Resident Individual Income Tax Return

Section A Part 1 : Return Information

Personal Details

Personal Identification Number A005498974S Taxpayer Name DAVID OWUOR OTIENO

South of Nairobi, South of Nairobi, Ugenya
Address Type of Return Original
District, 00200, 36996.
Return Period From 01/01/2021 Return Period To 31/12/2021
Year of Income 2021 Date of Application 20/02/2022
Do you have any income other than Do you want to declare a Wife's Income
Yes No
employment income? (Yes/No)
Have been issued the Exemption Certificate
No
for disablity?

Wife Details
Wife PIN Wife Name
Does your wife have any Income other than
employment income?
Does your wife have been issued the
Exemption Certificate for disablity?

Section A Part 2 : Bank Details

Description Details
Bank Name KENYA COMMERCIAL BANK LIMITED
Branch Name Kisumu
City KISUMU
Accounts Holder's Name DAVID OWUOR OTIENO
Accounts Number 1141170418

Section A Part 3 : Details of Auditor

Description Details(Self) Details(Wife)

PIN of Auditor
Name of Auditor
Date of Audit Certificate

Section A Part 4 : Landlord Details

Period of
Occupancy
Physical Full Address Postal Address
During the Amount of
Details PIN of Name of Year
Sr.No. Gross Rental
For Landlord Landlord
Post Income (Ksh)
Tax Descriptive Postal Date Date
L.R.Number Building Street/Road City/Town County District P.O.Box Office
Area/Locality Address Code From To
Name
 Period of
Occupancy
Physical Full Address Postal Address
During the Amount of
Details PIN of Name of Year
Sr.No. Gross Rental
For Landlord Landlord
Post Income (Ksh)
Tax Descriptive Postal Date Date
L.R.Number Building Street/Road City/Town County District P.O.Box Office
Area/Locality Address Code From To
Name
Not Available
Total(Self) 0.00
Total(Wife) 0.00

Section A Part 5 : Tenant Details

Period of
Occupancy
Physical Full Address Postal Address
During the Amount of
Details PIN of Tenant Name of Year
Sr.No. Gross Rental
For (If Available) Tenant
Tax Post Income (Ksh)
Descriptive P.O. Postal Date Date
L.R.Number Building Street/Road City/Town County District Area / Office
Address Box Code From To
Locality Name
Not Available
Total(Self) 0.00
Total(Wife) 0.00

Section A Part 6 : Details of Exemption Certificate for Disability

Sr.No. Details For Exemption Certificate Number Date From Date To

Not Available

Section B : Profit and Loss Account for the Year Ending on 31st December, 2021 (Self)

