Form Cd-E-4 - Annual Declaration And Payment Form For Corporate Income Tax Page 2

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[10] Net profit (loss) by Financial Declaration...............................................................................................................................[10]

Adustments to Income

[11] Foreign source of income (schedule A) .......................................................................................[11]

[12] Recovery of bad debts (schedule B).............................................................................................[12]

[13] Capital gain (schedule C)..................................................................................................................[13]

[14] Dividends (schedule D).....................................................................................................................[14]

[15] Other income/gain (schedule E)....................................................................................................[15]

[16] Total adjustment to income (add lines [11] to [15])...........................................................................................................[16]

[17] Profit (loss) after adjustment to income (line [10] + line [16])........................................................................................[17]

Adjustments to Expenses (mostly negative numbers shown in brackets - except line 24)

[18] Disallowed expenses (schedule F).................................................................................................[18]

[19] Representation costs (schedule G)................................................................................................[19]

[20] Reserve funds (schedule H)..............................................................................................................[20]

[21] Payments to related persons (schedule I)..................................................................................[21]

[22] Depreciation (schedule J )................................................................................................................[22]

[23] Amortization (schedule K)................................................................................................................[23]

[24] Special allowance for new assets (schedule L) ........................................................................[24]

[25] Capital loss (schedule C)...................................................................................................................[25]

[26] Other expenses (schedule M)..........................................................................................................[26]

[27] Total adjustment to expenses (add lines [18] to [26]).......................................................................................................[27]

[28]

Profit (loss) of business after adjustment to expenses (line [17]- line [27])

, (When line 27 is in brackets add the whole numbers)

[29] Charitable contributions (attach receipts), (limit of 5% of line 28)....................................[29]

[30] Loss carry forward (refer to guide)................................................................................................[30]

[31] Add lines [29] and [30]..................................................................................................................................................................[31]

[32] Adjusted profit (line [28]- line [31])..........................................................................................................................................[32]

[33] Corporate income tax

.....................................................[33]

(If line 32 is a profit, multiply by 10%. If line [32] is a loss, enter 0)

For Insurance Companies only

[34] Gross premiums for the tax period...............................................................................................[34]

[35] Corporate Income Tax for Insurance Companies ( [34] * 5%)........................................................................................[35]

Refund or Amount Due

[36] Corporate Income Tax (add the amounts in the line [33] and [35] according to your situation)......................[36]

[37] Foreign states tax credit (schedule O)..........................................................................................[37]

[38] Tax withheld on interest, royalties and rent by resident payers (schedule P) -attach

certificates........................................................................................................................................................[38]

[39] Total Credits for the period [37] +[38] ..................................................................................................................................[39]

[40] Line [36] less [39] ...........................................................................................................................................................................[40]

[41] Installments paid (Schedule Q)..................................................................................................................................................[41]

[42] Tax to be paid with this form [40]-[41]...................................................................................................................................[42]

If the result on line [42] is (+) you have an Amount Due. If the result on line [42] is (-) you have a refund. Write the amount in the

appropriate box.

[43] Amount Due

[44] Refund ..........

[45] Bank Name ................................................

[46] Account Holder........................................

[47] Account Number.....................................