LEMBAGA HASIL DALAM NEGERI MALAYSIA

UNDER SECTION 77 INCOME TAX ACT 1967INCOME TAX FORM OF A DECEASED PERSON'S ESTATE

YEAR OF ASSESSMENT

2007<>>>>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>?

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Correspondence Address of Executor/ Administrator

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State <>>>>>>>>>>>>>>>?

FOR OFFICE USE

Day Month Year

1 = Yes

1 = Yes

Town

Postcode

Postcode

Statei

2 = No

2 =No

Day Month Year

PART A: PARTICULARS OF DECEASED PERSON'S ESTATE Domicile in Malaysia at the Time of Demise

State

1 = Yes 2 = None

2 = NoneDate of Demise

Letter of Administration / Grant of probate Compliance with Public Rulings

A2

A4

A6

A3

A5

A1

A7

Business Premise Address of Deceased Person's

A8

A9

A11

A10 Address where records of deceased person's estate are maintained

Tax Reference No. TP

Will

Date of Letter of Administration / Grant of Probate

Country of Domicile at Time of Demise

- --

Other address (if A10 = 3)

1 = 2 = 3 =

If maintained at address as per A8 If maintained at address as per A9 If maintained at an address other than A8 and A9

1

2

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-1-

Name of Deceased Person's Estate

A7a Record-keeping ! 2 = No 1 = Yes

(Use Country Code)

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Date received (1) Date received (2) Date received (3)

This form is prescribed under section 152 Income Tax Act 1967

1 = Yes

CP2C-Pin. 2007

TP Form

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<>>>>>>>>>>>>>>>>>>>>>>>? <>>>>>>>>>>>>>>? <>>>? TownPostcode

State

Address of Bank

Bank Account No.

Name of Bank

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Particulars of Executors / Administrators

Name

Tax Reference No.

Particulars of Executor's / Administrator's Bank (for purpose of income tax refund, if any)

Passport No.

-2-

Jenis fail: SG/OG/C

A13c

A13b

A13a

* delete whichever is not relevant

A13

A12e A12d

A12c A12b

A12a

A12

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Executor / Administrator I

Executor / Administrator II

Executor / Administrator I Executor / Administrator II

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Telephone No.

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<>>>>>>>>?Name of Deceased Person's Estate

Tax Reference No.

Wasi / Pentadbir I

Wasi / Pentadbir II

Identity Card/ Police/ Army/ Registration No *

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B1

B2

B3

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B7

B8

B9

Statutory Income From Business

Business Code Amount Business 1

Business 2

Business 3 + 4 and so forth ( if any )

Tax Reference No.

Statutory Income From Partnership

Amount

B4

B5

B6

B7

B8

B9

Partnership 1

Partnership 2

Partnership 3 + 4 and so forth ( if any )

Aggregate statutory income from businesses ( B1 to B6 )

LESS: Business losses brought forward (Restricted to amount in B7)

TOTAL ( B7 - B8 )

BAHAGIAN B: PENDAPATAN BERKANUN, JUMLAH PENDAPATAN DAN JUMLAH CUKAI YANG DIKENAKAN

Note: Fill in Part B if the taxpayer is DOMICILED in Malaysia at the time of his demise

PART B : STATUTORY INCOME, TOTAL INCOME AND TOTAL TAX CHARGEABLE

B10 B10

B11

B12

B13

B14

B15

B16

B17

B18

B19

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B12

B13

B14

B15

B16

B17

B18

B19

Dividends

STATUTORY INCOME FROM OTHER SOURCES

Interest and discounts

Rents, royalties and premiums

Annuities and other periodical payments

Other gains or profits

Additions pursuant to paragraph 43(1)(c)

Aggregate statutory income from other sources ( B10 to B15 )

AGGREGATE INCOME ( B9 + B16 )

LESS: Current year business losses (Restricted to amount in B17)

TOTAL ( B17 - B18 )

D

D

D

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Reference No.

