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Request for a Tax Deduction Directive_ Form C - FORM C _20080229_.cdr

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Request for a Tax Deduction Directive_ Form C - FORM C _20080229_.cdr Powered By Docstoc
					                                                                                        INCOME TAX                                                            Form C
                                                                                        Request for a tax deduction directive                                 ??? ???
                                                                                        Retirement Annuity funds

Year of assessment ended on:            C C Y Y             M M      D D                                                                 For official use
Income tax reference number                                                                                                             Application number




Particulars of member

 Surname

 First names

 Date of birth                     C    C     Y    Y        M     M        D       D                 Identity number

 Other identification                                                                  Specify other identification

 If the taxpayer/member is not registered for Income tax, select one of the following reasons:
                                       SITE                          Unemployed                  Other, specify

 Annual income                 R                                                                  Employee number

Residential address



                                                                                                                                               Postal code

 Postal address



                                                                                                                                               Postal code



Particulars of fund

 Name of fund

 Contact person

 Telephone number                            C    O     D    E                             N     U   M    B   E    R

 Fund approval number              1 8 2 0 4                                                                            Policy number

 PAYE reference number             7
Indicate whether this fund is 01 An approved fund                     02 Other, specify

 Postal address



                                                                                                                                               Postal code


Particulars of gross lump sum due

 Reason for directive:                 Retirement                                              Retirement due to ill health                   Transfer prior to retirement

                                       Death prior to retirement                               Death after retirement                         Surplus apportionment

                                       Tax affairs not in order                                Maintenance order                              Divorce order
                                       Withdrawal

 Date of accrual                   C    C     Y    Y     M       M     D       D           Date of death of member (if applicable) C      C     Y   Y     M    M     D       D

 Gross amount of lump sum payment                                                                                  R
 (Including the amount deemed to be accrual in respect of par 2B of the Second Schedule)                                                                            ,
Total value of full annuity                                                                                        R                                                ,
Amount distributed to non-members spouse in respect of divorce order                                               R                                                ,
 Commencement date of              C    C     Y    Y     M       M     D       D
 policy
                                                                                           1-2
Particulars of gross lump sum due (Continue)

 Did the fund pay any portion of the lump sum payment into another fund?                                                                                                               YES         NO
 If ‘YES’, state the name of
 the fund
 Fund approval number                   1 8 2 0 4
 The amount transferred to the transferee fund                                                                                    R
                                                                                                                                                                                               ,
 On death of member prior to retirement from the fund: What amount would the taxpayer have
 derived in respect of the commutation of one-third of the annuity if he had Retired the day
 preceding his death?                                                                                                             R
                                                                                                                                                                                               ,
 On death of member prior to retirement from the fund: State total contributions by member to
 the fund, accumulated at 7% compound interest to the date of death.                                                              R
                                                                                                                                                                                               ,
 Where the member’s contribution to the fund have exceeded such amounts as ranked for
 deduction against his income in terms of section 11(n) of the Income Tax Act no. 58 of 1962, as
 amended or the corresponding provisions of any previous Income Tax Act, state total amount
 (if known) of excess during membership.                                                         R
                                                                                                                                                                                               ,

Period of employment in Public Sector fund
(Only applicable where a benefit was paid into the current fund from a pension fund as contemplated in paragraph (a) or (b) of the definition of “pension fund” in section 1)

 Date from                              C     C       Y       Y   M     M      D      D         Date to C        C     Y     Y        M    M      D      D        =                   Completed years
 Amount transferred or the amount attributed to the period of membership in the pension fund as contemplated in par (a) / (b) of the definition of
 ‘pension fund’ in sec 1.                                                                                                         R
                                                                                                                                                                                               ,
 Date the amount was transfer from Public Sector fund                                                                                                        C    C     Y       Y     M    M   D        D


               Date of accrual                                                          Amount                                                                   Name of fund
  C     C     Y     Y      M      M      D        D       R
                                                                                                                       ,
  C     C     Y     Y      M      M      D        D       R
                                                                                                                       ,
  C     C     Y     Y      M      M      D        D       R
                                                                                                                       ,


Declaration

 Certified to be true and correct to the best of my knowledge.


                                                                                                                                                             C    C     Y       Y     M    M   D        D
                        Signature of administrator                                                                                                                                  Date




Definitions

 Other identification:                Passport number, work permits number, etc.

 Annual Income:                       Must reflect all income for a full year for e.g. Salary, remuneration, earnings, emolument, wages, bonus, fees, gratuities,
                                      commission, pension, overtime payments, royalties, stipend, allowances and benefits, interest, annuities, share of profits,
                                      rental income, compensation, honorarium.

 Employee number:                     A number allocated by the employer to the employee.

 Fund Approval Number: The number allocated to the Fund by SARS, which consists of 18/20/4 plus six other numbers.

 Policy Number:                       A number allocated by the Fund to the member.

 Period of employment in Public Sector fund: These fields must only be completed where a benefit was transferred from a pension fund as
                         contemplated in paragraph (a) or (b) of the definition of 'pension fund' in section 1 to an fund as contemplated in paragraph
                         (c) of the definition of pension fund in section 1 (approved fund).

                                                                                                     2-2

				
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