Business Farming Interest Commission Consolidated

Sr.No. Description Rental (Ksh) Other (Ksh)
(Ksh) (Ksh) (Ksh) (Ksh) (Ksh)
1. Gross Turnover of Business or Profession (1.1+1.2) 914,100.00 0.00 0.00 0.00 0.00 0.00 914,100.00
1.1 Gross Turnover ( General Trading / Manufactured Goods) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
1.2 Gross Turnover of Profession / Consultancy Fees 914,100.00 0.00 0.00 0.00 0.00 0.00 914,100.00
2. Cost of Sales (2.1+2.2+2.3+2.4-2.5) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.1 Opening Stock (2.1.1+2.1.2+2.1.3) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.1.1 Raw Materials 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.1.2 Work in Progress 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.1.3 Trading / Manufactured Goods (finished goods) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.2 Purchases (2.2.1+2.2.2) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.2.1 Local Purchases 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.2.2 Imports 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.3 Other Direct Costs (2.3.1+2.3.2) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.3.1 Direct Wages 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.3.2 Direct Expenses 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.4 Factory Overheads (2.4.1+2.4.2+2.4.3+2.4.4+2.4.5+2.4.6) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.4.1 Rent and Rates 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.4.2 Fuel and Power 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.4.3 Indirect Wages 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.4.4 Consumables 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.4.5 Depreciation 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.4.6 Other Overheads 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.5 Closing Stock (2.5.1+2.5.2+2.5.3) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.5.1 Raw Materials 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.5.2 Work in Progress 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2.5.3 Trading / Manufactured Goods (finished goods) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
3 Gross Profit (1 - 2) 914,100.00 0.00 0.00 0.00 0.00 0.00 914,100.00
4 Other Income (4.1+4.2+4.3+4.4+4.5+4.6+4.7+4.8+4.9+4.10) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4.1 Dividend 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4.2 Annuity 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4.3 Natural Resource Reciepts 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4.4 Royalties 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4.5 Gifts in connection with the use or exploitation of property 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4.6 Profit on Disposal of Assets 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4.7 Realized Exchange Gain 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4.8 Unrealized Exchange Gain 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4.9 Bad Debts Recovered 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4.10 Insurance Compensation 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4.11 Other Income (Part II "Total of Other Income") 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5 Operating Expense (5.1 to 5.28) 604,000.00 0.00 0.00 0.00 0.00 0.00 604,000.00
5.1 Advertisement 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.2 Audit Expenses 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.3 Bad Debts Written Off 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.4 Commission 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.5 Computer Expenses 39,000.00 0.00 0.00 0.00 0.00 0.00 39,000.00
5.6 Consumption of Stores and Spare Parts 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.7 Conveyance Expenses 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.8 Donations 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.9 Entertainment 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.10 Freight and Transport 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.11 Gifts 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.12 Hotel, Boarding and Lodging Expenses 257,000.00 0.00 0.00 0.00 0.00 0.00 257,000.00
5.13 Legal Expenses 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.14 Power and Fuel 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.15 Provision for Bad and Doubtful Debts 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.16 Rent Expenses for Premises 120,000.00 0.00 0.00 0.00 0.00 0.00 120,000.00
5.17 Repairs of Building 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.18 Repairs of Machinery 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.19 Sales Promotion including Publicity (other than advertisement) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.20 Staff Welfare Expenses 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.21 Start up cost / Pre- Operating Expenses 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.22 Stationery & Printing 24,000.00 0.00 0.00 0.00 0.00 0.00 24,000.00
5.23 Subsistence Allowance 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5.24 Telephone Expenses 36,000.00 0.00 0.00 0.00 0.00 0.00 36,000.00
5.25 Training Expenditure 80,000.00 0.00 0.00 0.00 0.00 0.00 80,000.00
5.26 Travelling Expenses including Foreign Travelling 36,000.00 0.00 0.00 0.00 0.00 0.00 36,000.00
5.27 Work Shop - Conference Expenses 12,000.00 0.00 0.00 0.00 0.00 0.00 12,000.00
5.28 Livestock, game and produce bought or received in exchange 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6 Administrative Expenses (6.1+6.2+6.3+6.4+6.5) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6.1 Depreciation 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6.2 Loss on Disposal of Assets 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6.3 Scientific Research Expenses 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6.4 Management Fees 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Employment Expenses
6.5 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(6.5.1+6.5.2+6.5.3+6.5.4+6.5.5+6.5.6+6.5.7+6.5.8+6.5.9)
6.5.1 Salaries and Wages 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6.5.2 Bonus 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6.5.3 Reimbursement of Medical Expenses 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6.5.4 Leave Encashment 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6.5.5 Leave Travel Benefits 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6.5.6 Rent Expenses for Employees 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6.5.7 Contribution to Retirement Fund 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6.5.8 Contribution to any Other Fund 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6.5.9 Any Other Employment Cost 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7 Financial Expenses (7.1+7.2+7.3+7.4+7.5+7.6) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7.1 Interest Expense 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7.2 Bank Charges 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7.3 Commitment Fees 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7.4 Insurance 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7.5 Realized Exchange Loss 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7.6 Unrealized Exchange Loss 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Other Expenses (Describe the Head of Expense)(Part I Total of
8 0.00 0.00 0.00 0.00 0.00 0.00 0.00
"Total of Others Expences")
9 Profit / (Loss) before Tax (3 + 4 - 5 - 6 - 7 - 8) 310,100.00 0.00 0.00 0.00 0.00 0.00 310,100.00
10 Income Tax Expense 0.00 0.00 0.00 0.00 0.00 0.00 0.00
11 Profit/(Loss) after tax carried to Balance Sheet(9(Consolidated-10)) 0.00 0.00 0.00 0.00 0.00 0.00 310,100.00
Part I : Other Expenses ( Describe the Head of Expense)

Sr.No. Name of Expense Business (Ksh) Farming (Ksh) Rental (Ksh) Interest (Ksh) Commission (Ksh) Other (Ksh)
 Sr.No. Name of Expense Business (Ksh) Farming (Ksh) Rental (Ksh) Interest (Ksh) Commission (Ksh) Other (Ksh)
Not Available
Total of Other Expenses 0.00 0.00 0.00 0.00 0.00 0.00

Part II : Part II : Other Income (Describe the Head of Income) (Self)

Sr.No. Name of Income Business (Ksh) Farming (Ksh) Rental (Ksh) Interest (Ksh) Commission (Ksh) Other (Ksh)
Not Available
Total of Other Income 0.00 0.00 0.00 0.00 0.00 0.00

Section B : Profit and Loss Account for the Year Ending on 31st December, 2021 (Wife)

