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM BAHASA INGGRIS DAN MATA UANG DOLLAR AMERIKA SERIKAT
LAMPIRAN - V
KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
1771 - V/$SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
(7)
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
(6)
100%
2 0A A
• LIST OF CAPITAL CONTRIBUTION IN AFFILIATION COMPANIES
• LIST OF ACCOUNT PAYABLE FROM SHARESHOLDERS AND/OR AFFILIATION COMPANIES
• LIST OF ACCOUNT RECEIVABLE TO SHARESHOLDERS AND/OR AFFILIATION COMPANIES
T I N :
TAXPAYER'S NAME :
BOOKS OF ACCOUNT PERIOD :
PART A : LIST OF CAPITAL CONTRIBUTION IN AFFILIATION COMPANIES
(1)
PART B : LIST OF ACCOUNT PAYABLE FROM SHARESHOLDER AND/OR AFFILIATION COMPANIES
(1)
PART C : LIST OF ACCOUNT RECEIVABLE TO SHARESHOLDER AND/OR AFFILIATION COMPANIES
(1)
Page- page Attachment-VI
D.1.1.32.36
TA
XA
BL
E Y
EA
R
FO
RM 1771 - VI
IDE
NT
ITY
to
DIRECTORATE GENERAL OF TAXES
ATTACHMENT - VI
MINISTRY OF FINANCE OF THE REPUBLIC OF INDONESIA
ANNUAL INCOME TAX RETURN FOR CORPORATE
NO%
ADDRESS T I NAMOUNT OF CAPITAL CONTRIBUTION
(IDR)NAME
(6)(2) (3) (4) (5)
TOTAL
NO NAME T I NTOTAL LOAN INTEREST/YR
(IDR) %
TTL
YEAR
(2) (3) (4) (5) (6)
(6)
INTEREST/YR
%
(4) (5)
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
NO NAME T I NTOTAL LOAN
YEAR(IDR)
from
(2) (3)
2 0 A A
• DAFTAR PENYERTAAN MODAL PADA PERUSAHAAN AFILIASI
• DAFTAR UTANG DARI PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
• DAFTAR PIUTANG KEPADA PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
N P W P :
NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
BAGIAN A : DAFTAR PENYERTAAN MODAL PADA PERUSAHAAN AFILIASI
(1)
JBA
BAGIAN B : DAFTAR UTANG DARI PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
(1)
BAGIAN C : DAFTAR PIUTANG KEPADA PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
(1)
Halaman ke- dari halaman Lampiran-VI
D.1.1.32.36
IDE
NT
ITA
S
s.d.
NO NAMA ALAMAT
(2)
NPWP
(4)
LAMPIRAN - VI
TA
HU
N P
AJ
AK
FO
RM
UL
IR 1771 - VI SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
NO NAMA NPWPJUMLAH PINJAMAN
TAHUN
JUMLAH BAGIAN A
%
(2) (3) (4) (5) (6)
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
NO NAMA N P W PJUMLAH PINJAMAN
TAHUN(Rupiah)
(3)
(2) (3) (4) (5) (6)
BUNGA/TH
%
BUNGA/TH
(Rupiah)
(Rupiah)
JUMLAH PENYERTAAN MODAL
%
(5) (6)
2 0 A
• LIST OF CAPITAL CONTRIBUTION IN AFFILIATION COMPANY
• LIST OF PAYABLE FROM SHARESHOLDER AND/OR AFFILIATION COMPANY
• LIST OF ACCOUNT RECEIVABLE TO SHARESHOLDER AND/OR AFFILIATION COMPANY
T I N :
TAXPAYER'S NAME :
ACCOUNTING PERIOD :
PART A : LIST OF CAPITAL CONTRIBUTION IN AFFILIATION COMPANY
(1)
PART B : LIST OF ACCOUNT PAYABLE FROM SHARESHOLDER AND/OR AFFILIATION COMPANY
(1)
PART C : LIST OF ACCOUNT RECEIVABLE TO SHARESHOLDER AND/OR AFFILIATION COMPANY
(1)
Page- page Attachment-VI
D.1.1.32.42
to
NO%
TA
XA
BL
E Y
EA
R
FO
RM
IDE
NT
ITY
NO NAME T I NTOTAL LOAN
(6)
YEARINTEREST/YR
