Part IX

Annual Statement of Deduction of Income Tax from Salary

[ See rule 44(1) ] Tax Year :______________ Page No_______________
A. Employer's Profile LTU/RTO:_________________________________________
NTN/FTN:___________________ Employer Name:____________________________________ Address:__________________________________________(in block letters)
Telephone:__________________ Fax:_______________________ Email______________________________________________________
B. Particulars of Employees and details of Tax Deducted

Credit for tax

Teacher/
paid by Tax Deducted
Chargeable researcher/re
Serial NTN CNIC Name of Employee Gross Tax employees & Deposited
Salary duction in
given by by Employer
gross tax
Employer(*)
1 2 3 4 5 6 7 8 9=(6-7-8)

Total
(*) Credit for tax collected alongwith telephone, mobile, motor vehicles
I, _____________________________holder of CNIC No________________________ in my capacity as Self / Member or Partner of Association of Persons / Principal Officer / Trustee / Representative of
the Employer named above do hereby solemnly declare that to the best of my knowledge and belief the information given in this Statement is correct, complete and in accordance with the provisions of the
Income Tax Ordinance, 2001 and Income Tax Rules, 2002. I further certifiy that the amount of chargeable salary indicated against each employee has been determined / calculated. Keeping in view the
provisions of the Income Tax Ordinance 2001 and Income Tax Rules, 2002.
(The altermative in the verification, which is not applicable, Should be scored out)

Date_________________(dd/mm/yyyy) Signature:____________________