lembaga hasil dalam negeri malaysia c1 form …a closing date 5 (amo a lembaga hasil dalam negeri...
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LEMBAGA HASIL DALAM NEGERI MALAYSIA
RETURN FORM OF A CO-OPERATIVE SOCIETY
UNDER SECTION 77A INCOME TAX ACT 1967
This form is prescribed under section 152 Income Tax Act 1967 C1 Form
CP5(CS) [Pin. 2012]
YEAR OF ASSESSMENT
2012
1
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
1
5
4
3
<>>>>>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>? <>>>>>>>>?
[Declare in Ringgit Malaysia (RM) currency]
CS
E
1 = Yes
Opening Date of Accounts
6
7
Compliance with Public Rulings
Employer’s No.
Income Tax No.
Name of Co-operative Society
2 = No
Closing Date of Accounts
<>>>>>>?
Day Month Year
<>>>>>>?
Day Month Year
Record-keeping 8 1 = Yes
2 = No
Business Code Amount (RM)
STATUTORY INCOME, TOTAL INCOME AND TOTAL TAX CHARGEABLE PART A:
Statutory Business Income
<>>>?
A1 Business 1
Business 2
Income Tax No.
Statutory Partnership Income
Amount (RM)
Business 3
Business 4
Business 5 + 6 and so forth A5
A4 C4
A3
A2 <>>>?
<>>>?
<>>>?
<>>>?
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>_>>_>>_>>?
, , ,
<>>>>>>>>?
<>_>>_>>_>>?
Partnership 1
Partnership 2
D
D
, , ,
A7
A6
<>>>>>>>>?
<>_>>_>>_>>?
, , ,
Status of Tax ( f rom page 4 ) (Enter ‘X ’ in the re levant box )
Tax repayable (item B11)
Tax paid in excess (item C4)
There is balance of tax payable (item B10/C3 whichever is relevant)
Not taxable / Nil balance (if B10/B11/C3/C4 = ‘0’)
<>>>>>>>>>>>>>>?
2 Reference No. (Registration No.)
Date received (1) Date received (2) Date received (3)
For Office Use
<>_>>_>>_>>?
<>_>>_>>_>>?
A14
A15
A16
A17
A18
A19
A20
A21
A22
A23
A24
Other Statutory Income
Dividends
Interest and discounts
Rents, royalties and premiums
Other income
Additions pursuant to paragraph 43(1)(c)
Aggregate of other statutory income (A14 to A18)
AGGREGATE INCOME (A13 + A19)
Current year business losses (Restricted to A20)
TOTAL (A20 – A21)
Other Expenditure
Prospecting expenditure – Schedule 4 and paragraph 44(1)(b)
Pre-operation business expenditure – Schedule 4B and paragraph 44(1)(b
A14
A15
A16
A17
A18
A19
A20
A21
A22
A23
A24
<>_>>_>>_>>?, ,
<>_>>_>>_>>?
,
, ,
<>_>>_>>_>>?
,
, ,
<>_>>_>>_>>?
,
, ,
<>_>>_>>_>>?
,
, ,
<>_>>_>>_>>?
,
, , ,
<>_>>_>>_>>?,
, ,
, ,
,
, , ,
2
CS <>>>>>>>>?
LESS:
LESS:
<>_>>_>>_>>?, , , TOTAL (A22 – A23 – A24) A25 A25
A26
Donations / Gifts / Contributions / Zakat
A26 Gift of money to the Government / Local Authority
LESS:
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?
<>_>>_>>_>>?
, , ,
, , ,
Name of Co-operative Society Society
TOTAL (A11 – A12)
A11
A12
A13
Aggregate statutory income from businesses (A1 to A10)
Business losses brought forward (Restricted to A11)
A11
A12
A13
<>_>>_>>_>>?,
<>_>>_>>_>>?
, ,
<>_>>_>>_>>?
, , ,
, , ,
LESS:
D Partnership 3
Partnership 4
Partnership 5 + 6 and so forth
D
D A10
A9
A8 <>>>>>>>>?
<>>>>>>>>?
<>>>>>>>>?
<>_>>_>>_>>?
<>_>>_>>_>>?
<>_>>_>>_>>?, , ,
, , ,
, , ,
3
PART B: TAX PAYABLE
B3b
B3c
B2a
INCOME TAX COMPUTATION (AT FIXED RATE)
Apportionment of Income Tax
B1
5
8
B4
B1
B2
TOTAL INCOME TAX (B2a + B2b + B3a + B3b + B3c)
Tax on the balance
Tax on the first
Chargeable Income (from A36)
INCOME TAX COMPUTATION [AT CO-OPERATIVE SICIETY RATE (Refer to the schedule)]
B3a
B3
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>?, ,
<>_>>_>>?, ,
<>_>>_>>?, ,
<>_>>_>>_>>?, , ,
->>_>>_>>_>?, , , .
