Schedule N Individual - Rental Income Form

Schedule N Individual

Rev. 05.02

RENTAL INCOME

200__

Taxable year beginning on ______________, _____ and ending on _____________, _____

Taxpayer's name

Social Security Number

Part I

Questionnaire

68

Rental Income (check one):

Check here if this is your principal industry or business

Code

;

;

;

Taxpayer

1

Spouse

2

Location of rented property - Number, Street and City

;

Fully Taxable

(01)

Tax Incentives under:

;

Act No. 78 of 1993

(02)

;

Act No. 52 of 1983

(03)

;

Act No. 8 of 1987

(04)

;

Act No. 135 of 1997

(05)

Nature of rented property (i.e. residence, apartment, etc.)

Case or concession number

Number of employees

Part II

Determination of Gain or Loss

77

0 0

1.

Income .............................................................................................................................................................................

(01)

0 0

Less: Operating expenses and other costs (Detail in Part III) .............................................................................

2.

(10)

0 0

3.

Net income ......................................................................................................................................................................

(11)

0 0

Less: Net operating loss from previous years (Submit schedule, see instructions) .......................................

4.

(12)

0 0

5.

Adjusted net income .....................................................................................................................................................

(13)

0 0

Less: Exempt amount

%

6.

of line 5 (See instructions) ..................................................................

(14)

Gain (or loss) (If it is a gain determined under provisions not considered under Act No.135 of 1997, transfer

7.

0 0

to page 1, Part 2, line 2 O of the return. If it is a loss, see instructions) .......................................................................

(15)

8.

Tax on income derived from the operation of a business with exemption decree under Act 135 of 1997:

;

;

;

;

;

10%

7%

4%

2%

Other _____ % (Multiply line 7 by the corresponding %.

0 0

Transfer to page 2, Part 4, line 24 of the return) (See instructions) ......................................................................

(20)

Part III

Operating Expenses and Other Costs

87

0 0

1.

Salaries, commissions and allowances to employees ..........................................................................................

(01)

0 0

2.

Payroll expenses ...........................................................................................................................................................

(02)

0 0

3.

Contributions to pension plans ...................................................................................................................................

(03)

0 0

4.

Contributions to deferred income plans ....................................................................................................................

(04)

0 0

5.

Medical or hospitalization insurance .........................................................................................................................

(05)

0 0

6.

Interest on business debts ...........................................................................................................................................

(06)

0 0

7.

Property taxes ................................................................................................................................................................

(07)

0 0

8.

Other taxes, patents and licenses ..............................................................................................................................

(08)

0 0

9.

Repairs ............................................................................................................................................................................

(09)

0 0

10.

Motor vehicles expenses .............................................................................................................................................

(10)

0 0

11.

Utilities .............................................................................................................................................................................

(11)

0 0

12.

Insurance ........................................................................................................................................................................

(12)

0 0

13.

Advertising ......................................................................................................................................................................

(13)

0 0

14.

Travel expenses ............................................................................................................................................................

(14)

0 0

15.

Professional services ...................................................................................................................................................

(15)

0 0

16.

Maintenance ..................................................................................................................................................................

(16)

0 0

17.

Depreciation and amortization (Submit Schedule E) .............................................................................................

(17)

0 0

18.

Other expenses (Submit detailed schedule) ............................................................................................................

(18)

Total (Transfer to Part II, line 2 of this Schedule) ....................................................................................................

19.

(30)

0 0

Conservation Period: Ten (10) years