Business Farming Interest Commission Consolidated

Sr.No. Description Rental (Ksh) Other (Ksh)
(Ksh) (Ksh) (Ksh) (Ksh) (Ksh)
1. Gross Turnover of Business or Profession (1.1+1.2)
1.1 Gross Turnover ( General Trading / Manufactured Goods)
1.2 Gross Turnover of Profession / Consultancy Fees
2. Cost of Sales (2.1+2.2+2.3+2.4-2.5)
2.1 Opening Stock (2.1.1+2.1.2+2.1.3)
2.1.1 Raw Materials
2.1.2 Work in Progress
2.1.3 Trading / Manufactured Goods (finished goods)
2.2 Purchases (2.2.1+2.2.2)
2.2.1 Local Purchases
2.2.2 Imports
2.3 Other Direct Costs (2.3.1+2.3.2)
2.3.1 Direct Wages
2.3.2 Direct Expenses
2.4 Factory Overheads (2.4.1+2.4.2+2.4.3+2.4.4+2.4.5+2.4.6)
2.4.1 Rent and Rates
2.4.2 Fuel and Power
2.4.3 Indirect Wages
2.4.4 Consumables
2.4.5 Depreciation
2.4.6 Other Overheads
2.5 Closing Stock (2.5.1+2.5.2+2.5.3)
2.5.1 Raw Materials
2.5.2 Work in Progress
2.5.3 Trading / Manufactured Goods (finished goods)
3 Gross Profit (1.0 - 2.0)
4 Other Income (4.1+4.2+4.3+4.4+4.5+4.6+4.7+4.8+4.9+4.10)
4.1 Dividend
4.2 Annuity
4.3 Natural Resource Reciepts
4.4 Royalties
4.5 Gifts in connection with the use or exploitation of property
4.6 Profit on Disposal of Assets
4.7 Realized Exchange Gain
4.8 Unrealized Exchange Gain
4.9 Bad Debts Recovered
4.10 Insurance Compensation
4.11 Other Income (Part II "Total of Other Income")
5 Operating Expense (5.1 to 5.28)
5.1 Advertisement
5.2 Audit Expenses
5.3 Bad Debts Written Off
5.4 Commission
5.5 Computer Expenses
5.6 Consumption of Stores and Spare Parts
5.7 Conveyance Expenses
5.8 Donations
5.9 Entertainment
5.10 Freight and Transport
5.11 Gifts
5.12 Hotel, Boarding and Lodging Expenses
5.13 Legal Expenses
5.14 Power and Fuel
5.15 Provision for Bad and Doubtful Debts
5.16 Rent Expenses for Premises
5.17 Repairs of Building
5.18 Repairs of Machinery
5.19 Sales Promotion including Publicity (other than advertisement)
5.20 Staff Welfare Expenses
5.21 Start up cost / Pre- Operating Expenses
5.22 Stationery & Printing
5.23 Subsistence Allowance
5.24 Telephone Expenses
5.25 Training Expenditure
5.26 Travelling Expenses including Foreign Travelling
5.27 Work Shop - Conference Expenses
5.28 Livestock, game and produce bought or received in exchange
6 Administrative Expenses (6.1+6.2+6.3+6.4+6.5)
6.1 Depreciation
6.2 Loss on Disposal of Assets
6.3 Scientific Research Expenses
6.4 Management Fees
6.5 Employment Expenses
(6.5.1+6.5.2+6.5.3+6.5.4+6.5.5+6.5.6+6.5.7+6.5.8+6.5.9)
6.5.1 Salaries and Wages
6.5.2 Bonus
6.5.3 Reimbursement of Medical Expenses
6.5.4 Leave Encashment
6.5.5 Leave Travel Benefits
6.5.6 Rent Expenses for Employees
6.5.7 Contribution to Retirement Fund
6.5.8 Contribution to any Other Fund
6.5.9 Any Other Employment Cost
7 Financial Expenses (7.1+7.2+7.3+7.4+7.5+7.6)
7.1 Interest Expense
7.2 Bank Charges
7.3 Commitment Fees
7.4 Insurance
7.5 Realized Exchange Loss
7.6 Unrealized Exchange Loss
8 Other Expenses (Part I Total of "Total of Other Expenses")
9 Profit / (Loss) before Tax (3 + 4 - 5 - 6 - 7 - 8)
10 Income Tax Expense
11 Profit/(Loss) after tax carried to Balance Sheet(9(Consolidated-10))
Part I : Other Expenses ( Describe the Head of Expense)

Sr.No. Name of Expense Business (Ksh) Farming (Ksh) Rental (Ksh) Interest (Ksh) Commission (Ksh) Other (Ksh)
Not Available
Total of Other Expenses 0.00 0.00 0.00 0.00 0.00 0.00

Part II : Part II : Other Income (Describe the Head of Income) (Wife)

Sr.No. Name of Income Business (Ksh) Farming (Ksh) Rental (Ksh) Interest (Ksh) Commission (Ksh) Other (Ksh)
Not Available
Total of Other Income 0.00 0.00 0.00 0.00 0.00 0.00

Section C : Balance Sheet as on 31st December, 2021

APPLICATION OF FUNDS

Sr.No. Description Self(Ksh) Wife(Ksh)

1. Fixed Assets - Non Current Assets (1.1+1.2+1.3+1.4+1.5+1.6-1.7) 1.00 0.00

1.1 Land and Building 1.00 0.00
1.2 Plant and Machinery 0.00 0.00
1.3 Motor Vehicles 0.00 0.00
 1.4 Furniture and Fixtures 0.00 0.00
1.5 Other Assets 0.00 0.00
1.6 Intangible Assets 0.00 0.00
1.7 Accumulated Depreciation / Amortisation 0.00 0.00

2. Investments (2.1+2.2+2.3+2.4+2.5) 0.00 0.00

2.1 Shares 0.00 0.00
2.2 Debentures 0.00 0.00
2.3 Fixed Deposits 0.00 0.00
2.4 Government Securities 0.00 0.00
2.5 Other Investments 0.00 0.00

3. Current Assets, Loans and Advances (3.1+3.2+3.3) 0.00 0.00

3.1 Current Assets (3.1.1+3.1.2+3.1.3+3.1.4) 0.00 0.00
3.1.1 Inventories (3.1.1.1+3.1.1.2+3.1.1.3+3.1.1.4) 0.00 0.00
3.1.1.1 Stores / Consumable including Packing Materials 0.00 0.00
3.1.1.2 Raw Materials (other than in 3.1.1.1) 0.00 0.00
3.1.1.3 Work-in-Progress 0.00 0.00
3.1.1.4 Trading / Manufactured goods (Finished Goods) 0.00 0.00
3.1.2 Accounts Receivable /Debtors (3.1.2.1+3.1.2.2+3.1.2.3) 0.00 0.00
3.1.2.1 Trade Receivables/Debtors 0.00 0.00
3.1.2.2 Prepayments 0.00 0.00
3.1.2.3 Other Receivables / Other Debtors 0.00 0.00
3.1.3 Cash and Bank Balance (3.1.3.1+3.1.3.2) 0.00 0.00
3.1.3.1 Bank Balance 0.00 0.00
3.1.3.2 Cash in Hand and Cash Equivalents 0.00 0.00
3.1.4 Other Current Assets 0.00 0.00
3.2 Loans and Advances (3.2.1+3.2.2+3.2.3+3.2.4) 0.00 0.00
3.2.1 Loans to Related Parties 0.00 0.00
3.2.2 Loans and Advances to Staff 0.00 0.00
3.2.3 Deposits (Other than Fixed Deposit) 0.00 0.00
3.2.4 Loans and Advances to Others 0.00 0.00
3.3 Deferred Tax Assets 0.00 0.00