<>_>>_>>_>?, , . <?
<_?.
Rate (%)
At Rate (%)
->>_>>_>>_>?, , , .
->>_>>_>>_>?, , , . B4
A35
A34
Deduction under subsection 65A(b)
CHARGEABLE INCOME (A32 + A33 – A34 – A35) A36
A34
A35
A36
Deduction under subsection 65A(a)
LESS:
B2b
->>_>>_>>_>?, , , .
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
CS <>>>>>>>>?
Name of Co-operative Society
<>_>>_>>_>>?TAXABLE PIONEER INCOME A33
A32 A32
A33
, , ,
, , ,
TOTAL INCOME [A25 – (A26 to A31)]
A31 A31 Zakat Perniagaan (restricted to 2.5% of aggregate income in A20)
<>_>>_>>_>>?
A30
A28
A27C
A28
A30
A27B
A29A29
A27A
Gift of money for the provision of library facilities or to libraries
Gift of money or cost of contribution in kind for any approved sports activity or sports body
Gift of money or cost of contribution in kind for any project of national interest approved by the Minister of Finance
Gift of money to approved institutions or organisations
Restricted to 7% of A20
<>_>>_>>_>>?
<>_>>_>>_>>?
, , ,
, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
A27
Gift of artefacts, manuscripts or paintings
Gift of paintings to the National Art Gallery or State Art Gallery
Income Tax
Income Tax
<>_>>_>>?
<>_>>_>>?
<>_>>_>>?
<>_>>_>>?
<>_>>_>>?
<>_>>_>>?
<>_>>_>>?
<>_>>_>>?
<>_>>_>>?
<>_>>_>>?
<>_>>_>>_>>?
<>? Amount (RM)
, ,
D3
D2
D1
D4
D5
D11
Claim Code Amount (RM)
TOTAL CLAIMED (D1 to D10)
PART D: SPECIAL DEDUCTION, FURTHER DEDUCTION AND DOUBLE DEDUCTION Claim Code
D11
D8
D7
D6
D9
D10
<>? , ,
<>?
<>? , ,
<>? , ,
, ,
<>? , ,
<>? , ,
<>? , ,
<>? , ,
<>? , ,
, , ,
4
CS <>>>>>>>>?Name of Co-operative Society
->>_>>_>>_>?B5
B6
B8
B9
B10
B11
Section 133 tax relief
Total Deduction / Relief (B5 hingga B8)
TAX PAYABLE * (B4 – B9)
TAX REPAYABLE * (B9 – B4)
LESS:
B6
B8
B9
B10
B11
OR
Section 132 tax relief
Section 110 tax deduction (others)
Tax deduction under section 51 of Finance Act 2007 (dividends)
B5 , , , .
->>_>>_>>_>?, , , .
->>_>>_>>_>?, , , .
->>_>>_>>_>?, , , .
->>_>>_>>_>?, , , .
->>_>>_>>_>?, , , .
B7 B7 ->>_>>_>>_>?, , , .
PART C: STATUS OF TAX FOR YEAR OF ASSESSMENT 2012
->>_>>_>>_>?C1
C2
C3
C4
Tax payable (from B10)
Instalments paid
Balance of tax payable * (C1 – C2)
Tax paid in excess * (C2 – C1)
OR
, , ,
LESS:
C1
C2
C3
C4
->>_>>_>>_>?, , ,
->>_>>_>>_>?, , ,
->>_>>_>>_>?, , ,
.
.
.
. *Please enter the tax position (B10 / B11 / C3 / C4 whichever is applicable) under the item
‘Status of Tax’ on page 1.
Restricted to B4
[For a ‘Tax Repayable’ case, fill in items M7, M8 and M9 on page 9]
G1 Schedule 4 expenditure
G2 Schedule 4B expenditure
G3 Schedule 7A allowance
G1
G2
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , , <>_>>_>>_>>? , , ,
PART H: INCOME OF PRECEDING YEAR NOT DICLARED
H1 H1 <>_>>_>>_>>? , , ,
PART G: INCENTIVE CLAIM
5
CS <>>>>>>>>?
