bilingual 1770 S-2015 - Direktorat Jenderal Pajak

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GENERAL INSTRUCTIONS FOR THE COMPLETION SPT 1770 DIGITAL FORM
1.
This form is in compliance with the regulations the Director General of Taxes Number PER34/PJ/2010 about Income Tax Annual Return Form and General Instructions as amended
by regulation the Director General of Taxes Number PER-19/PJ/2014. This form is used for
completion income tax annual tax return for Taxable Year 2014 and onwards;
2.
This form is printed with a scale of 98% (not printed in mode "fit size" or "shrink size". This
printing results must be signed and must not be folded or crumpled. Use HVS paper size:
a.
F4/Folio/US Folio/Government Legal (8,5 X 13 inch);
b.
Minimum weight 70 gr;
3.
To be able to use this form optimally, use the application Adobe Reader version 8 or newer;
4.
Complete the Taxable Year, the identity of the Taxpayer and the other mandatory
information properly (red box
). Taxpayers can contact the tax office where the
Taxpayer is registered to ensure their Taxpayer Indentity Number (TIN) or through
applications on the site www.pajak.go.id.
Description of status of married individual are as follows:
a.
KK : Tax rights and obligations undertaken by the head of the family;
b.
HB : Spouse have lived separated based on a court decision;
c.
PH : It is requested in writing by both the husband and wife on the basis of an
agreement for the separation of property and income; and
d.
MT : It is requested by the wife who chooses to meet her tax right and obligation
separately.
5.
Complete the attachments form first (green box
). Summation formulas,
reduction, connection with certain parts and others have been available in this form, so that
Taxpayers do not need to do a recount (blue box
and brown box
);
6.
Blue boxes
and brown boxes
shows the results of automatic
calculation. There are times when automatic calculation is too late to execute. Taxpayer is
expected to keep doing re-checking the results of calculations on this tax return, especially
in the blue boxes
dan brown boxes
;
7.
8.
After all attachments completed, complete the main form on the yellow boxes
.
In case the taxpayer status is PH or MT, the Personal Exemption and Taxable Income will
automatically filled the symbol 0. Next, Taxpayer complete Calculation Income Tax Payable
for Taxpayers with status PH or MT in the pink boxes
;
9.
In case the taxpayer status is KK or HB, the Personal Exemption filled by the taxpayer in
accordance with the provisions;
10. Completion the main form continued in purple boxes
until finished;
11. The SHOW button used to show calculation formulas in completing digital tax return;
12. The RESET button used to clear the data of digital tax return form that have been loaded
previously. After completing the tax return and print it, do not forget to save it to another file
(Save-as and name different from the original file), then use the RESET button to clear the
file;
13. The HIDE button used to hide the calculation formula so that it can be printed blank form if
you want to complete it manually;
14. Detailed description of the completing income tax annual tax return please read the
Instruction Book.
TAXABLE YEAR
FORM
1770 S
HIDE
RESET
SHOW
ANNUAL INDIVIDUAL INCOME TAX RETURN
FOR TAXPAYER WHO HAVE INCOME:
MINISTRY OF FINANCE
OF THE REPUBLIC OF INDONESIA
• FROM ONE OR MORE EMPLOYER;
DIRECTORATE GENERAL OF TAXES • OTHER DOMESTIC INCOME; AND/OR
• SUBJECTED TO FINAL AND/OR FINALIZED TAX.
IDENTITY
ATTENTION:
•
•
FOLLOW INSTRUCTION IN THE INSTRUCTION BOOK
TAXPAYER IDENTIFICATION
NUMBER (TIN)
:
TAXPAYER'S NAME
:
OCCUPATION
:
PHONE NUMBER
:
TAX LIABILITY STATUS OF
MARRIED INDIVIDUAL
:
SPOUSE'S TIN
:
•
PRINT OR TYPE WITH CAPITAL LETTER AND BLACK INK
MARK " X " IN THE
2 0
AMENDED RETURN
APPROPRIATE BOX
KLU :
KK
FAX. NUMBER
HB
PH
-
:
MT
Data changes application submitted apart from this Tax Return, by using the Taxpayer Data Change Form and attached with the
required documents.
RUPIAH *)
*) The filing columns of Rupiah value must be without decimal value (see example in page 3 of instructions)
1 DOMESTIC NET INCOME IN RESPECT OF EMPLOYMENT
…….……………………………………………..