4. Current Liabilities and Provisions (4.1+4.2) 0.00 0.00

4.1 Current Liabilities (4.1.1+4.1.2+4.1.3+4.1.4+4.1.5) 0.00 0.00
4.1.1 Trade Payables /Creditors 0.00 0.00
4.1.2 Liabilities for Leased Assets 0.00 0.00
4.1.3 Accrued Interest 0.00 0.00
4.1.4 Bank Overdrafts 0.00 0.00
4.1.5 Other Current liabilities 0.00 0.00
4.2 Provisions (4.2.1+4.2.2+4.2.3) 0.00 0.00
 4.2.1 Provision for Income Tax 0.00 0.00
4.2.2 Provision of Bad Debts 0.00 0.00
4.2.3 Other Provisions 0.00 0.00
5. Net Assets (1+2+3-4) 1.00 0.00
FINANCE BY
6. Total Proprietor's Capital and Reserves (6.1+6.2+6.3+6.4+6.5+6.6) 1.00 0.00
6.1 Proprietor's Capital 1.00 0.00
6.2 Revaluation Reserve 0.00 0.00
6.3 Translation Reserve 0.00 0.00
6.4 General Reserve 0.00 0.00
6.5 Any Other Reserve 0.00 0.00
6.6 Profit / (Loss) for the Year 0.00 0.00

7. Long Term Liabilities (7.1+7.2+7.3) 0.00 0.00

7.1 Secured Liabilities (7.1.1+7.1.2+7.1.3+7.1.4) 0.00 0.00
7.1.1 Loans from Financial Institutions 0.00 0.00
7.1.2 Other Loans 0.00 0.00
7.1.3 Debt Securities Issued 0.00 0.00
7.1.4 Loans from Related Parties 0.00 0.00
7.2 Unsecured Liabilities (7.2.1+7.2.2+7.2.3+7.2.4) 0.00 0.00
7.2.1 Loans from Financial Institutions 0.00 0.00
7.2.2 Other Loans 0.00 0.00
7.2.3 Payables / Creditors for more than one year 0.00 0.00
7.2.4 Due to Related Parties 0.00 0.00
7.3 Deferred Tax Liability 0.00 0.00

8. Total Liabilities (6+7) 1.00 0.00

Section D Part 1 : Quantitative Details of Stock / Inventory (Trading Concern Details or Finished Goods Details in case of Manufacturing Concern)

Sr.No. Details For Item Name Unit of Measure Opening Stock (A) Purchase (B) Sales Quantity (C) Closing Stock (D) Shortage / (Excess), if any (A+B-C-D)
Not Available
Total(Self) 0.00 0.00 0.00 0.00 0.00
Total(Wife) 0.00 0.00 0.00 0.00 0.00

Section D Part 2 : Quantitative Details of Stock / Inventory (Raw Material Details in case of Manufacturing Concern)

Details Item Unit of Opening Purchase Consumption Sales Quantity Closing Stock Yield Finished Product % Shortage / (Excess), if any
Sr.No.
For Name Measure Stock (A) (B) (C) (D) (E) in units yield (A+B-C-D-E)
Not Available
Total(Self) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Total(Wife) 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Section E1 Part 1 : Addition to Plant and Machinery and Investment Deduction

 Cost Investment
Details
Sr.No. Item (New only) Item Description Item Category Model Serial Number Date of First Issue Location (Ksh) Deduction
For
(A) (B)
Not Available
Total(Self) 0.00 0.00
Total(Wife) 0.00 0.00

Section E1 Part 2 : Addition to Building , Investment Deduction

Storage Date of Days in Use or Cost Investment Residual Capital Residual Value
Details Building Qualifying Expenditure
Sr.No. Building Capacity (Metric First Available for (Ksh) Deduction Value B/F Allowance C/F (Ksh) (F)=
For Category for IBD (Ksh)(C)= (A-B)
Tonnes) Use Use (A) (Ksh) (B) (Ksh) (D) (Ksh) (E) (C+D-E)
Not Available
Total(Self) 0.00 0.00 0.00 0.00 0.00 0.00
Total(Wife) 0.00 0.00 0.00 0.00 0.00 0.00

Section E1 Part 3 : Deductions In Respect of Farm Works

Sale or
Expenditure Deductions
Details Qualifying Date of Written Down Value (WDV) at the Transfer Written Down Value (WDV) at the End of
Sr.No. Incurred (Ksh) during the Year
For Assets Expenditure Beginning of the Year (Ksh)(B) (Ksh) the Year (Ksh) (E) = (A+B-C-D)
(A) (Ksh)(D)
(C)
Not Available
Total(Self) 0.00 0.00 0.00 0.00 0.00
Total(Wife) 0.00 0.00 0.00 0.00 0.00