G4 Investment tax allowance <>_>>_>>_>>? , , , <>_>>_>>_>>? , , ,
Amount Absorbed
Balance Carried Forward
Chargeable income of preceding year not declared (if any)
PART J: DISPOSAL OF ASSET UNDER THE REAL PROPERTY GAINS TAX ACT 1976
J1 Has disposed of asset?
J2 Has the disposal been declared to LHDNM? (If J1 = 'Yes')
!
!
Name of Co-operative Society
1 = Yes 2 = No
1 = Yes 2 = No
<>_>>_>>_>>?
E1
E2
E3
E4
E5
E6
E7
E8
E9
E10
Business
PART E: CLAIM FOR SCHEDULE 3 ALLOWANCE Amount Absorbed
1
2
3
4
5
E1a
E5a
E4a
E3a
E2a
1
2
3
4
5
E6a
E10a
E9a
E8a
E7a
Balance Carried Forward
E1b
E5b
E4b
E3b
E2b
Balance Carried Forward
E6b
E10b
E9b
E8b
E7b
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
Partnership Amount Absorbed
F1A
F1
PART F: CLAIM FOR LOSSESType of Loss
F1Business/Partnership losses
Pioneer Losses
, , ,
Balance Carried Forward
<>_>>_>>_>>? , , ,
Amount Absorbed
<>_>>_>>_>>? , , ,
<>_>>_>>_>>?
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
K16
K17
K18
K19
K20
K21
K22
K23
Bad debts
Other expenses
TOTAL EXPENSES (K13 to K17)
NET PROFIT / LOSS
Non-allowable expenses
Fixed Assets:
Motor vehicles
Plant and machinery
Land and buildings
!(Enter “X” if value is negative)
K16
K17
K18
K19
K20
K21
K22
K23
CS <>>>>>>>>?
6
Name of Co-operative Society
PART K: FINANCIAL PARTICULARS OF CO-OPERATIVE SOCIETY Business Income (Main Business):
K1 Business Code
K2 Sales or turnover
K3 Opening stock
K4 Purchases and cost of production
K5 Closing stock
K6 Cost of sales (K3 + K4 – K5)
K7 GROSS PROFIT / LOSS (K2 – K6)
K8 Other business income
K9 Rental income
K10 Interest income
K11 Dividend income
K12 Other income
(Enter “X” if value is negative) !
K1
K2
K3
K4
K5
K6
K7
K8
K9
K10
K11
K12
<>>>?
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
LESS:
<>_>>_>>_>>?
<>_>>_>>_>>?
K13 Loan interest <>_>>_>>_>>? , , ,
, , ,
, , ,
K14
K15
Salaries and wages
Rental
K13
K14
K15
Expenses
Funds K39
TOTAL LIABILITY AND FUNDS (K38 + K39) K40
Amount of Members‘ Funds at the first dayof the basis period K41
Amount transferred during the basis period to the Statutory Reserve Fund pursuant to subsection 65A(a) K42
Amount pursuant to subsection 65A(b) K43
K39
K40
K41
K42
K43
<>_>>_>>_>>? , , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
7
CS <>>>>>>>>?
K37
K38
Other liabilities
TOTAL LIABILITY (K35 to K37 )
K37
K38
<>_>>_>>_>>? , , ,
<>_>>_>>_>>?, , ,
Name of Co-operative Society
<>_>>_>>_>>?
<>_>>_>>_>>?
<>_>>_>>_>>?
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>?, , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
<>_>>_>>_>>?
<>_>>_>>_>>?, , ,
, , ,
, , ,
, , ,
K24
K25
K26
K27
K28
K29
, , ,
K30
K31
K32
K33
Other fixed assets
TOTAL FIXED ASSET (K21 to K24)
Investments:
Investments
Current Assets:
Stock
Trade debtors
Sundry debtors
Cash at bank
Other current assets
TOTAL ASSET (K25 + K26 + K33)
TOTAL CURRENT ASSET (K27 to K32)
Cash in hand
K34
K24
K25
K26
K27
K28
K29
K30
K31
K32
K33
K34
!(Enter “X” if value is negative)
K35 Trade creditors
Sundry creditors
Liabilities:
K36
K35
K36
<>_>>_>>_>>? , , ,
<>_>>_>>_>>? , , ,
M4
M5
Date Registered
<>>>>>>>>>>>>>>>>>>>>>>>>? Place of Registration
<>>>>>>?Day Month Year
8
CS <>>>>>>>>?
