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MINISTRY OF HEALTH

ANNUAL RETURN OF TAX-DEDUCTIBLE RECEIPTS FOR INSTITUTION OF A PUBLIC


CHARACTER (IPC)

To: IPC Section FORM 6


Regulatory Compliance Division
Ministry of Health, HQ
College of Medicine Building
16 College Road
Singapore 169854

(i) This form must be signed by the President/Chairman/CEO or Honorary General


Secretary of the organisation.
(ii) This form must be submitted to the Ministry within 6 months after the close of the
organisation’s financial year-end.
(iii) If this is your first submission, please ensure all the funds raised prior to obtaining the
IPC status towards this fund is disclosed.

Name Of IPC:
IPC Reg. No:
Name Of Fund/Programme Approved
for IPC Status
Effective Date Of IPC Status
Approved Tax-Deductible Period:
Duration (In Years):
Information Declared For The Period :

PART I: FINANCIAL INFORMATION EXTRACTED FROM THE AUDITED STATEMENT OF


ACCOUNTS FOR PERIOD________________TO _________________

Total
A Tax-deductible donations $
B Income and donations received from other sources $
C Total Income $
D Total Expenditure $
E Excess/(Deficit) of total income over expenditure (C - D)

Breakdown of total expenditure:


1 - Direct Charitable Expenses $
2 - Fund raising expenses $
3 - All other operating expenses $

Percentage of expenditure relating to IPC activities over total %


income [(1+2)/C x 100]
Percentage of expenditure relating to non-IPC activities over total %
income [(3)/C x 100]
Explanation Notes:
(i) Charitable expenses refer to expenses incurred to meet the charity's objectives and other
charitable activities (both within and outside Singapore).
(ii) Fund raising expenses are expenses incurred in relation to fundraising activities.
(iii) All other operating expenses include expenses incurred for operating and administrative
purposes and are not charitable or fundraising in nature.
(iv) Please refer to MOH website for an updated definition of these financial terms.

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PART II: DECLARATION

On behalf of _________________________________________________(Name of IPC), I


____________________________ hereby declare that the above information is correct to
the best of my knowledge.

______________________ ______________ ___________


Name of Chairman/President Signature Date

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PART III: AUDITOR’S REPORT RELATED TO TAX-DEDUCTIBLE RECEIPTS

We have examined the Return of Tax-Deductible Receipts amounting to $____________


of______________________ (name of IPC) for the period from __________________to
_____________ (financial reporting period).

The Management/Trustees of the Fund* is responsible for establishing and maintaining


adequate accounting and internal control systems and for ensuring compliance with the
____________________________ (Please insert the prevailing Act and Regulations1
pertaining to the period under review). The Return is the responsibility of the
Management/Trustees of the Fund*. Our responsibility is to express an opinion on the
amounts shown in the Statements based on our examination.

Our examination was made in accordance with Singapore Standards on Auditing and,
accordingly, included such tests of the accounting records and such other auditing
procedures as we considered appropriate in the circumstances. We believe that our audit
provides a reasonable basis for our opinion.

In our opinion, the amounts of tax-deductible donations shown on the attached Return of Tax-
Deductible Receipts (marked for identification) totalling $_______ are in accordance with the
documents and records kept by [name of IPC] and have been included in accordance with
the relevant terms and conditions specified by the Ministry of Health.

During the course of our examination, nothing has come to our attention to cause us to
believe that:

a) Tax-deductible receipts were issued for donations other than outright cash donations;
b) Donations for which tax-deductible receipts have been issued were used for activities
other than those approved by the Regulations;
c) The internal accounting controls over the issue and custody of tax-deductible receipts
were inadequate;
d) There were significant contravention of the Regulations regarding the administration
of tax-deductible receipts;
e) Donations were used in contravention with the objects of the Fund.

Our report is solely for the purpose set forth in the first paragraph of this Auditor’s Report
Related to Tax Deductible Receipts and for your information, and is not to be used for any
other parties other than to the Ministry of Health. This report relates only to the items
specified in the Return and does not extend to any financial statements of the Fund, taken
as a whole.

______________ ___________________ ______________


Name of Auditor (Signature) Date

replace with appropriate terms

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Charities Act and all the Regulations – wef 1 Mar 2007
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