(US$) %
(2) (3) (4) (5) (6)
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED from
NO NAME T I NTOTAL LOAN
(2) (3) (4)
(US$)
(5) (6)
YEARINTEREST/YR
%
1771 - VI/$MINISTRY OF FINANCE OF THE
REPUBLIC OF INDONESIA
(US$)
AMOUNT OF CAPITAL CONTRIBUTIONT I NNAME
DIRECTORATE GENERAL OF TAXES
ATTACHMENT - VICORPORATE ANNUAL INCOME TAX RETURN
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
ADDRESS
(2) (3) (4) (5)
TOTAL PART A TPA
2 0 A A
• DAFTAR PENYERTAAN MODAL PADA PERUSAHAAN AFILIASI
• DAFTAR UTANG DARI PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
• DAFTAR PIUTANG KEPADA PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
N P W P :
NAMA WAJIB PAJAK :
PERIODE PEMBUKUAN :
BAGIAN A : DAFTAR PENYERTAAN MODAL PADA PERUSAHAAN AFILIASI
(1)
JBA
BAGIAN B : DAFTAR UTANG DARI PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
(1)
BAGIAN C : DAFTAR PIUTANG KEPADA PEMEGANG SAHAM DAN/ATAU PERUSAHAAN AFILIASI
(1)
Halaman ke- dari halaman Lampiran-VI
D.1.1.32.42
JUMLAH BAGIAN A
NPWPJUMLAH PENYERTAAN MODAL
(US$)
(2) (3) (4) (5) (6)
(2) (3) (4) (5) (6)
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
NO NAMA N P W PJUMLAH PINJAMAN
TAHUNBUNGA/TH
(US$) %
TAHUNBUNGA/TH
(US$) %
(2) (3) (4) (5) (6)
NO NAMA N P W PJUMLAH PINJAMAN
IDE
NT
ITA
S
s.d.
NO%
NAMA ALAMAT
LAMPIRAN - VI
TA
HU
N P
AJ
AK
FO
RM
UL
IR 1771 - VI/$SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM BAHASA INGGRIS DAN MATA UANG DOLLAR AMERIKA SERIKAT
KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
2 0 A A
2A
TAXABLE YEAR 2 0
FOR TAXABLE YEAR AND CURRENT TAXABLE YEAR
T I N : TAXPAYER'S NAME
YEAR. YEAR. YEAR. YEAR. YEAR. YEAR.
(1)
NOTE: …………………………...…,
*) COPY THE AMOUNT OF THIS COLUMN TO FORM 1771 LETTER A LINE 2
**) COPY THE AMOUNT OF THIS COLUMN TO FORM 1771 LETTER E LINE 14 POINT b TAXPAYER / AUTHORIZED REPRESENTATIVE
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
CALCULATION OF FISCAL LOSS CARRY FORWARD
NO
LOSS AND FISCAL NET INCOME FISCAL LOSS CARRY FORWARD
YEAR IDR(THIS TAXABLE YEAR) (CURRENT TAXABLE YEAR)
(IDR) (IDR) (IDR) (IDR) IDR *) IDR**)
(2) (3) (4) (5) (6) (7) (8) (9)
TOTAL
(……………………………………………………………)
TTL
2A
TAHUN PAJAK 2 0
UNTUK TAHUN PAJAK DAN TAHUN PAJAK BERJALAN
N P W P : NAMA WAJIB PAJAK :
TH. TH. TH. TH. TH. TH.
(1)
J U M L A H
CATATAN : …………………………...…,
*) PINDAHKAN JUMLAH KOLOM INI KE FORMULIR 1771 HURUF A ANGKA 2
**) PINDAHKAN JUMLAH KOLOM INI KE FORMULIR 1771 HURUF E ANGKA 14 BUTIR b WAJIB PAJAK / KUASA
(……………………………………………………………)
JML
(8) (9)(2) (3) (4) (5) (6) (7)
(TAHUN BERJALAN)
(RUPIAH) (RUPIAH) (RUPIAH) (RUPIAH) RUPIAH *) RUPIAH **)
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
PERHITUNGAN KOMPENSASI KERUGIAN FISKAL
NO
KERUGIAN DAN PENGHASILAN NETO FISKAL KOMPENSASI KERUGIAN FISKAL
TAHUN RUPIAH(TAHUN PAJAK INI)
2B
TAXABLE YEAR 2 0
FOR TAXABLE YEAR AND CURRENT TAXABLE YEAR
T I N : TAXPAYER'S NAME
YEAR. YEAR. YEAR. YEAR. YEAR. YEAR.