M3 Address of Business Premise
State
Town Postcode
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>? <>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
Name of Co-operative Society
Section
107A
109
109A
109B
L1
L2
L3
L4
M1
M2 Correspondence Address
Total Gross Amount Paid Total Tax Withheld AndRemitted To LHDNM Total Net Amount Paid
PART M: PARTICULARS OF CO-OPERATIVE SOCIETY
Main Business Address
PART L: PARTICULARS OF WITHHOLDING TAXGross payments to non-residents subject to withholding tax provision under section 107A, 109, 109A, 109B and 109F.
State
Town Postcode
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>? <>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>_>>_>>?, ,
<>_>>_>>?, ,
<>_>>_>>?, ,
<>_>>_>>?, ,
<>_>>_>>?, ,
<>_>>_>>?, ,
<>_>>_>>?, ,
<>_>>_>>?, ,
<>_>>_>>?, ,
<>_>>_>>?, ,
<>_>>_>>?, ,
<>_>>_>>?, ,
State
Town Postcode
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>? <>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
109F L5 <>_>>_>>?, , <>_>>_>>?, , <>_>>_>>?, ,
9
CS <>>>>>>>>?
M14a
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
Particulars of Co-operative Society’s Principal OfficersM14
Name
Chairman
Treasurer
Secretary
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
Name of Co-operative Society
M8
M9
M10
M11
M12
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
!
Name of Bank
Bank Account Number
Address of Bank
Address where co-operative society’s records are
If item “M10” does not apply, state the address where the co-operative society’s records are maintained
Telephone No.
1 = Address as per M1 2 = Address as per M2 3 = Address as per M3
<>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
M7
e-Mail M13
State
Town Postcode
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>? <>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
State
Town Postcode
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>? <>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?Address
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>? Website / Blog address
M6
10
CS <>>>>>>>>?
Name
Identity Card / Police / Army / Passport No.
Income Tax No.
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>?
Particulars of co-operative society’s five board members M15
M15a
M15b
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>?<? Type of file:
SG/OG
Name <>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>>>>?<?SG/OG
Name of Co-operative Society
Identity Card / Police / Army / Passport No.
Income Tax No. Type of file:
Chairman
M14b Identity Card / Police / Army No.
Treasurer
Secretary
Chairman
Treasurer
Secretary
Chairman
Treasurer
Secretary
Chairman
Treasurer
Secretary
M14h Amount of Allowance
<>_>>_>>?, ,
<>_>>_>>?, ,
<>_>>_>>?, ,
Passport No. M14c
<>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>>>>>?
, ,
M14f Salary / Commission / Bonus
<>_>>_>>?
<>_>>_>>?, ,
<>_>>_>>?, ,
M14d Income Tax No.
<>>>>>>>>>?
<>>>>>>>>>?
<>>>>>>>>>?
<?
<?
<?
Type of file: SG/OG
Type of file: SG/OG
Type of file: SG/OG
Telephone No.
<>>>>>>>>>>>?
<>>>>>>>>>>>?
<>>>>>>>>>>>?
M14e
<_>?
<_>?
<_>?
.
.
Equity Holding (%) M14g
<>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>>>>>?
.
DECLARATION 11
CS <>>>>>>>>?Name of Co-operative Society
M15c
M15d
M15e
Name <>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>>>>?<?SG/OG
Name <>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>>>>?<?SG/OG
Name <>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>?
<>>>>>>>>>?<?SG/OG
Identity Card / Police / Army / Passport No.
Income Tax No. Type of file:
Identity Card / Police / Army / Passport No.
Income Tax No. Type of file:
Identity Card / Police / Army / Passport No.
Income Tax No. Type of file:
DECLARATION
I
Identity Card / Police / Army / Passport No.* (* Delete whichever is not relevant)
hereby declare that this return form contains information that is true, correct and complete pertaining to the income tax of the co-operative for the Year of Assessment 2012 as required under the Income Tax Act 1967.
<>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
Signature Date
Designation
Day Month Year <>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>>>?
12
CS <>>>>>>>>?Name of Co-operative Society
f Tax Agent’s Approval No. <>>>>>>>>>>>>>?
Signature Date
Day Month Year <>>>>>>?
Designation <>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
PARTICULARS OF THE FIRM AND SIGNATURE OF THE PERSON WHO COMPLETE THIS FORM
a
b
c
d
e
Name of Firm
Address of Firm
Telephone No.
<>>>>>>>>>>>>>>>>>>>>>>>>?
Postcode
State
Town
Handphone No.
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>>>>>>>>>>>>>>?
<>>>>>>>>>>>?
<>>>>>>>>>>>?
<>>>>>>>>>>>>>>>?<>>>?