Section E1 Part 4 : Deductions in respect of Extractive Industries

Rate Total Cost (Net of

Details Item Item Serial Number Year Actual Cost Disposal at Cost during Amount of Wear and Tear Deduction
Sr.No. Item (%) Disposal) (Ksh)(D) = (B-
For Category Description (If Applicable) Incurred (Ksh) (B) the Year (Ksh) (C) for the Year (Ksh) (E) = (A*D)
(A) C)
Not Available
Total(Self) 0.00 0.00
Total(Wife) 0.00 0.00

Section E2 : Wear and Tear Deductions on Plant and Machinery and Deductions on Infrastructure

Part A : Reducing Balance Method(Self)

Sr.No. Class Class A Class B Class C Class D Total
1 Rate (%) 37.50 30.00 37.50 12.50 NA
2 Written Down Value (WDV) at the Beginning of the Year (Ksh) (A) 0.00
3 Additions during the Year net of Investment Deduction in E1_IDA_CA (Ksh) (B) 0.00
4 Disposal during the Year (Ksh) (C) 0.00
5 Net Balance for Wear and Tear Deductions (Ksh) (D) 0.00 0.00 0.00 0.00 0.00
6 Amount of Wear and Tear Deduction for the Year (Ksh) (E)=(D)*Rate(%) 0.00 0.00 0.00 0.00 0.00
7 Written Down Value (WDV) at the End of the Year (Ksh) (F) = (D - E) 0.00 0.00 0.00 0.00 0.00
 Part A : Reducing Balance Method(Wife)

Sr.No. Class Class A Class B Class C Class D Total

1 Rate (%) 37.50 30.00 37.50 12.50 NA
2 Written Down Value (WDV) at the Beginning of the Year (Ksh) (A)
3 Additions during the Year net of Investment Deduction in E1_IDA_CA (Ksh) (B)
4 Disposal during the Year (Ksh) (C)
5 Net Balance for Wear and Tear Deductions (Ksh) (D)
6 Amount of Wear and Tear Deduction for the Year (Ksh) (E)
7 Written Down Value (WDV) at the End of the Year (Ksh) (F)

Section E2 : Wear and Tear Deductions on Plant and Machinery and Deductions on Infrastructure

Part B : Straight Line Method

Details Item Serial Date of Rate Actual Cost Disposal at Cost during Total Cost (Net of Amount of Wear and Tear Deduction Item
Sr.No. Item
For Description Number Purchase (%) (A) (Ksh) (B) the Year (Ksh) (C) Disposal) (Ksh)(D) = (B-C) for the Year (Ksh) (E) = (A*D) Category
Not Available
Total(Self) 0.00 0.00
Total(Wife) 0.00 0.00
Section E : Summary of Capital Allowance

Sr.No. Description Self(Ksh) Wife(Ksh)

1 Investment Deduction ֠Plant and Machinery (Total of "Investment Deduction" from E1_IDA_CA Part 1 ) 0.00 0.00
2 Investment Deduction - Industrial Building (Total of "Investment Deduction" from E1_IDA_CA Part 2) 0.00 0.00
3 Capital Allowance - Industrial Building (Total of " Capital Allowance" from E1_IDA_CA Part 2) 0.00 0.00
4 Wear and Tear Deduction (Total of "Amount of Wear and Tear Deduction during the Year" from E2_CA_WTA_WDV_I) 0.00 0.00
5 Wear and Tear Deduction (Total of "Amount of Wear and Tear Deduction during the Year" from E2_CA_WTA_SLM_II) 0.00 0.00
6 Deductions in Respect of Farm Works (Total of "Deductions during the Year" from E1_IDA_CA Part 4) 0.00 0.00
7 Deductions in respect of Mining(Total of " Wear and Tear Deduction for the Year" from E1_IDA_CA Part 5) 0.00 0.00
8 Total of all Deductions towards Capital Expenditure (1 to 7) 0.00 0.00

Section F : Details of Employment Income

Allowances and Total

Value of Car Benefit (Total of Pension if in
Benefits from Employment
PIN of Name of "Value of Car Benefit" from Net Value of excess of Ksh
Sr.No. Self/Wife Gross Pay (Ksh) (A) Employment (Other Income (Ksh)
Employer Employer I_Computation_of_Car_Benefit) Housing (Ksh) (D) 300,000 (Ksh)
than Car and (F) =
(Ksh) (C) (E)
Housing) (Ksh) (B) (A+B+C+D+E)
1 Self P000618406U SGS KENYA 0.00 0.00 0.00 0.00 0.00 0.00
Total(Self) 0.00
Total(Wife) 0.00

Section G : Details of Share of Profit / (Loss) in which Taxpayer is a Partner

 Amount Total Income
of
PIN of Name of Type of % Share of Amount of Share of Remuneration and Amount of Interest on Interest from
Sr.No. Self/Wife Partnership Partnership Income Profit Profit (Ksh)(A) Value of Benefit Capital (Ksh)(C) on Partnership(s)
Firm Firm Received (Ksh) (B) (Ksh)(E) =
Drawing (A+B+C+D)
(Ksh)(D)
Not Available
Total(Self) 0.00
Total(Wife) 0.00

Section H : Details of Share of Income in which Taxpayer is a Beneficiary of Estate(s)/Trust(s)/Settlement

