Form of return of withholding tax under the Income-tax

Ordinance, 1984 (Ord. XXXVI OF 1984)

(Return under section 75A)
FOR COMPANY TAXPAYERS ONLY
1.

Name of the Company:

................................................................................

2. TIN/UTIN:

3. TCAN:

4.

(a) Circle: .................................. (b) Taxes Zone: .............................................

5.

Deduction/Collection Period:
(a)
1st quarter (July-September),
(b)
2nd quarter (October-December),
(c)
3rd quarter (January-March),
(d)
4th quarter (April-June),

6.

(a) Address:

Year ........ ;
Year ........ ;
Year ........ ;
Year ........ ;

.........................................................................................
.........................................................................................
.........................................................................................

(b Phone:...........................................................................................................
(c) Fax No.: .......................................................................................................
(d) e-mail:...........................................................................................................
(e) web address:
7.

Contact person:

http://www.......................................................................
(a)

Name:.......................................................................

(b)

Designation:..............................................................

(c)

Telephone: ................................................................

(d)

Mobile:

(e)

e-mail: .......................................................................

.................................................................

8.

Particulars of tax deducted or collected:

SL.

Type of
payment

(1)
(2)
1. Salary
2. a.
Payment
to
contractors/ suppliers
b. Indenting commission
c.

Shipping
agency
commission
3. a. Service of doctor

4.

5.
6.
7.

8.
9.

10.
11.

12.
13.

14.

15.

16.
17.

Section of Payment
I.T.O, during the
1984
quarter
(3)
50
52
52
52
52A(1)

b. Royalty or technical 52A(2)

know-how fee
c. Fees for professional 52A(3)
& technical services
a. Payment for private
52AA
security service
b.
Payment
to
52AA
Stevedoring agencies
c. Any other service
52AA
L/C commission
52I
Freight forward agency
52M
commission
Payment
to
foreign
52O
technician serving in
diamond cutting industry
Payment for services
52P
from convention hall etc.
Payment to resident
52Q.
person against services
provided
to
foreign
person
House/office rent
53A
Collection of tax from
53AA
shipping business of a
resident
Receipt from export of
53B
manpower
Collection of tax from
53BB
export of knit-wear and
woven garments
Collection of tax from 53BBB
member
of
stock
exchanges
Collection of tax from 53BBBB
export of any good
except certain items
Receipt from public
53C
auction
Courier business of a
53CC

(4)

Rate of Amount of
deduction/
tax
collection deduction/
collection
(5)
(6)

non-resident
18. Payment to actor/actress
19. Payment as commission
or
discount
for
distribution of goods
20. Payment
to
foreign
buyer's agent
21. Interest on savings and
fixed deposit
22. Insurance commission
23. Payment to surveyor of
general insurance
24. Rental value of vacant
land, plant or machinery
25. Advertising
bill
of
newspaper or magazine
26. Sale of share at a
premium
27. Transfer of securities by
sponsor shareholders
28. Dividends
29. Lottery
30. Payment to non-resident

53D
53E

53EE
53F
53G
53GG
53J
53K
53L
53M
54
55
56

Verification
I,
..........................................................................................,
designation
........................................................................................ solemnly declare that to the best of my
knowledge and belief the information given in this return is correct and complete.
Place: .............................
Date : ............................

Signature and seal

NB: 1. The return shall be accompanied by a statement of deduction or collection of tax

of treasury challans or payment orders.
2. Tax shall be deposited to respective account code according to the following
Name of the
Zone
Taxes Zone-1, Dhaka
Taxes Zone-2, Dhaka
Taxes Zone-3, Dhaka
Taxes Zone-4, Dhaka
Taxes Zone-5, Dhaka
Taxes Zone-6, Dhaka
Taxes Zone-7, Dhaka
Taxes Zone-8, Dhaka
Taxes Zone-1, Chittagong
Taxes Zone-2, Chittagong
Taxes Zone-3, Chittagong
Taxes Zone-Khulna
Taxes Zone-Rajshahi
Taxes Zone-Rangpur

Income taxCompanies

Income tax-other
than Company

1-1141-0001-0101
1-1141-0005-0101
1-1141-0010-0101
1-1141-0015-0101
1-1141-0020-0101
1-1141-0025-0101
1-1141-0030-0101
1-1141-0035-0101
1-1141-0040-0101
1-1141-0045-0101
1-1141-0050-0101
1-1141-0055-0101
1-1141-0060-0101
1-1141-0065-0101

1-1141-0001-0111
1-1141-0005-0111
1-1141-0010-0111
1-1141-0015-0111
1-1141-0020-0111
1-1141-0025-0111
1-1141-0030-0111
1-1141-0035-0111
1-1141-0040-0111
1-1141-0045-0111
1-1141-0050-0111
1-1141-0055-0111
1-1141-0060-0111
1-1141-0065-0111

along with copy

table:

Taxes Zone-Sylhet
Taxes Zone-Barisal
Large Taxpayer Unit
Central Survey Zone

1-1141-0070-0101
1-1141-0075-0101
1-1145-0010-0101
1-1145-0005-0101

1-1141-0070-0111
1-1141-0075-0111
1-1145-0010-0111
1-1145-0005-0111