1
[Total net income from each Form 1721-A1 and/or 1721-A2 attached or other Withholding Tax Receipt]
2 OTHER DOMESTIC NET INCOME
………………………………………………………………………………………………………………………….
2
A. NET INCOME
[From Form 1770 S-I Total Part A ]
3 FOREIGN NET INCOME
………………………………………………………………………………………………………………………….
3
[Complete it from separate attachment, if any foreign income, see instruction book]
4 TOTAL NET INCOME (1+2+3)
……………………………………………………………………………
5
0
………………………………………………………………………………………
6
B.TAXABLE
INCOME
6 TOTAL NET INCOME AFTER ZAKAT/OBLIGATED CHARITY (4-5)
7 PERSONAL EXEMPTIONS
7
0
……………………………………………………………………………………………. 8
0
TK /
8 TAXABLE INCOME (6-7)
K/
K/I/
……………………………………………………………………
C. TAX PAYABLE
9 TAX PAYABLE (TAX RATE ON ARTICLE 17 X LINE 8)
[For Taxpayers with status PH/MT filled from Attachment Calculation of Income Tax Payable as referred to in Section G:
Attachments letter d]
10 ADJUSTMENT FOR FOREIGN TAX CREDITS REFUNDED AND HAD BEEN CREDITED IN THE PREVIOUS
YEAR RETURN (Income Tax Article 24)
11 TOTAL TAX PAYABLE (9+10)
D. TAX CREDIT
TAX OVERLY WITHHELD
14 PREPAID TAX:
a.
12
0
(11-12) …………………………………………………….. 13
0
MONTHLY INSTALLMENT OF INCOME TAX ARTICLE 25
14a
b. NOTICE OF TAX COLLECTION ON INCOME TAX ARTICLE 25
(PRINCIPAL ONLY)
15 TOTAL TAX CREDIT (14a + 14b)
14b
0
…………………………………………………………………………………………
15
E. INCOME TAX OVER/UNDER
PAID
SETTLED ON
a. UNDERPAID TAX (INCOME TAX ARTICLE 29)
16
(13-15)
b. OVERPAID TAX (INCOME TAX ARTICLE 28 A)
DD
MM
YY
0
16
17 REQUEST: Overpaid amount stated in 16.b would be :
F. MONTHLY
INSTALLMENT OF
INCOME TAX ARTICLE
25 FOR THE
SUBSEQUENT YEAR
G. ATTACHMENTS
0
…………………………………………………………………………………………… 11
TAX DUE AFTER CREDIT3
b.
0
9
10
12 TAX WITHHELD BY OTHER PARTY, PAID /WITHHELD IN FOREIGN AND BORNED BY THE GOVERNMENT
[From Form 1770 S-I Total Part C column (7)]
13 a.
0
……………………………………………………………………………………… 4
5 ZAKAT/OBLIGATED CHARITY
a.
REFUNDED
c.
REFUNDED WITH SKPPKP ARTICLE 17 C (COMPLIANCE TAXPAYER)
b.
COMPENSATED WITH
OUTSTANDING TAX PAYABLE
d.
REFUNDED WITH SKPPKP ARTICLE 17 D (CERTAIN CRITERIA OF TAXPAYER)
18
18 MONTHLY INSTALLMENT FOR THE SUBSEQUENT
……………………………………………………………………………………………………………………..
YEAR
THE AMOUNT IS CALCULATED BY:
a.
1/12 X THE TOTAL OF LINE 13
b.
CALCULATION IN SEPARATE ATTACHMENT
a.
Copy of Form 1721-A1 and/or 1721-A2 or Withholding Receipt of Income Tax Art.21
d.
Income Tax Calculation For Married Taxpayer with Separation of Property and
Income (PH) or Has Her Own TIN (MT)
b.
Tax Payment Receipt of Income Tax Article 29
e.
…………………………………………………………..
c.
Power of Attorney (If Needed)
DECLARATION
Understanding all the sanctions provided by the law and regulations, i hereby declare that the information stated in this
return, including all attachments provided, are true, complete, clear, and under no circumtances whatsoever.