Details PIN of Name of % Share of Amount of Actual Taxable Amount on Deemed Basis Amount of Share of Income
Sr.No.
For Estate/Trust/Settlement Estate/Trust/Settlement Income (A) Distributable Income (Ksh) (B) (Ksh)(C) = ((B*100)/70) (Ksh)(D) = (C*A)
Not Available
Total(Self) 0.00
Total(Wife) 0.00

Section I : Computation of Value of Car Benefit

Value
Car Type of
PIN of CC Cost of Hiring / Leasing Cost of owned car Period of Use during of Car
Sr.No. Self/Wife Registration Make Body Type Car
Employer Rating (Ksh) (Ksh) the Year (in Months) Benefit
Number Cost
(Ksh)
Not Available
Total(Self) 0.00
Total(Wife) 0.00

Section J : Computation of Mortgage Interest

Amount Outstanding at Amount of Interest Paid

Sr.No. Self/Wife PIN of Lender Name of Lender Mortgage Account Number Amount Borrowed (Ksh)
Year End (Ksh) (Ksh)
Not Available
Total(Self) 0.00
Total(Wife) 0.00

Section K : Computation of Deduction for Home Ownership Saving Plan

Sr.No. Self/Wife Financial Institution PIN Financial Institution Name Account Number Total Deposit for the Year (Ksh)
Not Available
Total(Self) 0.00
Total(Wife) 0.00

Section L : Computation of Insurance Relief

 Amount
of
PIN of Name of Sum Annual Insurance
Sr.No. Self/Wife Insurance Insurance Purpose of Policy Insurance Policy Holder Age of Commencement Maturity Date Assured Premium Relief
Life/Education/Health Policy Number (Self/Wife/Child) Child Date Paid
Company Company (Ksh) (Ksh) (A) (Ksh) (B)
= (A) *
15%
Not Available
Total(Self) 0.00
Total(Wife) 0.00

Section M : Details of PAYE Deducted at Source from Salary

Name of Tax Payable on Taxable Amount of Tax Deducted Amount of Tax Payable or
Sr.No. Self/Wife PIN of Employer Taxable Salary (Ksh)
Employer Salary (Ksh) (A) (PAYE) (Ksh) (B) Refundable (PAYE)
1 Self P000618406U SGS KENYA 0.00 0.00 0.00 0.00
Total(Self) 0.00
Total(Wife) 0.00

Section N : Details of Installment Tax Paid

Payment Registration
Sr.No. Self/Wife Date of Deposit Amount of Installment Tax Paid (Ksh)
Number
Not Available
Total(Self) 0.00
Total(Wife) 0.00

Section O : Details of Tax Withheld

Sr.No. Self/Wife PIN of Withholder Name of Withholder Withholding Certificate Number Withholding Transaction Date Amount of Tax Withheld (Ksh)
Not Available
Total(Self) 0.00
Total(Wife) 0.00

Section P : Details of Advance Tax Paid on Commercial Vehicles

Vehicle Registration Load Capacity Seating Capacity Amount of Advance Tax

Sr.No. Self/Wife Body Type Usage
Number (Tonnage) Passenger Paid (Ksh)
Not Available
Total(Self) 0.00
Total(Wife) 0.00

Section Q : Details of Income Tax Paid

Section Q1 : Advance Payment

Sr.No. Details For Payment Registration Number Date of Deposit Amount of Income Tax Paid (Ksh)
Not Available
 Sr.No. Details For Payment Registration Number Date of Deposit Amount of Income Tax Paid (Ksh)
Total(Self) 0.00
Total(Wife) 0.00
Section Q2 : Self Assesment Tax

Sr.No. Details For Payment Registration Number Date of Deposit Amount of Income Tax Paid (Ksh)
Not Available
Total(Self) 0.00
Total(Wife) 0.00
Total (Section Q1 Total + Section Q2 Total)(Ksh)Self 0.00
Total (Section Q1 Total + Section Q2 Total)(Ksh) Wife 0.00

Section R : Details of Double Taxation Avoidance Agreement

Sr.No. Details For Country Document Reference Number Date Of Deduction Gross Employment Income (Ksh) Amount of Tax Relief (Ksh)
Not Available
Total(Self) 0.00
Total(Wife) 0.00

Section S : Details of Losses Brought Forward and Carried Forward(Self)

Business Farming Interest Commission

Sr.No. Financial Year Rental (Ksh) Other (Ksh) Total (Ksh)
(Ksh) (Ksh) (Ksh) (Ksh)
Loss B/f A B C D E F A to F
1 2012 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2 2013 0.00 0.00 0.00 0.00 0.00 0.00 0.00
3 2014 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4 2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5 2016 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6 2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7 2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00
8 2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9 2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 Total of earlier year losses B/f (1+2+3+4+5+6+7+8+9) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
11 Losses Adjusted 0.00 0.00 0.00 0.00 0.00 0.00 0.00
12 Losses C/f (10-11) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
13 Current year loss (S_Income_Computation_Self Line Number 12) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
14 Total Loss carried forward to future (11+12) 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Section S : Details of Losses Brought Forward and Carried Forward(Wife)

Business Farming Interest Commission
Sr.No. Financial Year Rental (Ksh) Other (Ksh) Total (Ksh)
(Ksh) (Ksh) (Ksh) (Ksh)
Loss B/f A B C D E F A to F
1 2012
 2 2013
3 2014
4 2015
5 2016
6 2017
7 2018
8 2019
9 2020
10 Total of earlier year losses B/f (1+2+3+4+5+6+7+8+9)
11 Losses Adjusted
12 Losses C/f (10-11)
13 Current year loss (S_Income_Computation_Wife Line Number 12)
14 Total Loss carried forward to future (11+12)

