It is a good practice to save your work frequently. Please use SAVE AS DRAFT option.
4.
In Forms wherever information is captured in tables
(a) Adding new Row: Click ADD button to add a new row and enter values in the field provided.
(b) Deleting Row: Select the row to delete from the list and click DELETE ROW button.
5.
Please verify the Form before you submit.
IT Form A
(Abridged)
Affix your
passport
photograph here
GOVERNMENT OF STATE
PERSONAL INCOME TAX RETURNS FORM
APPLICABLE DURING THE YEAR ENDED 31 ST DECEMBER
PART A – PERSONAL PARTICULARS
Name in full (Surname first) DOB
Phone Email
TIN (If you already have)
Address
Occupation Industry Sector
(Please see attched industry sector list)
Name of Employer (If any)
Address of business or Employment
City
About your Spouse
Marital status If Married, Name of Spouse
Occupation Employer or Business Name
Nationality Date of Arrival in Nigeria
PART B
INCOME DECLARATION FOR YEAR ENDED 31ST DECEMBER,
(Complete each section. Write “none” if a section does not apply to you)
DEDUCTIONS CLAIMED FROM INCOME OF THE YEAR ENDED, 31ST DECEMBER,
Contributions or involvement in the following, enjoy relief at various allowable rates; NHIS – 5%, NHF – 2.5%, Pension contribution – 8%, Life assurance premium – 100%, Gratuity – 100%. Other deductions that may be claimed by approaching the ESIRB include; Widows and orphans Pension Ordinance, NISTF, Provident or other societies fund. Please list the deductions claimed (if any) and the amounts at applicable rates.
Part C: Compute your Consolidated Relief Allowance (CRA)
Tax Reliefs
Tax Amount
Higher of N200,000 p.a or 1% of aggregate income
₦ 0.00
20% of income
₦ 0.00
CRA
₦ 0.00
Part D: Compute Chargeable Income (CI)
Source of Income
₦
K
Annual Income (AI)
Cummulative Relief Allownace (CRA)
Total Deduction Exempt Items (TEI)
Chargeable Income (CI) = AI – CRA - TEI
Part E: Apply Income tax rates to corresponding bands while deducting the amounts from the CI
Bands and Rates
₦
K
Subtract first N300,000 at 7%
-
Subtract next N300,000 at 11%
-
Subtract next N500,000 at 15%
-
Subtract next N500,000 at 19%
-
Subtract next 1,600,000 at 21%
-
Calculate remaining balance of the CI at 24%
-
Annual Payable Tax (Total)
-
Note:
Your minimum annual
tax is 1% of your
aggregate income, even
If your tax computation
results in negative
chargeable value.
Note:
Monthly Payable Tax
(Divide Annual Tax by 12)
₦
K
-
Declaration (Which must be completed and signed)
I, hereby declare that the information supplied in this form is a true and correct statement of the amount of my income from all sources.
Given under my hand, this ______________day of _________________20 _____________
__________________________________________
Signature of person making this Return