TAXPAYER
REPRESENTATIVE
DATE
DD
COMPLETE NAME
:
TIN
:
F.1.1.32.18
0
MM
YY
SIGNATURE
MINISTRY OF FINANCE
OF THE REPUBLIC OF INDONESIA
DIRECTORATE GENERAL OF TAXES
TIN
:
TAXPAYER'S NAME
:
PART A
:
TAXABLE YEAR
FORM
1770 S - I
ATTACHMENT - I
•
•
•
ANNUAL INDIVIDUAL INCOME TAX RETURN
OTHER DOMESTIC NET INCOMES
NON TAXABLE INCOME
LIST OF INCOME TAX WITHHELD BY OTHER PARTIES, PAID/WITHHELD IN FOREIGN AND BORNED BY
THE GOVERNMENT
2 0
OTHER DOMESTIC NET INCOMES
(NOT INCLUDING INCOME SUBJECT TO FINALIZED INCOME TA)
NO.
TYPES OF INCOME
(1)
(2)
TOTAL NET INCOME
(Rupiah)
(3)
1. INTEREST
2. ROYALTIES
3. RENT
4. AWARDS AND PRIZES
5. GAIN FROM THE SALE/TRANSFER OF PROPERTY
6. OTHER INCOMES
TOTAL PART A
0
TPA
Copy Total Part A to Form 1770 S Part A line 2
PART B
:
NON TAXABLE INCOME
NO.
TYPES OF INCOME
(1)
(2)
GROSS INCOME
(Rupiah)
(3)
1. AID / DONATION / GRANT
2. INHERITANCE
3. DISTRIBUTION OF PROFIT EARNED BY MEMBER OF PARTNERSHIP WHOSE CAPITAL DOES NOT
CONSIST OF SHARES, PARTNERSHIP, ASSOCIATION, AND FIRM
4. CLAIM ON HEALTH, ACCIDENT, LIFE, DUAL PURPOSE AND SCHOLARSHIP
5. SCHOLARSHIP
6. OTHER NON TAXABLE INCOME
TOTAL PART B
PART C
:
0
TPB
LIST OF INCOME TAX WITHHELD BY OTHER PARTIES, PAID/WITHHELD IN FOREIGN AND BORNED BY THE GOVERNMENT
NO
NAME OF WITHHOLDING AGENT
TIN OF WITHHOLDING AGENT
(1)
(2)
(3)
WITHHOLDING TAX RECEIPT
NUMBER
(4)
DATE
(5)
TYPES OF TAX :
INCOME TAX ARTICLE
21/22/23/24/26/DTP *)
TOTAL OF INCOME TAX
WITHHELD
(Rupiah)
(6)
(7)
1.
2.
3.
4.
5.
etc
TOTAL PART C
0
TPC
Copy Total Part C to Form 1770 S Part D Line 12
Catatan :
- DTP : BORNED BY THE GOVERNMENT
*)
- Fill column (6) with following options: 21/22/23/24/26/DTP (Example: 21, 22, 23, 24, 26, DTP)
- If there is a Tax Credit of Income Tax Article 24, the column should be filled with maximum creditable amount according to separate attachment
(Follow the Instruction related to Part C of Attachment I and Annual Tax Return line 3)
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
Page
from
pages Attachment-I
1770 S - II
ANNUAL INDIVIDUAL INCOME TAX RETURN
MINISTRY OF FINANCE
OF THE REPUBLIC OF INDONESIA
DIRECTORATE GENERAL OF TAXES
TIN
:
TAXPAYER'S NAME
:
PART A
:
TAXABLE YEAR
FORM
ATTACHMENT - II
•
•
•
•
INCOME SUBJECT TO FINAL TAX AND/OR FINALIZED TAX
ASSETS AT YEAR-END
LIABILITIES AT YEAR- END
LIST OF MEMBER OF FAMILY'S DEPENDENT
2
0
INCOME SUBJECT TO FINAL TAX AND/OR FINALIZED TAX
NO.
TAX BASE/GROSS INCOME
TYPES OF INCOME
INCOME TAX PAYABLE
(Rupiah)
(Rupiah)
(1)
(2)
(3)
1.
INTEREST OF DEPOSIT, SAVINGS, DISCOUNT OF CENTRAL BANK'S
CERTIFICATE, STATE SECURITIES
2.
INTEREST/DISCOUNT OF BOND
3.
SALES VALUE OF SHARES TRADED IN THE STOCK
4.
LOTTERY PRIZES
5.
SEVERANCE PAYMENT, RETIREMENT ALLOWANCE AND PENSIONS
PAID IN LUMP SUM
6.
