SAMPLE

COMPANY RETURN FORM FOR

YEAR OF ASSESSMENT 2022
IMPORTANT REMINDER
1) Due date to furnish return form and pay the tax or balance of tax payable: 7 months from the close of accounting period
2) This sample form is provided for reference and learning purpose.
3) This sample form CANNOT be used for the purpose of submission to Lembaga Hasil Dalam Negeri Malaysia (LHDNM).
4) In accordance with the provision of the Income Tax Act 1967, a company shall:
a) furnish a return on an electronic medium or by way of electronic transmission [subsection 77A(1A)] with effect
from the Year of Assessment 2014;
b) declare its income in the return form based on financial statements made in accordance with the requirements as
provided in the act of incorporation of the respective entities [subsection 77A(4)]; and
c) furnish correct particulars in the return form [paragraph 77A(3)(b) and paragraph 120(1)(h)].
5) Submission through e-Filing can be made via https://mytax.hasil.gov.my.
6) A company may be liable to an action under section 112 for failure to furnish a return on or before the due date for
submission.
7) An increase in tax of 10% under subsection 103(3) shall be imposed for failure to pay the tax or balance of tax payable on
or before the due date for submission.
8) Method of payment for tax or balance of tax payable:
a) ByrHASiL at the ByrHASiL LHDNM Portal, https://byrhasil.hasil.gov.my/.
 Payment via FPX (Financial Process Exchange) at https://byrhasil.hasil.gov.my/fpx.php.
 Payment via Visa, Mastercard and American Express credit cards at https://byrhasil.hasil.gov.my/creditcard/.
b) Appointed banks - Information is available at https://www.hasil.gov.my.
c) Pos Malaysia Berhad – Counter only.
If the payment is made over the bank counter or Pos Malaysia counter, write down the name, address, telephone number,
income tax number, year of assessment, payment code ‘086’ and instalment no. ‘99’ on the reverse side of the financial
instrument. Check the receipt(s) / bank payment slip(s) before leaving the payment counter.
9) Pursuant to section 89, a change of address must be notified to LHDNM within 3 months of the change. Notification can be
made:
a) online by using e-Kemaskini for Company through MyTax. Please access via https://mytax.hasil.gov.my; or
b) using Form CP600B (Change of Address Notification Form) which can be obtained at the LHDNM Official Portal,
https://www.hasil.gov.my.
10) For further information, please contact Hasil Care Line:-
03-89111000 (Local) / 603-89111100 (Overseas)
 LEMBAGA HASIL DALAM NEGERI MALAYSIA Form YEAR OF ASSESSMENT
COMPANY RETURN FORM
UNDER SEKSYEN 77A OF THE INCOME TAX ACT 1967
This form is prescribed under section 152 of the Income Tax Act 1967
C 2022
CP5 - Pin. 2022

