2017 Monthly NonResident Employee WithholdingTax Form1
DIRECÇÃO GERAL IMPOSTUS
DIRECÇÃO NACIONAL INFORMAÇÃO CONTRIBUINTES PETROLIFERAS E MINERAIS
“ S e j a
u m
Building#5 (Ground Floor), Palacio do Governo RDTL, Avenida do
Presidente de Nicolau Lobato
P.O Box-18, Dili , Timor-Leste
Web: www.mof.gov.tl/Taxation/Petroleum Tax/Tax forms
b o m
c i d a d ã o ,
s e j a u m n o v o
N a ç a o ”
h é r o i
p a r a
a
n o s s a
TIMOR-LESTE NON-RESIDENT EMPLOYEE MONTHLY
PETROLEUM TAX WITHHOLDING FORM
(Income Tax Withheld from Timor-Leste Non-resident Employees)
For the Month of
Taxpayer Name
TIN
: …………………………… 2017
: …………………………………
: ………………………………..
Petroleum Withholding Tax – Non-resident employee tax
Type of Income
Rates (B)*
A
(Provide detail list of all non-resident
employees )
Number of the
employment
(AxB)
Withholding
Tax Amt (US$)
Total taxable
wages/s
alaries
paid
1
2
3
4
18%
18%
18%
20%
(US$)
Taxable wages/ salaries and similar
remuneration derived in respect of
employment exercised in the JPDA
or in Timor-Leste (onshore or
offshore) Territory [in US$].
Total Non-resident employee tax payment for the month
Date of payment to the TL Petroleum Fund Bank Account
------/------/------------
(dd/mm/yyyy)
Please providing the list of employee you employed and gross income they earned from different areas
Total employee : …………………..
Will your Company not withheld any
wages tax the Following period? (if any);
Total Gross Income : ………………………….
If yes, state the reason …………………………………….
………………………..…………………………………….
and confirm with Timor-Leste Tax Authority, with official documents
* Tax Rates are Numbered as 1,2,3&4 based on Different Tax Regimes as follows:
1 - Bayu Undan
2 - Greater Sunrise & EKKN
3 - JPDA but not Annex F
4- 100% Timor-Leste Territory
Contact Person :
Full name : ____________________________ position _____________________ email
__________________________________________ (Clear)
Next contact person;
Full name : ___________________________ Position : _______________________
email : ____________________________________________(Clear)
NDPMR Contact E-mails: hsarmento@mof.gov.tl or aramos@mof.gov.tl; or adcosta@mof.gov.tl or mofsoares@mof.gov.tl or
urodriques@mof.gov.tl
DNICPM Form No: 02-01-01 Last updated 29/12/2017
New Contact person if above contact has changed: full name;
………………………………….., email address; ………………………………. (clear)
Employer’s Declaration:
I, (full name and designation)_________________________________________________,
declare on behalf of the company, that the particulars set out in this statement are true and
correct.
Signature:________________________________________________Date:________
Notes:
1.
2.
3.
4.
5.
6.
7.
The withholding tax rates are mentioned after considering the effect of framework percentage (90% &
10%) under the Timor Sea Treaty. So, further reduction will not apply in computing the Timor-Leste
withholding tax;
Payment and lodgment of form due on or before 15th day of the following month or on next business day
if 15th is a public holiday in Timor-Leste;
Calculation sheet of the Non-resident employees tax must be attached with the tax form for the month;
Withholding tax deducted from wages/salaries of non-resident employees are final tax liabilities for all
tax regimes;
For Timor-Leste resident employees please use Resident Employee Monthly Withholding Tax Form;
Please attach copy of EFT bank transfer instruction form in support of electronic
payment of above taxes to the TL Petroleum Fund bank account which details are as
follows:
Name and Address of the Bank- The Federal Reserve Bank of New York, 33 Liberty Street, New York, NY 10045;
SWIFT CODE- FRNYUS33
Beneficiary Name – ‘Banking and Payments Authority of East Timor- Petroleum Fund Account’
Account Number- 021080973
th
Payment and lodgment of forms due on or before the 15 of the following month or on
next business day if 15th is a public holiday in Timor-Leste;
NDPMR Contact E-mails: hsarmento@mof.gov.tl or aramos@mof.gov.tl; or adcosta@mof.gov.tl or mofsoares@mof.gov.tl or
urodriques@mof.gov.tl
DNICPM Form No: 02-01-01 Last updated 29/12/2017
Annex List of employments
Name of Company
TIN
: ……………………………….
: ……………………………..
Tick
No
Name
Nationality
Jurisdictions of Tax Regime
JPDA
JPDA Non Annex
Annex F F & TLEA
Gross Income (Taxable wages/ salaries and
similar remuneration derived in respect of
employment exercised in the petroleum
operations in JPDA or in Timor-Leste)
US$ : ………………
Net Tax will be paid
to Timor-Leste
US$ : …………
Total
Note “ 1. Please provide list of employees and include tax calculations depend on operations area
2. fill employee name who in Bayu Udan field first, follow non Annex F and last for TLEA
3. Please add other page if necessary”
Monthly Payroll ……………./2017
I (full name) ………………………………….
Position ……………………………… declare this list right and total gross income and tax withheld true, correct, and complete.