HONORARIUM FROM CENTRAL AND LOCAL STATE BUDGET
7.
TRANSFER VALUE OF RIGHTS ON LAND AND BUILDING
8.
LEASE/RENT VALUE ON LAND OR BUILDING
9.
PROPERTY RECEIVED FROM BUILD OPERATE TRANSFER SCHEME
10.
SAVING INTEREST PAID BY COOPERATIVE TO MEMBER
11.
INCOME FROM DERIVATIVE TRANSACTION
12.
DIVIDEND
13.
WIFE INCOME FROM ONE EMPLOYER
14.
OTHER INCOME SUBJECT TO FINAL TAX AND OR FINALIZED TAX
(4)
TOTAL PART A
PART B
:
0
TPA
ASSETS AT YEAR-END
NO.
CODE
TYPE OF ASSETS
YEAR OF
ACQUISITION
COST OF ACQUISITION
(1)
(2)
(3)
(4)
(5)
DESCRIPTION
(Rupiah)
(6)
1.
2.
3.
4.
5.
etc
TOTAL PART B
PART C
NO.
:
0
TPB
LIABILITIES AT YEAR- END
CODE
NAME OF LENDER
LENDER ADDRESS
YEAR LENDING
TOTAL
(2)
(3)
(4)
(5)
(6)
(1)
1
2
3
4
5
dst
JUMLAH BAGIAN C
PART D
:
0
JBC
LIST OF MEMBER OF FAMILY'S DEPENDENT
NO.
NAME
IDENTITY NUMBER (NIK)
RELATIONSHIP IN FAMILY
OCCUPATION
(1)
(2)
(3)
(4)
(5)
1
2
3
4
5
IF NEEDED, ADDITIONAL PAGES MAY BE ADDED
Page
from
pages Attachment-II
WORKPAPER OF INCOME TAX PAYABLE CALCULATION
FOR MARRIED INDIVIDUAL WHO HAVE TAX LIABILITY STATUS MARRIED WITH AN AGREEMENT FOR THE SEPARATION OF PROPERTY AND
INCOME (PH) OR THE WIFE CHOOSE TO MEET HER TAX RIGHT AND OBLIGATION SEPARATELY (MT)
No.
Description
(1)
(2)
A
Suami 's Net Income
Isteri 's Net Income
(4)
(3)
NET INCOME
1
DOMESTIC NET INCOME FROM BUSINESS ACTIVITIES AND/OR INDEPENDENT PERSONAL SERVICE
[From Form 1770 Part A line 1]
2
0
DOMESTIC NET INCOME IN RESPECT OF EMPLOYMENT
[From Form 1770 Part A Line 2 or Form 1770 S Part A Line 1]
3
OTHER DOMESTIC NET INCOME
0
[From Form 1770 Part A line 3 or Form 1770 S Part A line 2]
4
0
FOREIGN NET INCOME
[From Form 1770 Part A line 4 or Form 1770 S Part A line 3]
5
ZAKAT/OBLIGATED CHARITY
0
[From Form 1770 Part A line 6 or Form 1770 S Part A line 5]
6
TOTAL ( 1 + 2 + 3 + 4 - 5 )
7
LOSS CARRY FORWARD
0
0
0
0
[Only for Individual Taxpayer who applying bookkeeping system. From Form 1770 Part A line 8]
8
TOTAL NET INCOME ( 6 - 7 )
No
Description
Value
(1)
(2)
(3)
B
TOTAL HUSBAND AND WIFE'S NET INCOME [ A.8.(3) + A.8.(4) ]
C
PERSONAL EXEMPTIONS
D
TAXABLE INCOME [ B - C ]
E
INCOME TAX PAYABLE (COMBINED)
1
5% x
2
15% x
3
25% x
4
30% x
0
0
0
0
0
0
0
0
0
0
0
TOTAL INCOME TAX PAYABLE (COMBINED)
F
PORTION INCOME TAX PAYABLE FOR
[ (A.8.(3) / B) x E ]
Suami
's Tax Return Part C Line 12 Form 1770 or Part C Line 9 Form 1770 S]
[Copy to
G
Suami
Isteri
[ (A.8.(4) / B) x E ]
Isteri's Tax Return Part C Line 12 Form 1770 or Part C Line 9 Form 1770 S]
PORTION INCOME TAX PAYABLE FOR
[Copy to
0
Suami
Name
:
TIN
:
Signature
Isteri
Name
:
TIN
:
Signature
0
0
PRINT INCOME TAX ANNUAL TAX RETURN (BAHASA VERSION)
ON THE NEXT PAGES
RESET
SHOW
FORMULIR
PAJAK PENGHASILAN WAJIB PAJAK ORANG PRIBADI
BAGI WAJIB PAJAK YANG MEMPUNYAI PENGHASILAN :
• DARI SATU ATAU LEBIH PEMBERI KERJA;
• DALAM NEGERI LAINNYA; DAN/ATAU
• YANG DIKENAKAN PPh FINAL DAN/ATAU BERSIFAT FINAL.
KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
IDENTITAS
•
•
SEBELUM MENGISI BACA DAHULU PETUNJUK PENGISIAN
NPWP
:
NAMA WAJIB PAJAK
:
PEKERJAAN
:
NO. TELEPON
:
STATUS KEWAJIBAN
:
PERPAJAKAN SUAMI-ISTERI
NPWP ISTERI / SUAMI
•
ISI DENGAN HURUF CETAK /DIKETIK DENGAN TINTA HITAM
2 0
TAHUN PAJAK
SPT TAHUNAN
1770 S
PERHATIAN
HIDE
BERI TANDA "X" PADA
SPT PEMBETULAN KE -
(KOTAK PILIHAN) YANG SESUAI
KLU :
NO. FAKS
KK
HB
PH
:
-
MT
:
Permohonan perubahan data disampaikan terpisah dari pelaporan SPT Tahunan PPh Orang Pribadi ini, dengan menggunakan
Formulir Perubahan Data Wajib Pajak dan dilengkapi dokumen yang disyaratkan.
RUPIAH *)
*) Pengisian kolom-kolom yang berisi nilai rupiah harus tanpa nilai desimal (contoh penulisan lihat petunjuk pengisian halaman 3)
1 PENGHASILAN NETO DALAM NEGERI SEHUBUNGAN DENGAN PEKERJAAN
…….……………………………………………..
1
A. PENGHASILAN NETO
[Diisi akumulasi jumlah penghasilan neto pada setiap Formulir 1721-A1 dan/atau 1721-A2 yang dilampirkan atau Bukti Potong Lain]
2 PENGHASILAN NETO DALAM NEGERI LAINNYA
[Diisi sesuai dengan Formulir 1770 S-I Jumlah Bagian A ]
3 PENGHASILAN NETO LUAR NEGERI
………………………………………………………………………………………………………………………….
2
………………………………………………………………………………………………………………………….
3
[Apabila memiliki penghasilan dari luar negeri agar diisi dari Lampiran Tersendiri, lihat petunjuk pengisian]
4 JUMLAH PENGHASILAN NETO (1+2+3)
5 ZAKAT/SUMBANGAN KEAGAMAAN YANG SIFATNYA WAJIB
……………………………………………………………………………
5
B.PENGHASILAN
KENA PAJAK
C. PPh TERUTANG
0
………………………………………………………………………………………
6
7
0
……………………………………………………………………………………………. 8
0
……………………………………………………………………
9 PPh TERUTANG (TARIF PASAL 17 UU PPh x ANGKA 8)
9
[Bagi Wajib Pajak dengan status PH atau MT diisi dari Lampiran Perhitungan PPh Terutang sebagaimana dimaksud dalam bagian G:
0
7 PENGHASILAN TIDAK KENA PAJAK
8 PENGHASILAN KENA PAJAK (6-7)
TK /
K/
K/I/
Lampiran huruf d]
10 PENGEMBALIAN / PENGURANGAN PPh PASAL 24 YANG TELAH DIKREDITKAN
11 JUMLAH PPh TERUTANG (9+10)
………………………………………
10
D. KREDIT PAJAK
13 a.
PPh YANG HARUS DIBAYAR SENDIRI
b.
PPh YANG LEBIH DIPOTONG/DIPUNGUT
14 PPh YANG DIBAYAR SENDIRI
E. PPh KURANG/LEBIH BAYAR
12
0
(11-12) …………………………………………………….. 13
0
a.
PPh PASAL 25
b.