BASIC PARTICULARS
1 Name of company

2 Reference no. (registration no.) 3

Income tax no. C
4 Incorporated in Malaysia 1 = Yes 2 = No Employer’s no.
5 E
6 Status of business 1 = In operation 2 = Dormant 7
Country of residence (Use the Country Code)
3 = In the process of winding up 8
Commencement
date of operations (dd/mm/yyyy)
9 Accounting period From (dd/mm/yyyy) To (dd/mm/yyyy)
10 Basis period From (dd/mm/yyyy) To (dd/mm/yyyy)
11 Company with paid-up ordinary share capital not exceeding RM2.5 million at the beginning of the basis period and 1 = Yes 2 = No
gross income from all business sources not exceeding RM50 million
12 Company established for the issuance of asset-backed securities 1 = Yes 2 = No
13 Controlled company 1 = Yes 2 = No 14 Company limited by guarantee 1 = Yes 2 = No
15 Substantial change in shareholding and subsection 44(5A) applies 1 = Yes 2 = No 3 = Not relevant
16 Claim / Surrender loss under the Group Relief provision 1 = Claim 2 = Surrender 3 = Not relevant
[If claiming, submit Form C (RK-T); If surrendering, submit Form C (RK-S)]
[Declare in Ringgit Malaysia (RM) currency]
PART A: STATUTORY INCOME, TOTAL INCOME AND CHARGEABLE INCOME RM Sen
A1 Aggregate statutory income from sources of business(es) and partnership(s) in Malaysia (Fill in the required .00
appendix)
Aggregate statutory income from sources of business(es) and partnership(s) outside Malaysia received in
A2 .00
Malaysia effective from 01.07.2022 (If 7 = MY) (Fill in the required appendix)
A3 AGGREGATE STATUTORY INCOME FROM BUSINESSES AND PARTNERSHIPS ( A1 + A2 ) .00
A4 LESS: Business losses brought forward (Restricted to A3) .00
A5 TOTAL ( A3 – A4 ) .00
A6 Aggregate of other statutory income from sources in Malaysia (Fill in the required appendix) .00
– Dividends, interest, discounts, rents, royalties, premiums, other income and additions pursuant to paragraph 43(1)(c)
A7 Aggregate of other statutory income from sources outside Malaysia received in Malaysia effective from
01.07.2022 (If 7 = MY) (Fill in the required appendix) .00
– Dividends, interest, discounts, rents, royalties, premiums and other income
A8 AGGREGATE STATUTORY INCOME FROM OTHER SOURCES ( A6 + A7 ) .00
A9 AGGREGATE INCOME ( A5 + A8 ) .00
A10 LESS: Current year business losses (Restricted to A9) .00
Prospecting expenditure under schedule 4 / pre-operational business expenditure under schedule 4B / permitted
A11
expenses under section 60F or 60H (Fill in the required appendix) .00
A12 Approved donations / gifts / contributions (Fill in the required appendix) .00
A13 Zakat perniagaan (Restricted to 2.5% of A9) .00
A14 Claim for loss under Group Relief provision .00
A15 TOTAL INCOME [ A9 – ( A10 to A14 ) ] (Enter ‘0’ if value is negative) .00
A16 TAXABLE PIONEER INCOME .00
A17 CHARGEABLE INCOME ( A15 + A16 ) .00
A18 CHARGEABLE INCOME OF FOREIGN FUND MANAGEMENT (section 60G) .00
A19 CHARGEABLE INCOME OF APPROVED INCENTIVE SCHEME (section 65B) .00
INCOME FROM SOURCES OUTSIDE MALAYSIA RECEIVED IN MALAYSIA FOR THE PERIOD FROM
A20
01.01.2022 TO 30.06.2022 (If 7 = MY) (Fill in the required appendix) .00
PART B: TAX PAYABLE / REPAYABLE AND STATUS OF TAX
B1 TOTAL CHARGEABLE INCOME [ from ( A17 to A20 ) ] .00
B2 Apportionment of Chargeable Income Rate (%) Income Tax
B2a .00 17 .
B2b .00 24 .
B2c .00 33 .
B2d .00 3 .
B2f .00 .
B2g .00 .
B3 TOTAL INCOME TAX CHARGED ( B2a to B2g ) .
B4 Tax reduction on income derived from exploration and exploitation of petroleum in a Joint
LESS: Development Area .
B5 Section 6D rebate (up to RM20,000, restricted to B3) .
B6 TOTAL ( B3 – B4 – B5 ) (Enter ‘0’ if value is negative) .
B7 LESS: Section 110B tax deduction . Section 110 tax deduction (others) .
Section 132 and 133 tax relief (Restricted to B3) . .
B8 TAX PAYABLE ( B6 – B7 ) .
B9 OR: TAX REPAYABLE ( B7 – B6 ) .
B10a LESS: Instalments paid pursuant to section 107C provision .
B10b Instalments paid pursuant to paragraph 107A(1)(a) provision .
B11 Balance of tax payable ( B8 – B10a – B10b ) / Tax paid in excess ( B10a + B10b – B8 ) .
(Enter ‘ X ’ if tax paid in excess)

1
PART C: CAPITAL ALLOWANCES AND CHARGES UNDER SCHEDULE 3, REINVESTMENT ALLOWANCE UNDER SCHEDULE 7A AND
INVESTMENT ALLOWANCE FOR SERVICE SECTOR UNDER SCHEDULE 7B
C1a Particulars of Schedule 3 allowance (Fill in the required appendix and item C1b)
Amount Absorbed Balance Carried Forward
C1b Total accelerated capital allowance (if relevant)
C2 Claim for industrial building allowance under subparagraph 42(1) Schedule 3 1 = Yes 2 = No

Amount Withdrawn / Disregarded Amount Absorbed Balance Carried Forward

(a) (b) (c)
C3 Particulars of Schedule 7A allowance (Fill in the required appendix)
C4 Particulars of Schedule 7B allowance (Fill in the required appendix)
PART D: INCENTIVE CLAIM
D1 Claim for Special Deduction(s), Further Deduction(s) and Double Deduction(s)
Claim Code Amount
i.
...

