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THE FEDERAL DEMOCRATIC REPUBLIC OF ETHIOPIA
ETHIOPIAN REVENUE AND CUSTOMS AUTHORITY |
Withholding Tax On Payment Declaration
(Income Tax Proclamation No. 286/2002 & Income Tax Regulation No. 78/2002) |
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Section 1 - Taxpayer Information
1. Name of Person or Organization Withholding Tax | 3. Taxpayer Identification Number | 4. Tax Account Number | 8. Withholding Period | Page 1 of 2 | |||
Month | Year 2014 | ||||||
2a. Region | 2b. Zone/Sub-city | 5. Tax Center | Document Number (Official Use Only) | ||||
2c. Woreda | 2d. Kebele/Farmer's Asso. | 2e. House Number | 6. Telephone Number | 7. Fax Number |
Section 2 - Declaration Details
a) No. | b) Withholdee TIN | c) Name of Organization or Person (Name, Father's Name and Grandfather's Name) | d) Withholdee's Address | *e) Withholding Type (Rental of Buildings/Other) | f) Taxable Amount | g) Tax Withheld ((f)x2%) | h) Withholding Tax Receipt | |||||
Region | Zone/ Sub-city | Woreda | Kebele/ Farmers Asso. | House No. | Number | Date | ||||||
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Enter Totals From All Continuation Sheets Here >> | ||||||||||||
TOTAL Columns f & g (Line 20 and 30) |
Section 3 - Calculation of Tax Due | Section 4 - Taxpayer Certification | Section 5 - Office Use Only |
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Taxpayer or Authorized Agent
Name
Signature Date |
Withholding Agent Seal |
For Tax Office
Tax Officer's Name
Signature Date |
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Generated by www.eGenzeb.com
(As of 07/08/06)
ERCA Form 1106 (1/2006)
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THE FEDERAL DEMOCRATIC REPUBLIC OF ETHIOPIA
ETHIOPIAN REVENUE AND CUSTOMS AUTHORITY |
Withholding Tax On Payment Declaration (Continuation Sheet For Form 1105) |
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Section 1 - Taxpayer Information
1. Name of Person or Organization Withholding Tax | 2. Tax Identification Number | 3. Tax Period | Page 2 of 2 | |||
Month | Year 2014 |
Section 2 - Declaration Details
a) No. | b) Withholdee TIN | c) Name of Organization or Person (Name, Father's Name and Grandfather's Name) | d) Withholdee's Address | *e) Withholding Type (Rental of Buildings/Other) | f) Taxable Amount | g) Tax Withheld ((f)x2%) | h) Withholding Tax Receipt | |||||
Region | Zone/ Sub-city | Woreda | Kebele/ Farmers Asso. | House No. | Number | Date | ||||||
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Enter Totals From Continuation Sheets Here >> | ||||||||||||
TOTAL Columns f and g |
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