Section T : Tax Computation(Self)

Business Farming Interest Commission Consolidated
Sr.No. Description Rental (Ksh) Other (Ksh)
(Ksh) (Ksh) (Ksh) (Ksh) (Ksh)
Profit / Loss as per Profit and Loss Account (Line number 11 of
1 310,100.00 0.00 0.00 0.00 0.00 0.00 310,100.00
B_Profit_Loss_Account_Self)
2 Less Exempt income (if included in Profit and Loss Account) 0.00 0.00 0.00 0.00 0.00 0.00
3 Adjusted Profit / Loss as per Profit and Loss Account (1-2) 310,100.00 0.00 0.00 0.00 0.00 310,100.00
4 Add Back: Disallowable Deductions (4.1 to 4.13) 0.00 0.00 0.00 0.00 0.00 0.00
Depreciation ((Line number 2.4.5 + Line number 6.1 of
4.1 0.00 0.00 0.00 0.00 0.00 0.00
B_Profit_Loss_Account_Self)
4.2 Entertainment Expenses (to the extent not allowable) 0.00 0.00 0.00 0.00 0.00 0.00
4.3 Expenses related to Exempt Income (if debited to P & L) 0.00 0.00 0.00 0.00 0.00 0.00
Loss on Disposal of Depreciable Assets (Line number 6.2 of
4.4 0.00 0.00 0.00 0.00 0.00 0.00
B_Profit_Loss_Account_Self)
4.5 Balancing Charge 0.00 0.00 0.00 0.00 0.00 0.00
4.6 Donations 0.00 0.00 0.00 0.00 0.00 0.00
General Provisions for bad and doubtful debts debited to P&L (Line
4.7 0.00 0.00 0.00 0.00 0.00 0.00
number 5.15 of B_Profit_Loss_Account_Self)
4.8 Start up Cost/ Pre-Operating Expenses 0.00 0.00 0.00 0.00 0.00 0.00
Unrealized Foreign Exchange Loss (Line number 7.6 of
4.9 0.00 0.00 0.00 0.00 0.00 0.00
B_Profit_Loss_Account_Self)
4.10 Operating Expenses 0.00 0.00 0.00 0.00 0.00 0.00
4.11 Administrative Expenses 0.00 0.00 0.00 0.00 0.00 0.00
4.12 Financial expenses 0.00 0.00 0.00 0.00 0.00 0.00
Other Disallowable Deductions (Part I Total of "Total of Other
4.13 0.00 0.00 0.00 0.00 0.00 0.00
Disallowable Deductions")
5 Deduct: Allowable Deductions (5.1 to 5.5) 0.00 0.00 0.00 0.00 0.00 0.00
Profit on Disposal of Assets(Line number 4.6 of
5.1 0.00 0.00 0.00 0.00 0.00 0.00
B_Profit_Loss_Account_Self)
5.2 Capital Allowances 0.00 0.00 0.00 0.00 0.00 0.00
 5.3 Scientific Research Expenditure 0.00 0.00 0.00 0.00 0.00 0.00
Unrealized Foreign Exchange Gains(Line number 4.7 of
5.4 0.00 0.00 0.00 0.00 0.00 0.00
B_Profit_Loss_Account_Self)
Other Allowable Deductions(Part II "Total of Other Allowable
5.5 0.00 0.00 0.00 0.00 0.00 0.00
Deductions")
Taxable Income from Partnership Firm(s) (G_Partnership_Income_Total
6 0.00 0.00 0.00 0.00 0.00 0.00
Income From Partnership(s))
7 Taxable Income (3+ 4-5+6+7) 310,100.00 0.00 0.00 0.00 0.00 310,100.00
Less: Loss B/F from previous year set off against current year of income
8 0.00 0.00 0.00 0.00 0.00 0.00
(Line Number 6 of R_Previous_Year_Losses)
9 Adjusted Taxable Income, (if 7-8 is positive,else 0) 310,100.00 0.00 0.00 0.00 0.00 310,100.00
Loss to be carried forward to next year for set off (if 7-8 is
10 0.00 0.00 0.00 0.00 0.00 0.00
negative,else 0)
Part I : Other Disallowable Deductions

Sr.No. Name of Expense Business (Ksh) Farming (Ksh) Rental (Ksh) Interest (Ksh) Commission (Ksh) Other (Ksh)
Not Available
Total of Other Expenses 0.00 0.00 0.00 0.00 0.00 0.00

Part II : Other Allowable Deductions

Sr.No. Name of Deduction Business (Ksh) Farming (Ksh) Rental (Ksh) Interest (Ksh) Commission (Ksh) Other (Ksh)
Not Available
Total of Other Deductions 0.00 0.00 0.00 0.00 0.00 0.00

Section T : Tax Computation(Wife)

