Employee'S Declaration Of Emoluments, Deductions And Tax Credits - Government Of The Republic Of Trinidad And Tobago Board Of Inland Revenue Page 2

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CLAIMS FOR DEDUCTIONS AND TAX CREDITS
Resident Individuals Only
1.
Personal Allowance ($60,000)
$________
2.
Tertiary Education Expenses ... ... ... ... ... ... ... ... ... ... ... ... ...
$________
Name and Address of Institution ....................................................................................
.........................................................................................................................................
Note: Limited to $60,000 per household.
For expenses incurred where the institution is situated outside Trinidad and Tobago,
excluding Public Regional Institutions. (See Note 3)
3.
Contributions/Premiums paid (See Note 5)
(a) Government Widows’ and Orphans’ Fund
... ... ... ... ... ... ... $...........…
(b) N.I.S (70% of Employees Contribution)
… … … … … … … $..............
(c) Approved Provident, Superannuation Fund, Approved Fund or Scheme ... $..............
(d) Approved Pension Fund Plan
... ... ... ... ... ... ... ... ... ... $..............
(e) Approved Deferred Annuity Plan ... ... ... ... ... ... ... ... ... ... $.............
Name of Financial Institution ………………………………………………………….
Total [Lines 4 (a) to (e)] Limited to $30,000 ... ... ... ... ... ... ... ... ... ... ... ... $________
4.
Alimony/Maintenance
... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... $________
Registered No.
Date
Name and Address
B.I.R. No.
Amount Payable
Deed/Court
of
Of Recipient(s)
of
$
Order
Deed
Recipient
6.
TOTAL DEDUCTIONS (Sum of Lines 1 to 5) ... ... ... ... ... ... ... ... ... ...
$________
7.
TAX CREDIT:
Venture Capital ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
$________
WHERE CLAIMS ARE MADE ONLY IN RESPECT OF PERSONAL ALLOWANCE, NATIONAL
INSURANCE CONTRIBUTIONS AND COMPANY’S GROUP PENSION PLANS THIS FORM DOES NOT
REQUIRE APPROVAL OF THE BOARD AND MUST BE LODGED DIRECTLY WITH YOUR EMPLOYER.

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