Информация УМНС РФ по Костромской обл. от 13.02.2004 г № НН-10-06/965
Декларация по налогу на доходы физических лиц-нерезидентов Российской Федерации по форме 4-НДФЛ
Attachment No 2
to Order of the MOT of Russia
of 16.10.2003 No. BG-3-
04/540_________________
Physical Persons Income Tax DECLARATION (4-NDFL)
For 200 _
(Please, state the tax year)
| To be submitted not later then
April 30 of the year after the
expired tax year
|
To the MOT of Russia Inspectorate No.
at the place of residence/registration
(please, underline the necessary)
Information about taxpayer
TIN _____________________________________
Surname _________________________________
Name ____________________________________
Patronymic ______________________________
Type of the document, certifying the identity ____________________
Document Series,
code _________ number _______________________
Date of issue |~~| [~~i
of the document ___________________ Date of birth ________________
(in figures, day, (in figures, day,
month and year) month and year)
┌─┐ ┌─┐
Sex: Male │ │ Female │ │
└─┘ └─┘
(please, mark the necessary with x)
Residence address in the country,
which the Declarant is a resident of
|
|
Residence address or address of the
place of business in the Russian Federation
Postal code ________ Code of the region _____________
District _________________________________________________________
City _____________________________________________________________
Settlement (village, township etc.) ______________________________
Street (avenue, lane etc.) _______________________________________
House number ________________ Building(estate) number ____________
Apartment number _____________
Contact telephone number
Home: area code ____ Tel.: __________________
Office: area code _______ Tel.:___________________________________
To be filled by the taxpayer
The Declaration with attached confirming documents
is submitted or their copies on _______ sheets
on ____ sheets
┌─┐ ┌─┐ ┌─┐ ┌─┐
personally │ │ through │ │ by post │ │ in electronic │ │
└─┘ agent └─┘ └─┘ form └─┘
(please, mark the necessary with x)
I Confirm the accuracy Of the data Which I Stated in
the Declaration ____________________________________
(in figures: date, month, year)
(the taxpayer's signature)
To be filled by the tax authority
The Declaration is registered
|
The Declaration with attached confirming
is received on ┌─┐ sheets documents or their copies
└─┘ ┌─┐
|
on └─┘ sheets
|
Date of submission │ │
└───────────────────────────┘
|
(signature of the tax official)
|
______________________________
(in figures: date, month, year)
The chamber examination was
carried out on | |
|
______________________(signature of the tax official)
(in figures: date, month, year)
|
Attention! Please, write in capital letters.
Seet 02
Declaration No. __________________ Form of TDC | |
TIN _________________________
Surname _________________________________________ N. ____ P. _____
Income of physical persons, who are not tax residents of the
Russian Federation (Form 4-NDFL)
1. Income taxable at the rate of 30%
Type of activity, which resulted in the received income, or type
of organization - source of income.
If the source of income payment is a physical person,
please, state his/her surname, name, patronymic __________________
__________________________________________________________________
Code of Amount of Taxable
income ____ income ____ Roubl _____ Kop ____ income ___ Roubl ____
Amount of
Kop. tax withheld ___ Roubl.
__________________________________________________________________
Type of activity, which resulted in the received income, or type
of organization - source of income.
If the source of income payment is a physical person,
please, state his/her surname, name, patronymic __________________
__________________________________________________________________
Code of Amount of Taxable
income ____ income ____ Roubl _____ Kop ____ income ___ Roubl ____
Amount of
Kop. tax withheld ___ Roubl.
__________________________________________________________________
Total 1: 1.1 Total amount 1.2 Amount of tax
of income _____ Roubl ______ Kop. _____ withheld ____ Roubl ______
2. Income in relation of which special tax rates are applied
according to the international legislation
2.1 Name of source of income payment _____________________________
__________________________________________________________________
2.1.1 Code of income 2.1.2. Amount of income 2.1.3 Taxable income amount
Roubl. Kop ______ Roubl _____ Kop.