NDPMR Contact E-mails: hsarmento@mof.gov.tl or aramos@mof.gov.tl; or adcosta@mof.gov.tl or mofsoares@mof.gov.tl or urodriques@mof.gov.tl
DNICPM Form No: 02-01-01 Last updated 29/12/2017
DIRECÇÃO NACIONAL INFORMAÇÃO CONTRIBUINTES PETROLIFERAS E MINERAIS
“ S e j a
u m
Building#5 (Ground Floor), Palacio do Governo RDTL, Avenida do
Presidente de Nicolau Lobato
P.O Box-18, Dili , Timor-Leste
Web: www.mof.gov.tl/Taxation/Petroleum Tax/Tax forms
b o m
c i d a d ã o ,
s e j a u m n o v o
N a ç a o ”
h é r o i
p a r a
a
n o s s a
TIMOR-LESTE NON-RESIDENT EMPLOYEE MONTHLY
PETROLEUM TAX WITHHOLDING FORM
(Income Tax Withheld from Timor-Leste Non-resident Employees)
For the Month of
Taxpayer Name
TIN
: …………………………… 2017
: …………………………………
: ………………………………..
Petroleum Withholding Tax – Non-resident employee tax
Type of Income
Rates (B)*
A
(Provide detail list of all non-resident
employees )
Number of the
employment
(AxB)
Withholding
Tax Amt (US$)
Total taxable
wages/s
alaries
paid
1
2
3
4
18%
18%
18%
20%
(US$)
Taxable wages/ salaries and similar
remuneration derived in respect of
employment exercised in the JPDA
or in Timor-Leste (onshore or
offshore) Territory [in US$].
Total Non-resident employee tax payment for the month
Date of payment to the TL Petroleum Fund Bank Account
------/------/------------
(dd/mm/yyyy)
Please providing the list of employee you employed and gross income they earned from different areas
Total employee : …………………..
Will your Company not withheld any
wages tax the Following period? (if any);
Total Gross Income : ………………………….
If yes, state the reason …………………………………….
………………………..…………………………………….
and confirm with Timor-Leste Tax Authority, with official documents
* Tax Rates are Numbered as 1,2,3&4 based on Different Tax Regimes as follows:
1 - Bayu Undan
2 - Greater Sunrise & EKKN
3 - JPDA but not Annex F
4- 100% Timor-Leste Territory
Contact Person :
Full name : ____________________________ position _____________________ email
__________________________________________ (Clear)
Next contact person;
Full name : ___________________________ Position : _______________________
email : ____________________________________________(Clear)
NDPMR Contact E-mails: hsarmento@mof.gov.tl or aramos@mof.gov.tl; or adcosta@mof.gov.tl or mofsoares@mof.gov.tl or
urodriques@mof.gov.tl
DNICPM Form No: 02-01-01 Last updated 29/12/2017
New Contact person if above contact has changed: full name;
………………………………….., email address; ………………………………. (clear)
Employer’s Declaration:
I, (full name and designation)_________________________________________________,
declare on behalf of the company, that the particulars set out in this statement are true and
correct.
Signature:________________________________________________Date:________
Notes:
1.
2.
3.
4.
5.
6.
7.
The withholding tax rates are mentioned after considering the effect of framework percentage (90% &
10%) under the Timor Sea Treaty. So, further reduction will not apply in computing the Timor-Leste
withholding tax;
Payment and lodgment of form due on or before 15th day of the following month or on next business day
if 15th is a public holiday in Timor-Leste;
Calculation sheet of the Non-resident employees tax must be attached with the tax form for the month;
Withholding tax deducted from wages/salaries of non-resident employees are final tax liabilities for all
tax regimes;
For Timor-Leste resident employees please use Resident Employee Monthly Withholding Tax Form;
Please attach copy of EFT bank transfer instruction form in support of electronic
payment of above taxes to the TL Petroleum Fund bank account which details are as
follows:
Name and Address of the Bank- The Federal Reserve Bank of New York, 33 Liberty Street, New York, NY 10045;
SWIFT CODE- FRNYUS33
Beneficiary Name – ‘Banking and Payments Authority of East Timor- Petroleum Fund Account’
Account Number- 021080973
th
Payment and lodgment of forms due on or before the 15 of the following month or on
next business day if 15th is a public holiday in Timor-Leste;
NDPMR Contact E-mails: hsarmento@mof.gov.tl or aramos@mof.gov.tl; or adcosta@mof.gov.tl or mofsoares@mof.gov.tl or
urodriques@mof.gov.tl
DNICPM Form No: 02-01-01 Last updated 29/12/2017
Annex List of employments
Name of Company
TIN
: ……………………………….
: ……………………………..
Tick
No
Name
Nationality
Jurisdictions of Tax Regime
JPDA
JPDA Non Annex
Annex F F & TLEA
Gross Income (Taxable wages/ salaries and
similar remuneration derived in respect of
employment exercised in the petroleum
operations in JPDA or in Timor-Leste)
US$ : ………………
Net Tax will be paid
to Timor-Leste
US$ : …………
Total
Note “ 1. Please provide list of employees and include tax calculations depend on operations area
2. fill employee name who in Bayu Udan field first, follow non Annex F and last for TLEA
3. Please add other page if necessary”
Monthly Payroll ……………./2017
I (full name) ………………………………….
Position ……………………………… declare this list right and total gross income and tax withheld true, correct, and complete.
NDPMR Contact E-mails: hsarmento@mof.gov.tl or aramos@mof.gov.tl; or adcosta@mof.gov.tl or mofsoares@mof.gov.tl or urodriques@mof.gov.tl
DNICPM Form No: 02-01-01 Last updated 29/12/2017