RETURN FORM OF AN INDIVIDUAL

RESIDENT WHO DOES NOT CARRY ON BUSINESS BE

UNDER SECTION 77 OF THE INCOME TAX ACT 1967 YEAR OF ASSESSMENT
This form is prescribed under section 152 of the Income Tax Act 1967 2022
BASIC INFORMATION
Name LEE HUI QIN
Tax Identification No. (TIN) IG 28724913010 Identification no. 960524015528
Current passport no. Passport no. registered with LHDNM
Citizen MALAYSIA Gender FEMALE
Type of assessment SEPARATE Status as at 31-12-2022 MARRIED
Date of birth 24/05/1996 Date of marriage 25/04/2021

STATUTORY INCOME AND TOTAL INCOME

Statutory income from sources of employment in Malaysia No. of employment = 2 38,366
Statutory income from sources of rents in Malaysia 0
Statutory income from sources of interest, discounts, royalties, premiums, pensions, annuities, other periodical payments
0
and other gains or profits pursuant to paragraph 43(1)(c) in Malaysia
Aggregate of other statutory income from sources outside Malaysia received in Malaysia effective from 01.07.2022

AGGREGATE INCOME 38,366

LESS : Approved investment under angel investor tax incentive 0

TOTAL 38,366

LESS : Approved donations / gifts / contributions 0

TOTAL 38,366
TOTAL INCOME (SELF) 38,366
TOTAL INCOME TRANSFERRED FROM HUSBAND / WIFE * FOR JOINT ASSESSMENT FROM SOURCES IN
0
MALAYSIA AND OUTSIDE MALAYSIA RECEIVED IN MALAYSIA EFFECTIVE FROM 01.07.2022
* Type of income transferred from Husband / Wife
INCOME FROM SOURCES OUTSIDE MALAYSIA RECEIVED IN MALAYSIA FOR THE PERIOD FROM 01.01.2022 - 0
30.06.2022
TOTAL INCOME TRANSFERRED FROM HUSBAND / WIFE * FOR JOINT ASSESSMENT FROM SOURCES OUTSIDE 0
MALAYSIA RECEIVED IN MALAYSIA FOR THE PERIOD FROM 01.01.2022 - 30.06.2022
DONATIONS / GIFTS / CONTRIBUTIONS
Gift of money to the Government / State Government / local authority
Gift of money to approved institution / organization / funds
Gift of money for any sports activity approved by the Minister of Finance
Gift of money or cost of contribution in kind for any project of national interest approved by the Minister of Finance
Gift of money in the form of wakaf to religious authority / religious body / public university or gift of money in the form of
endowment to public university
TOTAL Restricted to 10% of aggregate income 0.00
Gift of artefacts, manuscripts or paintings to the Government or State Government
Gift of money for the provision of library facilities or to libraries Restricted to 20,000
Gift of money or contribution in kind for the provision of facilities in public places for the benefit of disabled persons
Gift of money / cost / value of gift of medical equipment to any healthcare facility approved by the Restricted to 20,000
Ministry of Health
Gift of paintings to the National Art Gallery or any state art gallery
Total approved donations / gifts / contributions 0.00

RELIEF
Individual and dependent relatives 9,000

Medical treatment, special needs and carer expenses for parents (certified by medical practitioner) Restricted to
0
8,000
Basic supporting equipment for disabled self, spouse, child or parent Restricted to 0
6,000
Disabled individual 6,000 0

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Name LEE HUI QIN (IG 28724913010 )
Education fees (Self) :
(i) Other than a degree at masters or doctorate level - Course of study in law, accounting, Islamic financing, 0
technical, vocational, industrial, scientific or technological skills or qualifications
(ii) Degree at masters or doctorate level - Any course of study 0 Restricted to
0
7,000
(iii) Course of study undertaken for the purpose of upskilling or self-enhancement (restricted to 2,000) 0

Medical expenses on:

(i) serious diseases for self, spouse or child 0

(ii) fertility treatment for self or spouse 0 Restricted to

0
8,000
(iii) Vaccination for self, spouse and child (restricted to 1,000) 0

Expenses (Restricted to 1,000) on:

(i) Complete medical examination for self, spouse or child
(ii) COVID-19 detection test including purchase of self-detection test kit for self, spouse or child 0
(iii) Mental health examination or consultation for self, spouse or child

Lifestyle - Purchase for self, spouse or child Restricted to

0
2,500
Lifestyle – Additional relief for the use / benefit of self, spouse or child Restricted to 500 0
Lifestyle – Purchase of personal computer, smartphone or tablet for self, spouse or child use / benefit and not for business use Restricted to
0
2,500
Purchase of self breastfeeding equipment for own child up to 2 years of age Restricted to
(Claim once every 2 assessment years) 1,000
Child care fees for child aged 6 years and below to a registered Child Care Centre or a Kindergarten Restricted to
0
3,000
Net deposit in Skim Simpanan Pendidikan Nasional Restricted to
(total deposit in 2022 minus total withdrawal in 2022) 0
8,000
Husband /Wife /Payment of alimony to former wife Restricted to
0
4,000
Disabled husband / wife 5,000 0
Child 100% eligibility 50% eligibility
Child - Under the age of 18 years 0 X 2,000 = 0 0 X 1,000 = 0 0
0 X 2,000 = 0 0 X 1,000 = 0
Child - 18 years & above and studying 0 X 8,000 = 0 0 X 4,000 = 0 0