D2 Claim for incentive(s) under paragraph 127(3)(b)

Incentive Code Balance Brought Forward Amount Claimed Amount Absorbed Balance Carried Forward
i.
...
D3 Claim for incentive(s) under subsection 127(3A)
Incentive Approval No. Balance Brought Forward Amount Claimed Amount Absorbed Balance Carried Forward
i.
…
D4 Claim for incentive(s) under Income Tax Act 1967 / Promotion of Investment Act 1986 other than the incentives in items D1, D2 and D3
Balance Carried Forward
Incentive Code Balance Brought Forward Amount Claimed Amount Absorbed
(if relevant)
i.
...
PART E: CLAIM FOR LOSSES
Amount Disregarded Amount Absorbed Amount Surrendered Balance Carried Forward
(E1) (E2) (E3) (E4)
Fill in the required appendix
PART F: PARTICULARS OF COMPANY
F1 Information for refund: (Info: For refund to a third party account, please submit the application to the branch which handles your income tax file)
F1a Method of payment for tax refund 1 = Via own account in Malaysia 2 = Via DuitNow 3 = Via a third party account
F1b Name of bank
F1c Bank account no. F1d Bank identification no.

F2 Particulars of company directors (Fill in the required appendix) F3 Particulars of company’s major shareholders (Fill in the required appendix)
F4 Foreign equity in comparison with paid-up capital . %
F5 Government Linked Company (GLC) 1 = Yes 2 = No
F6 Company listed on Bursa Malaysia 1 = Yes 2 = No
F7 Has holding company 1 = Yes 2 = No (If ‘Yes’, fill in the required appendix)
F8 Carries out controlled transactions under section 139 and 140A 1 = Yes 2 = No (If ‘Yes’, fill in the required appendix)
F9 Receives income from sources outside Malaysia which is exempted
1 = Yes 2 = No (If ‘Yes’, fill in the required appendix)
from tax
F10 Subject to interest restriction under section 140C 1 = Yes 2 = No
(If ‘Yes’, fill in information on interest subject to section 140C in the following schedule)

Amount of tax - EBITDA Interest expense subject to section 140C Interest expense restricted Balance carried forward

F11a Has Advance Ruling (If ‘Yes’,also complete items F11b and F11c) 1 = Yes 2 = No
F11b Compliance with Advance Ruling 1 = Yes 2 = No
F11c Material difference in arrangement 1 = Yes 2 = No

F12a Has Advance Pricing Arrangement (If ‘Yes’,also complete items F12b and F12c) 1 = Yes 2 = No
F12b Compliance with Advance Pricing Arrangement 1 = Yes 2 = No
F12c Material difference in arrangement 1 = Yes 2 = No

F13 Financial particulars of company (Fill in the required appendix)

Has subsidiary company(ies) or related company(ies) in the Federal Territory
F14 1 = Yes 2 = No (If ‘Yes’, fill in the required appendix)
of Labuan
Made payments to Labuan entity(ies) which are exempted from the
F15 1 = Yes 2 = No (If ‘Yes’, fill in the required appendix)
provisions of paragraph 39(1)(r)

2
PART G: OTHER PARTICULARS
G1 Chargeable income of preceding year not declared (if any)
Type of Income Year of Assessment Amount

G2 Made payments in the basis period which are subject to withholding 1 = Yes 2 = No
tax under sections 107A, 107D, 109, 109A, 109B, 109E, 109F and 109G
G3a Disposal of asset under the Real Property Gains Tax Act 1976 1 = Yes 2 = No
(If ‘Yes’, also complete item G3b)
G3b Disposal declared to LHDNM 1 = Yes 2 = No

G4a Carry on e-Commerce ( If ‘Yes’, also complete item G4b) 1 = Yes 2 = No

G4b Website / social media address

G5a Subject to Income Tax (Country-by-Country Reporting) Rules 2016 1 = Yes 2 = No