(1)
NOTE: …………………………...…,
*) COPY THE AMOUNT OF THIS COLUMN TO FORM 1771 LETTER A LINE 2
**) COPY THE AMOUNT OF THIS COLUMN TO FORM 1771 LETTER E LINE 14 POINT b TAXPAYER / AUTHORIZED REPRESENTATIVE
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
CALCULATION OF FISCAL LOSS CARRY FORWARD
NO
LOSS AND FISCAL NET INCOME FISCAL LOSS CARRY FORWARD
YEAR US$(THIS TAXABLE YEAR) (CURRENT TAXABLE YEAR)
(US$) (US$) (US$) (US$) US$*) US$**)
(2) (3) (4) (5) (6) (7) (8) (9)
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH
LANGUAGE AND US DOLLAR CURRENCY
(……………………………………………………………)
TOTAL TTL
2B
TAHUN PAJAK 2 0
UNTUK TAHUN PAJAK DAN TAHUN PAJAK BERJALAN
N P W P : NAMA WAJIB PAJAK :
TH. TH. TH. TH. TH. TH.
(1)
J U M L A H
CATATAN : …………………………...…,
*) PINDAHKAN JUMLAH KOLOM INI KE FORMULIR 1771 /$ HURUF A ANGKA 2
**) PINDAHKAN JUMLAH KOLOM INI KE FORMULIR 1771 /$ HURUF E ANGKA 14 BUTIR b WAJIB PAJAK / KUASA
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADANBAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
PERHITUNGAN KOMPENSASI KERUGIAN FISKAL
NO
KERUGIAN DAN PENGHASILAN NETO FISKAL KOMPENSASI KERUGIAN FISKAL
TAHUN US$(TAHUN PAJAK INI) (TAHUN BERJALAN)
(US$) (US$) (US$) (US$) US$ *) US$ **)
(2) (3) (4) (5) (6) (7) (8) (9)
(……………………………………………………………)
JML
3A
FOR TAXABLE YEAR
T I N:
TAXPAYER'S NAME :
I LIST OF RELATED PARTIES
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
II DETAILS OF TRANSACTION WITH RELATED PARTIES
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
………………………,
TAXPAYER/AUTHORIZED REPRESENTATIVE
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
Determination of Price Method
shall be used Determination of Methods
(……………………………………………………………)
Types of Transaction Transaction's Value
STATEMENT OF TRANSACTION WITH RELATED PARTIES
Address Tax Identification Number (TIN) Business Activities
ANNUAL INCOME TAX RETURN FOR CORPORATE
SPECIAL ATTACHMENT
NameNo.
Name No.
Types of Relationship with
Taxpayer
3A
TAHUN PAJAK
NPWP:
Nama :
I DAFTAR PIHAK YANG MEMILIKI HUBUNGAN ISTIMEWA
No
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
II RINCIAN TRANSAKSI DENGAN PIHAK YANG MEMILIKI HUBUNGAN ISTIMEWA
No
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI ………………………,
WAJIB PAJAK / KUASA
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
LAMPIRAN KHUSUS
(……………………………………………………………)
4
5
2
3
Nama Mitra Transaksi Jenis Transaksi Nilai TransaksiMetode Penetapan Harga yang
digunakanAlasan Penggunaan Metode
1
4
5
2
3
Nama Alamat NPWP/ Tax Identification Number Kegiatan UsahaBentuk Hubungan dengan Wajib
Pajak
PERNYATAAN TRANSAKSI DENGAN PIHAK YANG MEMILIKI HUBUNGAN ISTIMEWA
1
3B
FOR TAXABLE YEAR
T I N:
TAXPAYER'S NAME :
I LIST OF RELATED PARTIES
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
II DETAILS OF TRANSACTION WITH RELATED PARTIES
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
………………………,
TAXPAYER/AUTHORIZED REPRESENTATIVE
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
(……………………………………………………………)
Determination of Price Method
shall be used Determination of MethodsNo. Name Types of Transaction Transaction's Value
STATEMENT OF TRANSACTION WITH RELATED PARTIES
No. Name Address Tax Identification Number (TIN) Business Activities Types of Relationship with Taxpayer
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN
ENGLISH LANGUAGE AND US DOLLAR CURRENCY
3B
NPWP:
Nama :
I DAFTAR PIHAK YANG MEMILIKI HUBUNGAN ISTIMEWA
No
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
1 2 3 4
II RINCIAN TRANSAKSI DENGAN PIHAK YANG MEMILIKI HUBUNGAN ISTIMEWA
No
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
………………………,
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
WAJIB PAJAK / KUASA
(……………………………………………………………)
Metode Penetapan Harga yang
digunakanAlasan Penggunaan MetodeNama Mitra Transaksi Jenis Transaksi Nilai Transaksi
Nama Alamat NPWP/ Tax Identification Number Kegiatan UsahaBentuk Hubungan dengan Wajib
Pajak
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
TAHUN PAJAK
PERNYATAAN TRANSAKSI DENGAN PIHAK YANG MEMILIKI HUBUNGAN ISTIMEWA
3A-2
FOR TAXABLE YEAR
TIN:
TAXPAYER'S NAME :
I
No
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
II DETERMINATION OF TRANSACTION'S VALUE ABOVE , SHALL BE REFERRED TO THE TERM ARMS LENGTH AND ORDINARY BUSINESS PRINCIPLE
YES NO
……………………….., ………………………
TAXPAYER/AUTHORIZED REPRESENTATIVE
( ………………………… )
IN CASE OF THE COMPANY HAS MADE TRANSACTIONS WITH PARTIES OF TAX HAVEN COUNTRY RESIDENT IN THIS TAXABLE YEAR
Name of Transaction Colleagues Types of Transaction Country Transaction Value
SPECIAL ATTACHMENT
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
ANNUAL INCOME TAX RETURN FOR CORPORATE
STATEMENT OF TRANSACTION WITH PARTIES OF TAX HAVEN COUNTRY RESIDENT
3A-2
TAHUN PAJAK
NPWP:
Nama :
I
No
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
II PENETAPAN NILAI TRANSAKSI DI ATAS, DITETAPKAN DENGAN MENGGUNAKAN PRINSIP KEWAJARAN DAN KELAZIMAN USAHA
Ya Tidak
……………………….., ………………………
WAJIB PAJAK / KUASA
( ………………………… )
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
PERNYATAAN TRANSAKSI DENGAN PIHAK YANG MERUPAKAN PENDUDUK NEGARA TAX HAVEN COUNTRY
5
4
3
2
1
DALAM HAL WAJIB PAJAK DALAM TAHUN PAJAK INI MELAKUKAN TRANSAKSI DENGAN PIHAK-PIHAK YANG MERUPAKAN PENDUDUK NEGARA TAX HAVEN COUNTRY
Nama Mitra Transaksi Jenis Transaksi Negara Nilai Transaksi
LAMPIRAN KHUSUS
3B-2
FOR TAXABLE YEAR
TIN:
TAXPAYER'S NAME :
I
No
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
II DETERMINATION OF TRANSACTION'S VALUE ABOVE , SHALL BE REFERRED TO THE TERM ARMS LENGTH AND ORDINARY BUSINESS PRINCIPLE
YES NO
……………………….., ………………………
TAXPAYER/AUTHORIZED REPRESENTATIVE
( ………………………… )
SPECIAL ATTACHMENT
ANNUAL INCOME TAX RETURN FOR CORPORATE
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF
ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
STATEMENT OF TRANSACTION WITH PARTIES OF TAX HAVEN COUNTRY RESIDENT
IN CASE OF THE COMPANY HAS MADE TRANSACTIONS WITH PARTIES OF TAX HAVEN COUNTRY RESIDENT IN THIS TAXABLE YEAR
Name of Transaction Colleagues Types of Transaction Country Transaction Value
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
3B-2
TAHUN PAJAK
NPWP:
Nama :
I
No
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
a b c d e f g
II PENETAPAN NILAI TRANSAKSI DI ATAS, DITETAPKAN DENGAN MENGGUNAKAN PRINSIP KEWAJARAN DAN KELAZIMAN USAHA
Ya Tidak
……………………….., ………………………
WAJIB PAJAK / KUASA
( ………………………… )
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
DALAM HAL WAJIB PAJAK DALAM TAHUN PAJAK INI MELAKUKAN TRANSAKSI DENGAN PIHAK-PIHAK YANG MERUPAKAN PENDUDUK NEGARA TAX HAVEN COUNTRY