0 X 6,000 = 0 0 X 3,000 = 0
Child - Disabled child 0 X 14,000 = 0 0 X 7,000 = 0 0

Life insurance and EPF

(a) Pensionable public servant category who do not contribute to EPF /approved scheme - Life insurance premium Restricted to
7,000
OR (b) Other than (a)
(i) Premium life insurance Restricted to 2,400
3,000
(ii) Contribution to EPF/approved scheme Restricted to 4,000
4,000
Private retirement scheme and deferred annuity Restricted to 0
3,000
Education and medical insurance Restricted to 2,400
3,000
Contribution to the Social Security Organization (SOCSO) according to Employees Social Security Act 1969 or Employment 246
Restricted to 350
Insurance System Act 2017
Domestic tourism expenses Restricted to 0
1,000
Payment of installation, rental, purchase including hire-purchase of equipment or subscription for use of electric vehicle charging Restricted to 0
facility for own vehicle (Not for business use) 2,500

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Name LEE HUI QIN (IG 28724913010 )

TAX SUMMARY
TOTAL INCOME 38,366
Total relief 18,046
CHARGEABLE INCOME 20,320
Tax on the first 20,000 At rate (%) 150.00
Tax on the balance 320 3.0 9.60
Tax on income from sources outside Malaysia received in 0 3 0.00
Malaysia for the period from 01.01.2022 - 30.06.2022
TOTAL INCOME TAX 159.60
LESS : TOTAL REBATE 159.60
Self 400 Husband/wife 0 Zakat and fitrah 0.00
Departure levy for umrah travel/religious travel for other No. of trips 0
religions
TOTAL TAX CHARGED 0.00
LESS : Total tax deductions/Relief (Section 132 and 133 tax relief restricted to total tax charged) 0.00
Section 110 (others) 0.00
Section 132 0.00 Section 133 0.00
TAX PAYABLE FOR THE YEAR OF ASSESSMENT 2022 0.00
Payment made for 2022 income – SELF and HUSBAND / WIFE for joint assessment 33.20
Monthly Tax Deductions (MTD) / Section 33.20 Self installments / 0.00
S107D CP500

TAX PAID IN EXCESS FOR THE YEAR OF ASSESSMENT 2022 33.20

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Name LEE HUI QIN (IG 28724913010 )

OTHER PARTICULARS
Telephone no. 0146193872 Handphone no. 0146193872
e-Mail huiqinlee24@gmail.com
Employer's no. E 91572810 Tax borne by employer YES
Disposal of asset under the Real Property Gains Tax Act 1976 YES
Disposal declared to LHDNM YES
Has financial account(s) at financial institution(s) outside Malaysia NO
Method of payment for tax refund : Payment via bank account MAYBANK ISLAMIC BERHAD 101628055657
Correspondence address NO 12, JALAN RONGGENG 14, TAMAN SKUDAI BARU

81300, JOHOR BAHRU, JOHOR

PARTICULARS OF HUSBAND / WIFE

No. Name of husband / wife Identification no. Date of birth

1 CHIN KAI GUAN 950425015857 25/04/1995

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Name LEE HUI QIN (IG 28724913010 )

DECLARATION
I LEE HUI QIN Identification No. 960524015528
hereby declare that the information regarding the income and claim for deductions and reliefs given by me in this return form and in any document attached is true,
correct and complete.

IMPORTANT REMINDER
Due date to furnish this form and pay tax or balance of tax payable: 30 April 2023
Submission through e-Filing (e-BE) can be made via http://mytax.hasil.gov.my
Failure to furnish a return on or before the due date for submission:
- Penalty under subsection 112(3) of the Income Tax Act 1967 (ITA 1967) shall be imposed.
Failure to pay the tax or balance of tax payable on or before the due date for submission:
- An increase in tax of 10% under subsection 103(3) of the ITA 1967 shall be imposed.
Method of payment for tax or balance of tax payable:
a) Payment by Bill Number

i. Effective 1 January 2023, Bill Number will be the mandatory reference number for payment of tax or balance of tax payable. Bill Number can be
obtained as follows:
- e-Filing Acknowledgement Receipt for submission via e-Filing.
- Generate Bill Number at MyTax portal at https://mytax.hasil.gov.my > ezHasil services > e-Billing > Generate Bill if return form is furnished
manually.
- Printed on Notice of Asssement and letter of demands from LHDNM
ii. Payment using Bill Number can be made as follows:T
- ByrHASiL service at https://byrhasil.hasil.gov.my/
- LHDNM Payment Centre counter
- Appointed commercial banks by LHDNM – Information is available at http://www.hasil.gov.my
iii. For payment purposes, please make sure the correct bill number is used. Taxpayers may print the payment slips and scan the QR code on the
payment slips as a reference when payment is made.
b) Payment by Tax Identification No. (TIN)
i. During the transition period, payment by TIN is still available as follows:
- LHDNM Payment Centre counter
- Virtual Account number (VA) generated through e-TT at https://ett.hasil.gov.my
- Appointed commercial banks by LHDNM – Information is available at https://www.hasil.gov.my
- Pos Malaysia Berhad counter
ii. If payment is made over the bank counter or Pos Malaysia Berhad counter, write down the name, address, telephone number, TIN, year of
assessment, payment code 084 and number of installments on the reverse side of the financial instrument. Check the payment receipt(s) before
leaving the payment counter

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