( If ‘Yes’, also complete item G5b)

1 = Yes – Reporting entity (Fill in the required appendix)

G5b Subject as a reporting entity / non-reporting entity
2 = No – Non-reporting entity (Fill in the required appendix)

G6 Has financial account(s) at financial institution(s) outside Malaysia 1 = Yes 2 = No

PART H: PARTICULARS OF AUDITOR

H1 Name of firm
H2 Address of firm

Postcode Town
State
H3 Income tax no. of firm H4 Telephone no. of firm
H5 E-mail of firm

PART J: PARTICULARS OF THE TAX AGENT AND SIGNATURE OF THE PERSON WHO COMPLETES THIS RETURN FORM
J1 Name of tax agent
J2 Tax agent’s approval no. / / /
J3 Name of firm
J4 Address of firm

Postcode Town
State
J5 Income tax no. of firm J8 Signature of tax agent
J6 Telephone no. of firm
J7 E-mail of firm J9 Date of signature (dd/mm/yyyy)

DECLARATION

I Identification / Passport No *
( * Delete whichever is not relevant )

hereby declare that this return form ** contains information that is true, correct and complete pertaining to the income tax of this company as required under
the Income Tax Act 1967.
** 1 = This return form is prepared based on audited 3 = This return form is prepared based on the liquidator’s account
financial statements under the Companies Act 2016. in accordance with the requirements under the Companies Act
2 = This return form is prepared based on unaudited 2016 (If item 6 = 3).
financial statements which are exempted under the
Companies Act 2016.

Date: (dd/mm/yyyy) Signature:

Designation:

3
 FORM C (RK-T) [Amend. 2011]
LEMBAGA HASIL DALAM NEGERI MALAYSIA
GROUP RELIEF FORM FOR CLAIMANT COMPANY
(Section 44A of the Income Tax Act 1967)
This form is prescribed undersection 152 of the Income Tax Act 1967

YEAR OF ASSESSMENT

A. This form must be completed and furnished together with the Form C by the company claiming the loss under
the Group Relief provision.
B. This form shall become part of the Form C pursuant to section 77A of the Income Tax Act 1967.
C. Letter of authority [verified copy of Form C (RK-S)] from each surrendering company must be retained for
examination by Lembaga Hasil Dalam Negeri Malaysia.
D. Use separate forms if the number of companies surrendering the loss exceeds five (5) companies.

1. Particulars Of The Company Claiming The Loss

(a) Name of Company

(b) Income Tax No.

(c) Basis Period From To

2. Particulars Of The Company Surrendering The Loss

Order of Basis Period Amount Surrendered

Priority Income Tax No. Name of Surrendering Company (RM)
From To

TOTAL:

DECLARATION

Identity Card / Passport No. *

* Delete whichever is not relevant

by means of authority vested under subsection 75(1) of the Income Tax Act 1967, hereby declare that this form contains
information that is true, complete and correct as required under the Income Tax Act 1967 and the conditions for the claim of
loss under section 44A of the same Act have been compled with, and the election made by the company is final and
irrevocable.

Date Designation Signature

1
 FORM C (RK-S) [Amend. 2011]
LEMBAGA HASIL DALAM NEGERI MALAYSIA
GROUP RELIEF FORM FOR SURRENDERING COMPANY
(Section 44A of the Income Tax Act 1967)
This Form is prescribed under section 152 of the Income Tax Act 1967

YEAR OF ASSESSMENT

A. This form must be completed and furnished together with the Form C by the company surrendering the loss
under the Group Relief provision.
B. This form shall become part of the Form C pursuant to section 77A of the Income Tax Act 1967.
C. This form is acceptable as a letter of authority if completed and duly signed by the surrendering company
official as stated in subsection 75(1) of the same Act. Hence, a verified copy of Form C (RK-S) has to be
prepared for each claimant company.
D. Use separate forms if the number of companies claiming the loss exceeds five (5) companies.

1. Particulars Of The Company Surrendering The Loss

(a) Name of Company

(b) Income Tax No.

