RETURN FORM OF A NON-RESIDENT INDIVIDUAL

e-M

UNDER SECTION 77 OF THE INCOME TAX ACT 1967

This form is prescribed under section 152 of the Income Tax Act 1967

YEAR OF ASSESSMENT

2014

PARTICULARS OF INDIVIDUAL
Name

YEW SHAN SHEN

(as per Identification document)

Income Tax No.

SG 12169635090

Citizen

SINGAPORE

Indentification No.

820208016014

Date of Birth

08/02/1982

Current Passport No.

E4664331A

Expiry Date of Current Passport

13/06/2019

Sex

FEMALE

Status as at 31-12-2014

SINGLE

Record -keeping

YES

Date of Marriage / Divorce /

Demise
Type of Assessment

SELF(SINGLE / DIVORCE / WIDOW / WIDOWER)

Identification No.

820208016014

Permanent Address in

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

Country of Origin of Individual

86000, KLUANG, JOHOR

Telephone No.

077723432

Name of Bank & Account No.

UNITED OVERSEAS BANK (MALAYSIA) BERHAD & 6013002948

Type of Foreign Currency

Requested

e-Mail

sunshine.yew@gmail.com

SWIFT Code

Employer's No.
STATUTORY INCOME AND TOTAL INCOME
Statutory income from businesss
Statutory income from partnerships
Aggregate statutory income from businesses

LESS: Business losses brought forward

TOTAL

Statutory income from employment / director's fees

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

State: Amount exempted

Statutory income from dividends and rents

0
8,400

Statutory income from discounts, premiums, pensions, annuities, other periodical payments,
other gains or profits and additions pursuant to paragraph 43(1)(c)
AGGREGATE INCOME
LESS : Current year business losses (Restricted to Aggregate income amount)
LESS : Qualifying prospecting expenditure - Schedule 4 and paragraph 44(1)(b)

8,400
0
9,180

LESS : Approved Donations / Gifts / Contributions

TOTAL

TAXABLE PIONEER INCOME

Gross income subject to tax at other rates. Please specify: ( )

TOTAL INCOME (SELF)

Tarikh cetakan : 11-04-2015 TT2014

Muka surat 1/4

Name

YEW SHAN SHEN

SG 12169635090

Income Tax No.

PARTICULARS OF HUSBAND / WIFE

Name of Husband / Wife

(as per Identification document)

Identification No.
Current Passport No.

Expiry Date of Current Passport

Date of Birth
INCOME OF PRECEDING YEARS NOT DECLARED
Type of Income

Year for which paid

Gross Amount

Provident and Pension Fund

Contribution

TAX PAYABLE / REPAYABLE

CHARGEABLE INCOME

COMPUTATION OF TAX CHARGEABLE

Division of Chargeable Income according to the rate applicable

Chargeable Income

Income Tax

Tax Rate (%)

26.00
0.00

0.00

0.00

0.00

TOTAL INCOME TAX

0.00

LESS:
Section 51 Finance

0.00

Act 2007 (dividends)

0.00

Section110
(others)

Section132 and
133

YEAR OF ASSESSMENT 2014 TAX PAYABLE

0.00

0.00
0.00

TAX SUMMARY
Chargeable Income

Total Income Tax

0.00

LESS : Total deduction and relief (Section 132 and 133 tax relief restricted to total)

0.00

YEAR OF ASSESSMENT 2014 TAX PAYABLE

0.00

Instalments/Monthly Tax Deductions Paid for 2014 Income SELF and HUSBAND / WIFE for joint assessment

0.00

Balance Of YA 2014 Tax Payable

0.00

Tarikh cetakan : 11-04-2015 TT2014

Muka surat 2/4

Name

YEW SHAN SHEN

Income Tax No.

SG 12169635090

FINANCIAL PARTICULARS OF INDIVIDUAL

Name of Business
Business Code

BALANCE SHEET

TRADING, PROFIT AND LOSS ACCOUNT

FIXED ASSETS

Sales/Turnover

Land and buildings

LESS :

Plant and machinery

Opening stock

Motor vehicles

Purchases and cost of production

Other fixed assets

Closing stock

TOTAL FIXED ASSETS

Cost of sales

0 Investments

GROSS PROFIT / LOSS

0 CURRENT ASSETS

OTHER INCOME

Stock

Other business income

Trade debtors

Dividends

Sundry debtors

Interest and discounts

Cash in hand

Rents, royalties and premiums

Cash at bank

Other income

Other current assets

TOTAL

0 TOTAL CURRENT ASSETS

EXPENSES

TOTAL ASSETS

Loan Interest

LIABILITIES

Salaries and wages

Loans and overdrafts

Rental/Lease

Trade creditors

Contracts and subcontracts

Sundry creditors

Commissions

TOTAL LIABILITIES

Bad debts

OWNER'S EQUITY

Travelling and transport

Capital account

Repairs and maintenance

Current account balance

brought forward

Promotion and advertisement

Current year profit/loss

Other expenses

Net advance/drawing

TOTAL EXPENDITURE

0
0

Current account balance carried

forward

NET PROFIT / LOSS

Non-allowable expenses

PARTICULAR OF BUSINESS INCOME

Losses carried forward

Pioneer loss carried forward
Business capital allowance carried forward
Partnership capital allowance carried forward

Tarikh cetakan : 11-04-2015 TT2014

Muka surat 3/4

Name

YEW SHAN SHEN

Income Tax No.

SG 12169635090

DECLARATION
I,

YEW SHAN SHEN

Identification No.

820208016014

hereby declare that the information regarding the income and claim for deductions and reliefs given by me in this return form is
true, correct and complete.
IMPORTANT REMINDER
* METHOD OF PAYMENT :
1. Payment can be made as follows :
1.1 Bank

- Information regarding payment via bank is available at the LHDNM Official Portal, http://www.hasil.gov.my

1.2 LHDNM

- ByrHASiL, via FPX (Financial Process Exchange) at the LHDNM Official Portal, http://www.hasil.gov.my
- LHDNM payment counters in Peninsular Malaysia (Kuala Lumpur Payment Centre), Sabah and FT Labuan

(LHDNM Kota Kinabalu Branch) and Sarawak (LHDNM Kuching Branch) or by mail. Cheques, money
orders and bank drafts must be crossed and made payable to the Director General of Inland Revenue.
When making payment, use the Remittance Slip (CP501) which is available at the LHDNM Official Portal,
http://www.hasil.gov.my
If sent by post, payment must be sent separately from the form. Payment by CASH must not be sent by
post.
1.3 Pos Malaysia
Berhad

counter and Pos Online

2. Write down the name, address, telephone number, income tax number, year of assessment , payment code "084" and
installment no. "99" on the reverse side of the financial instrument.
3. Check the receipts / bank payment slips before leaving the payment counter.

Tarikh cetakan : 11-04-2015 TT2014

Muka surat 4/4