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B21

B22

B23

B24

B25

B26

B27

Qualifying prospecting expenditure - Schedule 4 and paragraph 44(1)(b)

Qualifying farm expenditure - Schedule 4A and paragraph 44(1)(b)

TOTAL ( B19 - B20 - B21 ) ( Enter '0' if value is negative ))

LESS :

LESS : Other expenditure

B30

B28

B31

B33TOTAL INCOME ( B24 - B32 ) ( Enter '0' if value is negative )

Total donations and gifts ( B25 to B31 )

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B37

Tax on the first

Tax on the balance

TOTAL TAX CHARGEABLE ( B36a + B36b )

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At Rate (%)

B36

B36a

LESS: Personal relief

COMPUTATION OF TAX CHARGEABLE ( Refer to the tax rates schedule provided )

->>?B34

B27

B28

B30

B31

B32

B33

B35

B22

B24

B25

B26

B23

Gift of artefacts, manuscripts or paintings

Gift of money for the provision of library facilities or to libraries

Gift of money to the Government / State Government, local authorities or approved institutions and organisations

B20

B21

TOTAL ( B22 - B23 ) ( Enter '0' if value is negative )

LESS : Donations and Gifts

Annuities payable / periodical payments

, 8 0 0 0

Gift of paintings to the National Art Gallery or any state art gallery

CHARGEABLE INCOME ( B33 - B34 ) ( Enter '0' if value is negative )

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Gift of money or contribution in kind for any approved sports activity (B30+B31 restricted to 7% of aggregate income in B17) Gift of money or contribution in kind for any project of national interest approved by the Minister of Finance (B30+B31 restricted to 7% of aggregate income in B17)

B32

B36b

B35

B37

B29B29 Business zakat (restricted to 2.5% of aggregate income in B17) <>_>>_>>_>>? , , ,

Note: Fill in Part C if the taxpayer is NOT DOMICILED in Malaysia at the time of his demise

PART C : STATUTORY INCOME, TOTAL INCOME AND TOTAL TAX CHARGEABLE

Statutory Income From Business Business Code

Amount

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Tax Reference No.Statutory Income From Partnership

Amount

C7

C8

C9

C10

C11

C12

C13

C14

C15

C16

C17

C18

C19

-5-

C22

C20

C21

C17

C18

C19

C20

C21

C22

C13

C14

C15

C16

C8

C9

C10

C11

C12

C4

C5

C6

C7

C1

C2

C3

Business 1

Business 2

Business 3 + 4 and so forth ( if any )

Partnership 1

Partnership 2

Partnership 3 + 4 and so forth ( if any )

LESS: Business losses brought forward (Restricted to amount in C7)

Dividends

TOTAL ( C7 - C8 ) STATUTORY INCOME FROM OTHER SOURCES

Rents and premiums

Annuities and other periodical payments

Other gains or profits

Additions pursuant to paragraph 43(1)(c)

Discounts

Aggregate statutory income from other sources ( C10 to C15 )

AGGREGATE INCOME ( C9 + C16 )

LESS: Current year business losses (Restricted to amount in C17)

TOTAL ( C17 - C18 )

LESS : Other expenditure Qualifying prospecting expenditure - Schedule 4 and paragraph 44(1)(b) Qualifying farm expenditure - Schedule 4A and paragraph 44(1)(b) TOTAL ( C19 - C20 - C21 ) ( Enter '0' if value is negative )

D

D

D

Aggregate statutory income from businesses ( C1 to C6 )

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27

5

8

10

12

15

C23

C24

C25

C26

C28

C27

C32

C33

C34a

C34b

C34c

C34d

C35

C31

C23

C24

C25

C27

C28

C30

C32

C26

C33

C34

C34a

C34b

C34c

C34d

C36

C36a

C35

C36b

C36c

C36d

C36e

C36f

Gross income subject to tax at other rates

TOTAL INCOME/CHARGEABLE INCOME( C33 to C34d )

COMPUTATION OF TAX CHARGEABLE

Chargeable Income Rate (%) Tax Chargeable

TOTAL INCOME ( C24 – C32 ) ( Enter '0' if value is negative )Gross income subject to tax at other rates