(c) Basis Period From To

2. Particulars Of The Company Claiming The Loss

Order of Basis Period Amount Claimed

Priority Income Tax No. Name of Claimant Company (RM)
From To

TOTAL:

DECLARATION

Identity Card / Passport No. *

* Delete whichever is not relevant

by means of authority vested under subsection 75(1) of the Income Tax Act 1967, hereby declare that this form contains
information that is true, complete and correct as required under the Income Tax Act 1967 and the conditions for the
surrender of loss under section 44A of the same Act have been compled with, and the election made by the company is final
and irrevocable.

Date Designation Signature

1
 Item A1 (Attachment)

SUMMARY OF STATUTORY INCOME FROM SOURCES OF BUSINESS(ES) AND PARTNERSHIP(S) IN

MALAYSIA
PART I: BUSINESS
No. Business Identification Business Code Statutory Income
(RM)
i) Business 1
ii) Business 2
iii) Business 3
iv) Business 4
v) Business 5 + 6 and so forth
TOTAL: ( I )

PART II: PARTNERSHIP

No. Partnership Identification Income Tax No. Statutory Income
(RM)
i) Partnership 1 D
ii) Partnership 2 D
iii) Partnership 3 + 4 and so forth D
TOTAL: ( II )
AGGREGATE STATUTORY INCOME FROM SOURCES OF BUSINESS(ES) &
PARTNERSHIP(S) IN MALAYSIA ( I + II )
 UNTUK TUJUAN SPC SAHAJA

Item A2 (Attachment)

SUMMARY OF STATUTORY INCOME FROM SOURCES OF BUSINESS(ES) AND PARTNERSHIP(S) OUTSIDE MALAYSIA RECEIVED IN MALAYSIA
EFFECTIVE FROM 1 JULY 2022 (IF 7 = MY)
PART I: BUSINESS
No. Business Identification Business Code Country Amount Of Tax Statutory Income
(Use country code) Charged In The (RM)
Country Of
Origin
(RM)
i) Business 1
ii) Business 2
iii) Business 3
iv) Business 4
v) Business 5 + 6 and so forth
TOTAL: ( I )

PART II: PARTNERSHIP

No. Partnership Identification Business Code Country Amount Of Tax Statutory Income
(Use country code) Charged In The (RM)
Country Of
Origin
(RM)
i) Partnership 1
ii) Partnership 2
iii) Partnership 3 + 4 and so forth
TOTAL: ( II )
AGGREGATE STATUTORY INCOME FROM SOURCES OF BUSINESS(ES) & PARTNERSHIP(S) OUTSIDE
MALAYSIA RECEIVED IN MALAYSIA ( I + II )
 Item A6 (Attachment)

OTHER STATUTORY INCOME FROM SOURCES IN MALAYSIA

No. Type of Income RM
(i) Dividends .00
(ii) Interests .00
(iii) Discounts .00
(iv) Rents .00
(v) Royalties .00
(vi) Premiums .00
(vii) Other Income .00
(viii) Additions pursuant to paragraph 43(1)(c) .00
AGGREGATE OF OTHER STATUTORY INCOME FROM SOURCES IN .00
MALAYSIA [ (i) to (viii) ]
 UNTUK TUJUAN SPC SAHAJA

Item A7 (Attachment)

OTHER STATUTORY INCOME FROM SOURCES OUTSIDE MALAYSIA RECEIVED IN MALAYSIA

EFFECTIVE FROM 1 JULY 2022 (IF 7 = MY)
No. Country Received From Type of Income * Amount Of Tax Statutory Income
Related Charged In The
Entity(ies) Country Of Origin
(Use country code) (Enter: 1 = Yes (RM) (RM)
2 = No)

(i)
(ii)
(iii)
(iv)
(v)
AGGREGATE OF OTHER STATUTORY INCOME FROM SOURCES OUTSIDE
MALAYSIA RECEIVED IN MALAYSIA

Note :
* Type of Income:
a) Dividends
b) Interests
c) Discounts
d) Rents
e) Royalties
f) Premiums
g) Other Income
 Item A11 (Attachment)

OTHER EXPENSES
No. Type of Expenditure RM
(i) Prospecting expenditure under Schedule 4 .00
(ii) Pre-operational business expenditure under Schedule 4B .00
(iii) Permitted expenses under section 60F .00
(iv) Permitted expenses under section 60H .00

TOTAL [ (i) to (iv) ] .00

 Item A12 (Attachment)