STP PPh Pasal 25 (Hanya Pokok Pajak)
15 JUMLAH KREDIT PAJAK (14a + 14b)
F. ANGSURAN PPh
PASAL 25 TAHUN
PAJAK BERIKUTNYA
0
…………………………………………………………………………………………… 11
12 PPh YANG DIPOTONG/DIPUNGUT PIHAK LAIN/DITANGGUNG PEMERINTAH DAN/ATAU KREDIT PAJAK LUAR
NEGERI DAN/ATAU TERUTANG DI LUAR NEGERI [Diisi dari Formulir 1770 S-I Jumlah Bagian C Kolom (7)]
G. LAMPIRAN
0
……………………………………………………………………………………… 4
6 JUMLAH PENGHASILAN NETO SETELAH PENGURANGAN ZAKAT /SUMBANGAN KEAGAMAAN
YANG SIFATNYA WAJIB (4-5)
……………………………………………………………………
………………………………………………………………………
14a
………………………………………………………
14b
0
…………………………………………………………………………………………
15
TGL LUNAS
a. PPh YANG KURANG DIBAYAR (PPh PASAL 29)
16
b. PPh YANG LEBIH DIBAYAR (PPh PASAL 28 A)
(13-15)
TGL
BLN
THN
0
16
17 PERMOHONAN : PPh Lebih Bayar pada 16b mohon :
a.
DIRESTITUSIKAN
c.
DIKEMBALIKAN DENGAN SKPPKP PASAL 17C (WP dengan Kriteria Tertentu)
b.
DIPERHITUNGKAN DENGAN
UTANG PAJAK
d.
DIKEMBALIKAN DENGAN SKKPP PASAL 17D (WP yang Memenuhi Persyaratan Tertentu)
18
18 ANGSURAN PPh PASAL 25 TAHUN PAJAK BERIKUTNYA
……………………………………………………………………………………………………………………..
SEBESAR
DIHITUNG BERDASARKAN :
a.
1/12 x JUMLAH PADA ANGKA 13
b.
PENGHITUNGAN DALAM LAMPIRAN TERSENDIRI
a.
Fotokopi Formulir 1721-A1 atau 1721-A2 atau Bukti Potong PPh Pasal 21
d.
b.
Surat Setoran Pajak Lembar Ke-3 PPh Pasal 29
e.
c.
Surat Kuasa Khusus (Bila dikuasakan)
Perhitungan PPh Terutang bagi Wajib Pajak dengan status perpajakan PH atau MT
PERNYATAAN
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan peraturan
perundang-undangan yang berlaku, saya menyatakan bahwa yang telah beritahukan diatas beserta lampiran-lampirannya
adalah benar, lengkap dan jelas.
WAJIB PAJAK
KUASA
TANGGAL
TGL
NAMA LENGKAP
:
NPWP
:
F.1.1.32.18
0
BLN
THN
TANDA TANGAN
KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
NPWP
:
NAMA WAJIB PAJAK
:
BAGIAN A
:
•
•
•
TAHUN PAJAK
FORMULIR
1770 S - I
LAMPIRAN - I
SPT TAHUNAN PPh WAJIB PAJAK ORANG PRIBADI
PENGHASILAN NETO DALAM NEGERI LAINNYA
PENGHASILAN YANG TIDAK TERMASUK OBJEK PAJAK
DAFTAR PEMOTONGAN/PEMUNGUTAN PPh OLEH PIHAK LAIN DAN PPh YANG DITANGGUNG
PEMERINTAH
2 0
PENGHASILAN NETO DALAM NEGERI LAINNYA
(TIDAK TERMASUK PENGHASILAN DIKENAKAN PPh FINAL DAN/ATAU BERSIFAT FINAL)
NO.
JENIS PENGHASILAN
(1)
(2)
JUMLAH PENGHASILAN
(Rupiah)
(3)
1. BUNGA
2. ROYALTI
3. SEWA
4. PENGHARGAAN DAN HADIAH
5. KEUNTUNGAN DARI PENJUALAN/PENGALIHAN HARTA
6. PENGHASILAN LAINNYA
JUMLAH BAGIAN A
0
JBA
Pindahkan Jumlah Bagian A ke Formulir Induk 1770 S Bagian A
angka (2)
BAGIAN B
:
PENGHASILAN YANG TIDAK TERMASUK OBJEK PAJAK
NO.