Nama Mitra Transaksi Jenis Transaksi Negara Nilai Transaksi
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
PERNYATAAN TRANSAKSI DENGAN PIHAK YANG MERUPAKAN PENDUDUK NEGARA TAX HAVEN COUNTRY
5A
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME :
NOTE: ……………………………,
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
TAXPAYER /AUTHORIZED REPRESENTATIVE
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
2 0LIST OF BRANCH MAJOR
NO ADDRESS OF MAIN BRANCHES OFFICE TIN LOCATIONNUMBER OF MAIN
BRANCHES
(1) (2) (3) (4)
(……………………………………………………………)
5A
TAHUN PAJAK
N P W P :
NAMA WAJIB PAJAK :
CATATAN : ……………………………,
APABILA TIDAK MENCUKUPI DAPAT DIGANDAKAN
WAJIB PAJAK / KUASA
(……………………………………………………………)
(1) (2) (3) (4)
NO ALAMAT CABANG UTAMA NPWP LOKASI
JUMLAH
CABANG
PEMBANTU
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
2 0DAFTAR CABANG UTAMA PERUSAHAAN
5B
FOR TAXABLE YEAR
T I N :
TAXPAYER'S NAME :
NOTE: ……………………………,
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
TAXPAYER /AUTHORIZED REPRESENTATIVE
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
2 0LIST OF BRANCH MAJOR
NO ADDRESS OF MAIN BRANCHES OFFICE TIN LOCATIONNUMBER OF MAIN
BRANCHES
(1) (2) (3) (4)
(……………………………………………………………)
5B
TAHUN PAJAK
N P W P :
NAMA WAJIB PAJAK :
CATATAN : ……………………………,
APABILA TIDAK MENCUKUPI DAPAT DIGANDAKAN
WAJIB PAJAK / KUASA
LAMPIRAN KHUSUS
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADANBAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
2 0
DAFTAR CABANG UTAMA PERUSAHAAN
NO ALAMAT CABANG UTAMA NPWP LOKASI
JUMLAH
CABANG
PEMBANTU
(1) (2) (3) (4)
(……………………………………………………………)
7A
T I N : TAXPAYER'S NAME :
NOTES : ……………………,
• PLEASE FILL WITH THE DETAIL OF EACH WITHHOLDING RECEIPT/TAX PAYMENT.
• TAXPAYER / AUTHORIZED REPRESENTATIVE
• TAX CREDIT THAT CAN BE CREDITED IN COLUMN (8) SHALL BE CALCULATED BY ORDINARY CREDIT PER COUNTRY BASIS METHOD
• COPY THE TOTAL AMOUNT IN COLUMN (8) TO FORM 1771 LETTER C LINE 8.b.
• COPY THE TOTAL AMOUNT IN COLUMN (5) TO FORM 1771-I line 2.
• IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
SPECIAL ATTACHMENT
TAXABLE YEAR
2 0
(US$)
NO.
WITHHOLDING AGENT
TYPES OF INCOME
NET AMOUNTTAX DUE / PAID
IN FOREIGN COUNTRY
NAME ADDRESS(US$)
US$ FOREIGN EXCHANGE
(1) (2) (3) (4) (5) (6) (7) (8)
1,
2.
3.
4.
5.
6.
7.
8.
9.
10.
(……………………………………………………………)
ANNUAL INCOME TAX RETURN FOR CORPORATE
FOREIGN TAX CREDIT
TAX CREDITABLE
COLUMN (6) IDR FILL WITH CONVERTION VALUE FROM THE NUMBER IN COLUMN (7) FOREIGN EXCHANGE USING EXCHANGE RATE PREVAILING AT
THE TIME OF TAX PAYMENT/TAX DUE IN FOREIGN COUNTRY
TOTAL TTL
7A
N P W P : NAMA WAJIB PAJAK :
CATATAN : ……………………,
• DIISI DENGAN RINCIAN PER BUKTI PEMOTONGAN / PEMBAYARAN PAJAK.
• KOLOM (6) RUPIAH DIISI DENGAN NILAI KONVERSI DARI ANGKA DALAM KOLOM (7) VALAS DENGAN MENGGUNAKAN KURS PAJAK YANG WAJIB PAJAK / KUASA
BERLAKU PADA TANGGAL PEMBAYARAN / TERUTANGNYA PAJAK DI LUAR NEGERI.
• KREDIT PAJAK YANG DAPAT DIPERHITUNGKAN PADA KOLOM (8) DIHITUNG BERDASARKAN METODE ORDINARY CREDIT PER COUNTRY BASIS .
• PINDAHKAN HASIL PENJUMLAHAN KOLOM (8) KE FORMULIR 1771 HURUF C ANGKA 8.b.
• PINDAHKAN HASIL PENJUMLAHAN KOLOM (5) KE FORMULIR 1771-I Nomor 2.
• JIKA FORMULIR INI TIDAK CUKUP, DAPAT DIGANDAKAN SESUAI KEBUTUHAN.
JMLJUMLAH
(4)(3) (5) (6) (7) (8)
ALAMAT NO.