C37

Division of chargeable income according to the rate applicable

Royalties

Interest

Special classes of income under section 4A

Other income (please specify)

LESS :

TOTAL ( C22 - C23 ) ( Enter '0' if value is negative ) LESS : Donations and Gifts

Total donations and gifts ( C25 to C31 )

Gift of money for the provision of library facilities or to libraries

Gift of artefacts, manuscripts or paintings

Annuities payable / periodical payments

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Gift of money to the Government/ State Government, local authorities or approved institutions and organisations

Gift of paintings to the National Art Gallery or any state art gallery

TOTAL TAX CHARGEABLE ( C36a to C36g )

C30

C31

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Gift of money or contribution in kind for any approved sports activity (C30+C31 restricted to 7% of aggregate income in C17). Gift of money or contribution in kind for any project of national interest approved by the Minister of Finance (C30+C31 restricted to 7% of aggregate income in C17).

C36g

C37

C29C29 <>_>>_>>_>>?, , , Business zakat (restricted to 2.5% of aggregate income in C17)

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PART E: STATUS OF TAX FOR YEAR OF ASSESSMENT 2007

Year for which paid

!

-7-

Has the disposal been declared to Lembaga Hasil DalamNegeri Malaysia? (if G1 = 1)

Any disposal of shares in a real property company and/or real property?

Type of Income Gross Amount

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PART G :

1 = Yes 2 = No

1 = Yes 2 = No

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E2

E3

E1

D6

D2

D3

D4

D5

D1

E1

E4

E2

E3

E4

PART F: PRECEDING YEARS' INCOME NOT DECLARED

PART D: TAX PAYABLE / REPAYABLE

D4

D5

D6

F1

F3

F2

G1

G2

Section 110 tax deduction (dividends)

Section 132 tax relief

OR

LESS

Tax payable ( from D6 )

LESS : Installments paid

Balance of tax payable ( E1 - E2 )

Tax paid in excess ( E2 - E1 )

D3

D2

D1

Secton 110 tax deduction (others)

,

Section 133 tax relief

D7 TAX REPAYABLE [ ( D2 to D5 ) - D1 ] D7

TAX PAYABLE [ D1 - ( D2 to D5 ) ]

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DISPOSAL OF SHARES IN A REAL PROPERTY COMPANY AND DISPOSAL OF REAL PROPERTY SUBJECT TO REAL PROPERTY GAINS TAX PROVISION

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Reference No.

TOTAL TAX CHARGEABLE (from B36 or C36 )

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PART H: PARTICULARS OF BUSINESS INCOME

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H1a

H1b

H1c

Allowance Absorbed Balanced Carried Forward

Losses carried forward ( H1a + H1b )

Business 1

LOSSES

Balance from previous years' losses

Balance from current year losses

CAPITAL ALLOWANCES

H1

H1a

H1b

H1c

H2

H2e

H2f

H3

H2a

H2b

H2c

H2d

H3a

H3b

H3c

H3d

Section Total Gross Amount Paid

107A

PARTICULARS OF WITHHOLDING TAXES

109

109A

109B

Partnership 2

Partnership 3 + 4 and so forth ( if any )

J3

J4

-8-

K3

K4

Balance Carried Forward

PART J: SPECIAL DEDUCTION, FURTHER DEDUCTION AND DOUBLE DEDUCTION

Business 2

Partnership 1

Business 3 + 4 and so forth ( if any )

Claim Code Amount Amount

PART K: INCENTIVE CLAIM

J1

J2

TOTAL CLAIMED J5

Type of Incentive Amount Absorbed

K1

K3 Schedule 4 Qualifying Expenditure

Schedule 7A Allowance

K2

K4

Increased Exports Allowance For Qualifying Services

Schedule 4A Qualifying Expenditure

Balance Carried Forward

J5

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Reference No.