JENIS PENGHASILAN
(1)
(2)
JUMLAH PENGHASILAN
(Rupiah)
(3)
1. BANTUAN/SUMBANGAN/HIBAH
2. WARISAN
3. BAGIAN LABA ANGGOTA PERSEROAN KOMANDITER TIDAK ATAS SAHAM,
PERSEKUTUAN, PERKUMPULAN, FIRMA, KONGSI
4. KLAIM ASURANSI KESEHATAN, KECELAKAAN, JIWA, DWIGUNA, BEASISWA
5. BEASISWA
6. PENGHASILAN LAINNYA YANG TIDAK TERMASUK OBJEK PAJAK
JUMLAH BAGIAN B
BAGIAN C
NO
(1)
:
0
JBB
DAFTAR PEMOTONGAN/PEMUNGUTAN PPh OLEH PIHAK LAIN DAN PPh YANG DITANGGUNG PEMERINTAH
NAMA PEMOTONG/
NPWP PEMOTONG/
PEMUNGUT PAJAK
PEMUNGUT PAJAK
(2)
(3)
BUKTI PEMOTONGAN/
PEMUNGUTAN
NOMOR
TANGGAL
(4)
(5)
JENIS PAJAK :
PPh PASAL 21/
22/23/24/26/DTP*
JUMLAH PPh YANG
DIPOTONG / DIPUNGUT
(6)
(7)
1.
2.
3.
4.
5.
dst
JUMLAH BAGIAN C
Pindahkan Jumlah Bagian C ke Formulir
Induk 1770 S Bagian D angka 12
Catatan :
- DTP : Ditanggung Pemerintah
*)
- Kolom (6) diisi dengan pilihan PPh Pasal 21/22/23/24/26/DTP (Contoh : ditulis 21, 22, 23, 24, 26, DTP)
- Jika terdapat kredit pajak PPh Pasal 24, maka jumlah yang diisi adalah maksimum yang dapat dikreditkan sesuai lampiran tersendiri
(lihat petunjuk pengisian tentang Lampiran I Bagian C dan Induk SPT angka 3)
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
0
JBC
Halaman ke-
dari
halaman Lampiran-I
1770 S - II
SPT TAHUNAN PPh WAJIB PAJAK ORANG PRIBADI
KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK
NPWP
:
NAMA WAJIB PAJAK
:
BAGIAN A
:
TAHUN PAJAK
FORMULIR
LAMPIRAN - II
•
•
•
•
PENGHASILAN YANG DIKENAKAN PPh FINAL DAN/ATAU BERSIFAT FINAL
HARTA PADA AKHIR TAHUN
KEWAJIBAN/UTANG PADA AKHIR TAHUN
DAFTAR SUSUNAN ANGGOTA KELUARGA
PENGHASILAN YANG DIKENAKAN PPh FINAL DAN/ATAU BERSIFAT FINAL
DASAR PENGENAAN PAJAK/
SUMBER/JENIS PENGHASILAN
PENGHASILAN BRUTO
NO.
2
0
PPh TERUTANG
(Rupiah)
(Rupiah)
(2)
(1)
(3)
1.
BUNGA DEPOSITO, TABUNGAN, DISKONTO SBI, SURAT
BERHARGA NEGARA
2.
BUNGA/DISKONTO OBLIGASI
3.
PENJUALAN SAHAM DI BURSA EFEK
4.
HADIAH UNDIAN
5.
PESANGON, TUNJANGAN HARI TUA DAN TEBUSAN PENSIUN
YANG DIBAYARKAN SEKALIGUS
6.
HONORARIUM ATAS BEBAN APBN/APBD
7.
PENGALIHAN HAK ATAS TANAH DAN/ATAU BANGUNAN
8.
SEWA ATAS TANAH DAN/ATAU BANGUNAN
9.
BANGUNAN YANG DITERIMA DALAM RANGKA BANGUN GUNA
SERAH
BUNGA SIMPANAN YANG DIBAYARKAN OLEH KOPERASI
KEPADA ANGGOTA KOPERASI
10.
11.
PENGHASILAN DARI TRANSAKSI DERIVATIF
12.
DIVIDEN
13.
PENGHASILAN ISTERI DARI SATU PEMBERI KERJA
14.
PENGHASILAN LAIN YANG DIKENAKAN PAJAK FINAL
DAN/ATAU BERSIFAT FINAL
(4)
JUMLAH BAGIAN A
BAGIAN B
:
0
JBA
HARTA PADA AKHIR TAHUN
NO.