(1)
PEMOTONG PAJAK
NAMA
(2)
VALASRUPIAH
PAJAK YANG TERUTANG / DIBAYAR
DI LUAR NEGERIJENIS PENGHASILAN
JUMLAH NETO
(RUPIAH)
(……………………………………………………………)
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
(RUPIAH)
KREDIT PAJAK YANG
DAPAT DIPERHITUNGKAN
KREDIT PAJAK LUAR NEGERI
LAMPIRAN KHUSUS
TAHUN PAJAK
2 0
7B
T I N : TAXPAYER'S NAME :
FOR CORPORATION PERMITTED TO MAINTAIN BOOKS OF ACCOUNT IN ENGLISH LANGUAGE AND US DOLLAR CURRENCY
2.
(7) (8)
1,
(1) (2) (3) (4) (5) (6)
TAX CREDITABLEIN FOREIGN COUNTRYNAME ADDRESS
(US $)US $ FOREIGN EXCHANGE (US $)
FOREIGN TAX CREDIT
NO.WITHHOLDING AGENT
TYPES OF INCOMENET AMOUNT TAX DUE / PAID
SPECIAL ATTACHMENT ANNUAL INCOME TAX RETURN FOR CORPORATE
TAXABLE YEAR2 0
NOTES : ……………………,
TOTAL TTL
10.
9.
8.
7.
6.
5.
4.
3.
• PLEASE FILL WITH THE DETAIL OF EACH WITHHOLDING RECEIPT/TAX PAYMENT.
• TAXPAYER / AUTHORIZED REPRESENTATIVE
• TAX CREDIT THAT CAN BE CREDITED IN COLUMN (8) SHALL BE CALCULATED BY ORDINARY CREDIT PER COUNTRY BASIS METHOD
• COPY THE TOTAL AMOUNT IN COLUMN (8) TO FORM 1771 LETTER C LINE 8.b.
• COPY THE TOTAL AMOUNT IN COLUMN (5) TO FORM 1771-I line 2.
• IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
COLUMN (6) IDR FILL WITH CONVERTION VALUE FROM THE NUMBER IN COLUMN (7) FOREIGN EXCHANGE USING EXCHANGE RATE PREVAILING AT THE TIME OF TAX PAYMENT/TAX DUE IN FOREIGN COUNTRY
(……………………………………………………………)
7B
TAHUN PAJAK
N P W P : NAMA WAJIB PAJAK :
CATATAN : ……………………,
• DIISI DENGAN RINCIAN PER BUKTI PEMOTONGAN / PEMBAYARAN PAJAK.
• KOLOM (6) US $ DIISI DENGAN NILAI KONVERSI DARI ANGKA DALAM KOLOM (7) VALAS DENGAN MENGGUNAKAN KURS PAJAK YANG WAJIB PAJAK / KUASA
BERLAKU PADA TANGGAL PEMBAYARAN / TERUTANGNYA PAJAK DI LUAR NEGERI.
• KREDIT PAJAK YANG DAPAT DIPERHITUNGKAN PADA KOLOM (8) DIHITUNG BERDASARKAN METODE ORDINARY CREDIT PER COUNTRY BASIS .
• PINDAHKAN HASIL PENJUMLAHAN KOLOM (8) KE FORMULIR 1771/$ HURUF C ANGKA 8.b.
• PINDAHKAN HASIL PENJUMLAHAN KOLOM (5) KE FORMULIR 1771-I/$ NOMOR 2.
• JIKA FORMULIR INI TIDAK CUKUP, DAPAT DIGANDAKAN SESUAI KEBUTUHAN.
KREDIT PAJAK LUAR NEGERI
LAMPIRAN KHUSUS
BAGI WAJIB PAJAK YANG DIIZINKAN MENYELENGGARAKAN PEMBUKUAN
DALAM MATA UANG DOLLAR AMERIKA SERIKAT
2 0
SPT TAHUNAN PAJAK PENGHASILAN WAJIB PAJAK BADAN
NO.
PEMOTONG PAJAK
JENIS PENGHASILAN
JUMLAH NETOPAJAK YANG TERUTANG / DIBAYAR
(1) (2) (3)
4.
2.
(……………………………………………………………)
10.
9.
KREDIT PAJAK YANGDI LUAR NEGERI
NAMA ALAMAT (US$) DAPAT DIPERHITUNGKAN
US$ VALAS (US$)
(4) (5) (6) (7) (8)
1,
3.
5.
6.
7.
8.
JUMLAH JML