Business Farming Interest Commission Consolidated
Sr.No. Description Rental (Ksh) Other (Ksh)
(Ksh) (Ksh) (Ksh) (Ksh) (Ksh)
Profit / Loss as per Profit and Loss Account (Line number 11 of
1
B_Profit_Loss_Account_Wife)
2 Less Exempt income (if included in Profit and Loss Account)
3 Adjusted Profit / Loss as per Profit and Loss Account (1-2)
4 Add Back: Disallowable Deductions (4.1 to 4.13)
Depreciation ((Line number 2.4.5 + Line number 6.1 of
4.1
B_Profit_Loss_Account_Wife)
4.2 Entertainment Expenses (to the extent not allowable)
4.3 Expenses related to Exempt Income (if debited to P & L)
Loss on disposal of depreciable assets (Line number 6.2 of
4.4
B_Profit_Loss_Account_Wife)
4.5 Balancing Charge
4.6 Donations
General Provisions for bad and doubtful debts debited to P&L (Line
4.7
number 5.15 of B_Profit_Loss_Account_Wife)
4.8 Start up Cost/ Pre-Operating Expenses
4.9 Unrealized Foreign Exchange Loss (Line number 7.6 of
 B_Profit_Loss_Account_Wife)
4.10 Operating Expenses
4.11 Administrative Expenses
4.12 Financial expenses
Other Disallowable Deductions (Part I Total of "Total of Other
4.13
Disallowable Deductions")
5 Deduct: Allowable Deductions (5.1 to 5.5)
Profit on Disposal of Assets(Line number 4.6 of
5.1
B_Profit_Loss_Account_Wife)
5.2 Capital Allowances
5.3 Scientific Research Expenditure
Unrealized Foreign Exchange Gains(Line number 4.7 of
5.4
B_Profit_Loss_Account_Wife)
Other Allowable Deductions(Part II "Total of Other Allowable
5.5
Deductions")
Taxable Income from Partnership Firm(s) (G_Partnership_Income_Total
6
Income From Partnership(s))
7 Taxable Income (3+ 4-5+6+7)
Less: Loss B/F from previous year set off against current year of income
8
(Line Number 6 of R_Previous_Year_Losses)
9 Adjusted Taxable Income, (if 7-8 is positive,else 0)
Loss to be carried forward to next year for set off (if 7-8 is
10
negative,else 0)
Part I : Other Disallowable Deductions

Sr.No. Name of Expense Business (Ksh) Farming (Ksh) Rental (Ksh) Interest (Ksh) Commission (Ksh) Other (Ksh)
Not Available
Total of Other Expenses 0.00 0.00 0.00 0.00 0.00 0.00

Part II : Other Allowable Deductions

Sr.No. Name of Deduction Business (Ksh) Farming (Ksh) Rental (Ksh) Interest (Ksh) Commission (Ksh) Other (Ksh)
Not Available
Total of Other Deductions 0.00 0.00 0.00 0.00 0.00 0.00

Section T : Tax Computation

Sr.No. Description Self (Ksh) Wife (Ksh)

11 Total Deduction (11.1+ Higher value of 11.2 or 11.3) 0.00 0.00
11.1 Defined / Pension Contribution 0.00 0.00
11.2 Mortgage Interest (Total of "Amount of Interest Paid" from J_Computation_of_Mortgage but subject to Maximum 3,00,000 Ksh) 0.00 0.00
Deposit in Home Ownership Saving Plan (Total of "Total Deposit for the Year" from K_Home_Ownership_Saving_Plan but subject to Maximum
11.3 0.00 0.00
96,000 Ksh)
12 Total of Tax Payable Less Reliefs and Exemptions (12.5 - 12.6 - 12.7) 15,125.00 0.00
12.1 Employment Income ("Total Taxable Employment Income" from F_Employement_Income) 0.00 0.00
12.2 Taxable Income from Estate(s)/Trust(s)/Settlement (Total of "Amount of Share of Income (Ksh)" from H_Estate_Trust_Income) 0.00 0.00
12.3 Allowable Tax Exemption in case of Person with Disablility 0.00 0.00
12.4 Net Taxable Income (12.1+ 12.2+Line Number 9 (Consolidated) - 11-12.3) 310,100.00 0.00
12.5 Tax on Taxable Income (12.3 *applicable rates) 34,325.00 0.00
12.6 Personal Relief 19,200.00 0.00
12.7 Insurance Relief (Total of "Amount of Insurance Relief " from L_Computation_of_Insu_Relief but subject to Maximum 60,000 Ksh) 0.00 0.00
13 Tax Credits (13.1+13.2+13.3+13.4+13.5+13.6+13.7+13.8) 45,705.00 0.00
13.1 PAYE Deducted from Salary (Total of "Amount of Tax Deducted (PAYE)" from M_Details_of_PAYE_Deducted) 0.00 0.00
13.2 Allowable Tax in case of Estate(s)/Trust(s) ((Total of "Amount of Share of Income from H_Estate_Trust_Income) * 30%) 0.00 0.00
13.3 Total Installment Tax Paid (Total of "Amount of Installment Tax Paid" from N_Installment_Tax_Credits) 0.00 0.00
13.4 Withholding Tax (Total of "Withholding Tax Amount" from O_WHT_Credits) 45,705.00 0.00
13.5 Credits u/s 12A - Advance Tax on Commercial Vehicle (Total of "Amount of Advance Tax Paid" from P_Advance_Tax_Credits) 0.00 0.00
13.6 Income Tax Paid in Advance (Total of "Amount of Income Tax Paid" from Q_IT_Payment_Credits) 0.00 0.00
13.7 Credits u/s 41 (Total of "Amount of Tax Relief" from R_DTAA_Credits) 0.00 0.00
13.8 Withholding Tax (Total of "Withholding Tax Amount Of Monthly Rental Income") 0.00 0.00
14 Tax Due/Refund Due ((12 (Self) + 12 (Wife) - 13(Self) - 13 (Wife)) -30,580.00

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