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This document is a PAYE tax declaration form for a company called Energoinvest for the month of February 2021. It includes information like the company name and address, tax identification number, number of employees, total taxable income, and total tax withheld.

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Sileshi Gebru
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32 views

LaunchJasperReport F

This document is a PAYE tax declaration form for a company called Energoinvest for the month of February 2021. It includes information like the company name and address, tax identification number, number of employees, total taxable income, and total tax withheld.

Uploaded by

Sileshi Gebru
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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ETHIOPIAN REVENUES AND CUSTOMS SCHEDULE A-PAYE

AUTHORITY (MONTHLY)

Section 1 - Taxpayer Information


Taxpayer's Name: TIN: Tax Period:

Energoinvest 0000151254 Feb, 2021


Registration Addresse: Tax Account Number: (Official Use Only)

House No.: 19/396/13/306 3641230010


Kebele: WOREDA 03 Po.Box: 2596 Tax Centre:
Woreda: NO WOREDA-144 Document Number: 1629246850010
Zone/Sub-City: BOLE MOR-MEDIUM
Document Date: 02/02/2022
Region: ADDIS ABABA Ethiopia TAXPAYER
Telephone Number: Fax Number:
BRANCH OFFICE
Submission Number: 13340321378
Submission Date: 02/02/2022

Section 2 - Electronic Tax Declaration

Number of Employees on Your PayRoll for this Tax Period 10 3.00

Total Taxable Income 20 61,099.11

Total Tax Withheld 30 17,527.91

Section 3 - Taxpayer Certification


I declare that the above declaration and all information provided here-with is correct and complete. I understand that any misrepresentation
is punishable as per the Tax Law and the Penal Code. Declaration of preparer (other than the taxpayer) is based on all information of
which the preparer has any knowledge.
Printed Taxpayer Name or Authorized Date Company Seal For Official Use Only
Representative

Date of Payment Receipt Number


Signature of Taxpayer or Authorized
Representative

Amount of Payment Check Number


Printed Name of Preparer Date

Cashier's Signature
Signature of Preparer

Page 1 of 1

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