2.1.4 Tax 2.1.5 Amount of tax
rate withheld
% Roubl.
2.2 Name of source of income payment _____________________________
__________________________________________________________________
2.2.1 Code of income 2.2.2. Amount of income 2.2.3 Taxable income amount
Roubl. Kop ______ Roubl _____ Kop.
2.2.4 Tax 2.2.5 Amount of tax
rate withheld
% Roubl.
2.3 Name of source of income payment _____________________________
__________________________________________________________________
2.3.1 Code of income 2.3.2. Amount of income 2.3.3 Taxable income amount
Roubl. Kop ______ Roubl _____ Kop.
2.3.4 Tax 2.3.5 Amount of tax
rate withheld
% Roubl.
3. Amount of tax paid by the taxpayer _________________ Roubl.
4. Calculation of tax to be additionally paid (refunded)
4.1 Amount of tax to be paid
(amount of i.1.1 x 0,3 + tax calculated on income of i.2 in
accordance with Double taxation treaties. The amount of tax less
then 50 kopeks is neglected, while 50 kopeks and more are rounded
off to one rouble.) ______________________________________ Roubl.
4.2 Amount of tax withheld and paid in advance
(i. 1.2 + i. 2.1.5 + i. 2.2.5 + 2.3.5 + i.3)
___________________________________________________________ Roubl.
4.3 Amount of tax to be refunded from the budget
(Deduct i. 4.1 from i. 4.2. If a value of i.4.1 is more or equal
to value i. 4.2, then i. 4.3 is not to be filled
in) _________________________________ Roubl.
4.4 Amount of tax to be paid to the budget
(Deduct i. 4.1 from i. 4.2. If a value of i.4.1 is less or equal
to value i. 4.2. then i. 4.4 is not to be filled
in) _________________________________ Roubl.
5. Calculation of advance tax payments <*>
5.1 Amount of estimated income __________ Roubl _____ Kop.
5.2 Amount of advanced tax payment ____________________ Roubl.
--------------------------------
persons, engaged in private practice.
The documents and
their copies are attached on _____ sheets.
I confirm the accuracy of data,
which I stated
on this sheet page of Declaration. | |
In case of lack of space, additional sheets
are used. The fields for ii. 1 and 2 and
ii. 3-5 are filled on the last sheet.
Preparation of Declaration Form 4-NDFL
4.1.Fist sheet of Declaration
Personal data about the receiver of income are stated on this sheet.
The value "Code of document" is chosen from the Reference list 1 "Types of documents, certifying the identity of the taxpayer" Attachment to Forms No. 1-NDFL and No. 2-NDFL, approved by the Order of the MOT of Russia of 01.11.2000 No. BG-3-08/379.
In the field "Series, number" the requisites of the document, certifying the identity, are stated.
In the field of "Residence address or address of the place of business in the Russian Federation" the full residence address (with postal code) is to be stated on the basis of the document, certifying the identity, or other document, confirming the physical person's residence address.
Value of "Code of the region" is chosen from Reference list 5 "Codes of the regions of the Russian Federation, including city and spacecraft launching site Baikanur" Attachment to Forms No. 1-NDFL and No. 2-NDFL, approved by the Order of the MOT of Russia of 01.11.2000 No. BG-3-08/379 (see above). Beside the field "Residence address or address of the place of business in the Russian Federation" the physical person fill in the field "Residence address in the country, which the Declarant is a resident of.
4.2 Second sheet of Declaration
In item 1 "Income taxable at the rate of 30%" is to be stated all income, taxable at the rate of 30%, excluding income in relation of which special tax rates are applied according to the Double taxation avoidance treaties (agreements), which are to be stated in item 2 "Income in relation of which special tax rates are applied".
Руководитель Управления
государственный советник налоговой
службы Российской Федерации III ранга
Н.Н.НИКИТОВ