KODE
HARTA
NAMA HARTA
TAHUN
PEROLEHAN
HARGA PEROLEHAN
KETERANGAN
(1)
(2)
(3)
(4)
(5)
(6)
(Rupiah)
1.
2.
3.
4.
5.
dst
JUMLAH BAGIAN B
BAGIAN C
KODE
NO.
UTANG
(1)
:
0
JBB
KEWAJIBAN/UTANG PADA AKHIR TAHUN
NAMA PEMBERI PINJAMAN
(2)
(3)
ALAMAT
PEMBERI PINJAMAN
(4)
TAHUN
PEMINJAMAN
(5)
JUMLAH
(6)
1
2
3
4
5
dst
JUMLAH BAGIAN C
BAGIAN D
:
0
JBC
DAFTAR SUSUNAN ANGGOTA KELUARGA
NO.
NAMA
NIK
HUBUNGAN KELUARGA
PEKERJAAN
(1)
(2)
(3)
(4)
(5)
1
2
3
4
5
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
Halaman ke-
dari
halaman Lampiran-II
LEMBAR PENGHITUNGAN PAJAK PENGHASILAN TERUTANG
BAGI WAJIB PAJAK YANG KAWIN DENGAN STATUS PERPAJAKAN SUAMI-ISTERI PISAH HARTA DAN PENGHASILAN (PH) ATAU
ISTERI YANG MENGHENDAKI UNTUK MENJALANKAN HAK DAN KEWAJIBAN PERPAJAKANNYA SENDIRI (MT)
No.
Uraian
Penghasilan Neto Suami
Penghasilan Neto Isteri
(2)
(3)
(4)
(1)
A
PENGHASILAN NETO
1
PENGHASILAN NETO DALAM NEGERI DARI USAHA DAN/ATAU PEKERJAAN BEBAS
[Diisi dari Formulir 1770 Bagian A angka 1]
2
PENGHASILAN NETO DALAM NEGERI SEHUBUNGAN DENGAN PEKERJAAN
0
[Diisi dari Formulir 1770 Bagian A angka 2 atau Formulir 1770 S Bagian A angka 1]
3
PENGHASILAN NETO DALAM NEGERI LAINNYA
0
[Diisi dari Formulir 1770 Bagian A angka 3 atau Formulir 1770 S Bagian A angka 2]
4
PENGHASILAN NETO LUAR NEGERI
0
[Diisi dari Formulir 1770 Bagian A angka 4 atau Formulir 1770 S Bagian A angka 3]
5
ZAKAT / SUMBANGAN KEAGAMAAN YANG BERSIFAT WAJIB
0
[Diisi dari Formulir 1770 Bagian A angka 6 atau Formulir 1770 S Bagian A angka 5]
6
7
JUMLAH ( 1 + 2 + 3 + 4 - 5 )
0
0
0
KOMPENSASI KERUGIAN
[Khusus Bagi WP OP yang menyelenggarakan pembukuan. Diisi dari Formulir 1770 Bagian A angka 8]
8
0
JUMLAH PENGHASILAN NETO ( 6 - 7 )
No
Uraian
Nilai
(1)
(2)
(3)
B
JUMLAH PENGHASILAN NETO SUAMI DAN ISTERI [ A.8.(3) + A.8.(4) ]
C
PENGHASILAN TIDAK KENA PAJAK
D
PENGHASILAN KENA PAJAK [ B - C ]
E
PAJAK PENGHASILAN TERUTANG (GABUNGAN)
1
5% x
2
15% x
3
25% x
4
30% x
0
0
0
0
0
0
0
0
0
0
0
JUMLAH PAJAK PENGHASILAN TERUTANG (GABUNGAN)
0
F
PPh TERUTANG YANG DITANGGUNG Suami [ (A.8.(3) / B) x E ]
[Pindahkan nilai pada bagian ini ke SPT Suami
bagian C angka 12 Formulir 1770 atau ke bagian C angka 9 Formulir 1770 S]
0
G
PPh TERUTANG YANG DITANGGUNG Isteri [ (A.8.(4) / B) x E ]
[Pindahkan nilai pada bagian ini ke SPT Isteribagian C angka 12 Formulir 1770 atau ke bagian C angka 9 Formulir 1770 S]
0
,
Suami
Nama
:
NPWP
:
Tanda Tangan
Isteri
Nama
:
NPWP
:
Tanda Tangan
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