Total Tax Withheld and Remitted to LHDNM

PART L: FINANCIAL PARTICULARS OF DECEASED PERSON'S ESTATE TRADING, PROFIT, AND LOSS ACCOUNT

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L1

L2

L3

L4

L5

L7

L8

L9

L11

L10

L6

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L12

L13

L14

L15

L16

L17

L18

L19

L20

L21

L24

L25

L26

L27

L28

L1

L2

L3

L4

L5

L6

L7

L8

L9

L10

L11

L12

L13

L14

L15

L16

L17

L18

L19

L20

OTHER INCOME:

L21

L24

L25

L26

L27

L28

TOTAL INCOME ( L8 to L12 ) EXPENSES:

TOTAL EXPENSES ( L14 to L23 )

NET PROFIT/ LOSS

LESS:

BALANCE SHEET

-9-

Fixed Assets: :

((Enter "X" if negative)

Non-allowable expenses

Land and buildings

Repairs and maintenence

Travelling and transportation

Bad debts

Commissions

Contracts and subcontracts

Salaries and wages

Rental / lease

Loan interest

Plant and machinery

Other business income

Dividends

Interest and discounts

Other income

Rents, royalties and premiums

((Enter "X" if negative)

Closing stock

Opening stock

Business Code Sales or Turnover

Purchases and cost of production

Cost of sales ( L3 + L4 - L5 )

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Reference No.

GROSS PROFIT ( L2 - L6 ) / GROSS LOSS ( L6 - L2 )

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Current Assets: L33L33

L34

L35

L36

L37

L38

L39

L40

L41

L42

L43

L44

L45

L46

L47

L48

L49

L50

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PARTICULARS OF EXEMPT INCOME

L34

L35

L36

L37

L38

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M2

M4

M3

M1

M5

M4

M3

M2

M1

M5

Interest

Business and Partnership

Other income

Rents

Dividends

L39

L40

L41

L42

L43

L44

L45

L46

L47

L48

L49

L50

TOTAL ASSET ( L31 + L32 + L39 )

TOTAL CURRENT ASSET ( L33 to L38 )

LIABILITIES:

OWNER'S EQUITY: TOTAL LIABILITY ( L41 to L43 )

Stock

Trade debtors

Cash in hand

Sundry debtors

Cash at bank

Other current assets

Loans

Trade creditors

Sundry creditors

Capital account

Special fund

Net advance/drawing

Current account balance brought forward

Current account balance carried forward

Current year profit/loss

.

(Enter "X" if negative)

(Enter "X" if negative)

(Enter "X" if negative)

(Enter "X" if negative)

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PART M:

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L30

L29

L30

Motor vehicles

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L31

L32

TOTAL FIXED ASSETS ( L27 to L30 )

Investments

L31

L32

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Reference No.

(Enter "X" if negative) !

PARTICULARS OF THE FIRM AND SIGNATURE OF THE PERSON WHO COMPLETES THIS RETURN FORM

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Postcode

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Town

State

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Designation

Name of Firm

Address of Firm

a

b

c

d

e

f

Telephone No.

Handphone No.

e-mail

Tax Agent Approval No.

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Identity Card No. / Passport No. / Police No. / Army No. / Registration No. * *Delete whichever is not relevant hereby declare that the information regarding the income and claim for deductions given by me in this return form and in any documentattached is true, correct and complete.

Signature

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EXECUTOR'S DECLARATION

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-11-

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Month YearDay

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Designation

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Month YearDay

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<>>>>>>>>?Name Tax

Reference No.

Please read the following reminder before signing this return form

RM

REMITTANCE SLIP DIRECTOR GENERAL OF INLAND REVENUE To:

Enclosed herewith is the cheque/money order/postal order/bank draft for payment of income tax.

TAX REFERENCE NO. PAYMENT CODE INSTALMENT NO.

Amount of Payment

Identity Card No. Cheque No. and Others Name of Bank Telephone No. Date:

CP501 [Pin. 1/2007]

Name and Postal Address

084 99

YEAR OF ASSESSMENT

2007

!!!!!!!!!!!!, , , .

REMINDER

Check to ensure that the following has been done (Tick '√' in the relevant box):

Please ensure that this return form is completed and in order. Carefully check all information given before submitting it to Lembaga Hasil Dalam Negeri Malaysia (LHDNM).

