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non-resident individual income tax - Lembaga Hasil Dalam Negeri

non-resident individual income tax - Lembaga Hasil Dalam Negeri

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Name<br />

Tax Reference No.<br />

Year of Assessment<br />

No.<br />

1<br />

2<br />

3<br />

4<br />

5<br />

6<br />

7<br />

8<br />

9<br />

10<br />

11<br />

12<br />

13<br />

14<br />

15<br />

Date of<br />

Payment<br />

For Year<br />

Ended<br />

Warrant No. /<br />

Serial No.<br />

Name of Company<br />

Total Regrossed<br />

I/C No.<br />

Tax<br />

Rate<br />

RM sen RM sen<br />

TOTAL NET DIVIDEND<br />

X [ amount from B(i) ] Y [ amount from B(ii) ]<br />

Net Dividend<br />

RM sen<br />

HK-3<br />

HK-3: TAX DEDUCTION UNDER SECTION 51 OF FINANCE ACT 2007 (DIVIDENDS)<br />

Business Registration No.<br />

Submit this Working Sheet if entitled to a <strong>tax</strong> refund (Use separate HK-3 for dividends regrossed)<br />

A. List of dividend <strong>income</strong>:<br />

Gross Dividend Tax Deducted<br />

Note: Proceed with the computation overleaf if the rate of <strong>tax</strong> deducted on dividend received as per voucher/certificate differs from the <strong>tax</strong> rate for current year of assessment<br />

Working Sheet page - 38

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