• Payment can be made as follows:: (a) Bank - Counters of CIMB Bank Berhad (CIMB) and Public Bank Berhad (PBB) by

using the bank payment slip. - CIMB and PBB internet banking. (b) LHDNM - e-Payment at LHDNM website. - Payment counters of LHDNM or by mail: Cheques, money orders and bank drafts must be crossed and made payable to the Director

General of Inland Revenue. Use the Remittance Slip (CP501) when making payment.

Website: http://www.hasil.org.my

• Write down the name, address, telephone number, tax reference number, year of assessment and payment code on the reverse side of the financial instrument.

• Payment by CASH / CHEQUE / MONEY ORDER / POSTAL ORDER / BANK DRAFT must be separately remitted to LHDNM at the above address.

Tax computation has been done on the appropriate working sheets (according to the guidebook andexplanatory notes) and the amounts accurately transferred to Form TP.

If there is any balance of tax payable, payment must be made according to the following:-

All working sheets, records and documents are properly kept for reference by LHDNM.

All information have been clearly filled in the spaces provided. Name and tax reference number are clearly indicated on every page of this return form and relevant working sheets.

SEMENANJUNG MALAYSIA

SABAH & FT LABUAN

SARAWAK

Lembaga Hasil Dalam Negeri Malaysia Cawangan Pungutan, Tingkat 15, Blok 8A Kompleks Bangunan Kerajaan, Jalan Duta Karung Berkunci 11061 50990 Kuala Lumpur

Postal Address

Lembaga Hasil Dalam Negeri Malaysia Unit Pungutan Tingkat Bawah, 3 & 4, Wisma Hasil Jalan Tunku Abdul Rahman 88600 Kota Kinabalu Lembaga Hasil Dalam Negeri Malaysia Unit Pungutan Aras 1, Wisma Hasil No. 1, Jalan Padungan 93100 Kuching

Payment Counter Tingkat Bawah, Blok 8A Kompleks Bangunan Kerajaan Jalan Duta Kuala Lumpur

Tingkat Bawah Wisma Hasil Jalan Tunku Abdul Rahman Kota Kinabalu

Aras 1, Wisma Hasil No. 1, Jalan Padungan Kuching

MALAYSIAN INCOME TAX Remittance Slip

1. Payment can be made as follows: 1.1 Bank - Counters of CIMB Bank Berhad (CIMB) and Public Bank Berhad (PBB) by using the bank payment slip.

- CIMB and PBB internet banking. 1.2 LHDNM - e-Payment at LHDNM website.

- Payment counters of LHDNM or by mail: Cheques, money orders and bank drafts must be crossed and made payable to the Director General of Inland Revenue. Use the Remittance

Slip (CP501) when making payment.

2. Write down the name, address, telephone number, tax reference number, year of assessment and payment code on the reverse side of the financial instrument.

3. Check the receipts/bank payment slips before leaving the payment counter.

Lembaga Hasil Dalam Negeri Malaysia Cawangan Pungutan, Tingkat 15, Blok 8A Kompleks Bangunan Kerajaan, Jalan Duta Karung Berkunci 11061 50990 Kuala Lumpur

Postal Address Payment Counter PENINSULAR MALAYSIA

SABAH & FT LABUAN

SARAWAK

Lembaga Hasil Dalam Negeri Malaysia Unit Pungutan Tingkat Bawah, 3 & 4, Wisma Hasil Jalan Tunku Abdul Rahman 88600 Kota Kinabalu Lembaga Hasil Dalam Negeri Malaysia Unit Pungutan Aras 1, Wisma Hasil No. 1, Jalan Padungan 93100 Kuching

Tingkat Bawah, Blok 8A Kompleks Bangunan Kerajaan Jalan Duta Kuala Lumpur

Tingkat Bawah Wisma Hasil Jalan Tunku Abdul Rahman Kota Kinabalu

Aras 1, Wisma Hasil No. 1, Jalan Padungan Kuching