APPROVED DONATIONS / GIFTS / CONTRIBUTIONS

No. Type of Donation / Gift / Contribution RM
(i) Gift of money to the Government / State Government / local authority .00
(ii)(a) Gift of money to approved institutions / organisations / funds RM .00
(ii)(b) Gift of money for any sports activity approved by the Minister of Finance RM .00
(ii)(c) Gift of money or cost of contribution in kind for any project of national interest Restricted to (ii)
RM .00 10% of A9 .00
approved by the Minister of Finance
(ii)(d) Gift of money in the form of wakaf to any religious authority / religious body /
public university or gift of money in the form of endowment to a public RM .00
university
(iii) Gift of artifacts / manuscripts / paintings to the Government or State Government .00
(iv) Gift of money for the provision of library facilities or to libraries Restricted to RM20,000 .00
(v) Gift of paintings to the National Art Gallery or any state art gallery .00

TOTAL [ (i) to (v) ] .00

 UNTUK TUJUAN SPC SAHAJA

Item A20 (Attachment)

INCOME FROM SOURCES OUTSIDE MALAYSIA RECEIVED IN MALAYSIA FOR THE PERIOD FROM
1 JANUARY 2022 TO 30 JUNE 2022 [IF 7 = MY]
No. Country Received from Type of Income * Amount of Tax Gross Amount of
Related Charged in the Income Remitted
Entity(ies) Country of Origin
(Use country code) (Enter: 1 = Yes (RM) (RM)
2 = No)

(i)
(ii)
(iii)
(iv)
(v)
INCOME FROM SOURCES OUTSIDE MALAYSIA RECEIVED IN MALAYSIA

Note :
* Type of Income :
a) Businesses
b) Partnerships
c) Dividends
d) Interests
e) Discounts
f) Rents
g) Royalties
h) Premiums
i) Other income
 Item C1a (Attachment)

PARTICULARS OF CAPITAL ALLOWANCES AND CHARGES UNDER SCHEDULE 3

(A) (B) (C) (D) (E) (F) (G)
No. Business Business Balancing Balance Amount Balancing Capital Allowance Balance Carried
Identity Code Charge Brought Forward Disregarded Allowance Allowance Absorbed Forward
(B–C+D+E–F)

PART X: BUSINESS

i) Business 1

ii) Business 2

iii) Business 3

iv) Business 4
v) Business 5 + 6
and so forth
TOTAL X:

PART Y: PARTNERSHIP
(A) (B) (C) (D) (E) (F) (G)
No. Partnership Partnership Balancing Balance Amount Balancing Capital Allowance Balance Carried
Identity Income Tax No. Charge Brought Forward Disregarded Allowance Allowance Absorbed Forward
(B–C+D+E–F)

i) Partnership 1 D

ii) Partnership 2 D
Partnership 3 + 4
iii) D
and so forth
TOTAL Y:

GRAND TOTAL ( X + Y ):
 Item C3 (Attachment)
SUMMARY OF REINVESTMENT ALLOWANCE UNDER SCHEDULE 7A

SCHEDULE 7A ALLOWANCE DURING THE QUALIFYING PERIOD

(a) (b) (c) (d) (e) (f)
BALANCE AMOUNT OF AMOUNT AMOUNT AMOUNT BALANCE
BROUGHT ALLOWANCE WITHDRAWN CANNOT BE ABSORBED IN CARRIED
FORWARD ENTITLED TO PURSUANT CARRIED THE CURRENT FORWARD
BE CLAIMED TO FORWARD YEAR OF
TYPE OF RA *
IN RESPECT PARAGRAPH DUE TO ASSESSMENT
OF CAPITAL 2A OF CESSATION
* (ORDINARY
EXPENDITURE SCHEDULE OF BUSINESS
/ PENJANA)
INCURRED IN 7A OF THE
THE CURRENT QUALIFYING
YEAR OF PROJECT (f=a+b-c-d-e)
ASSESSMENT

SCHEDULE 7A ALLOWANCE AFTER THE QUALIFYING PERIOD

ALLOWANCE CANNOT BE CARRIED FORWARD AND ALLOWANCE ALLOWANCE CANNOT BE CARRIED FORWARD AND
DISREGARDED / ABSORBED UNTIL THE YEAR OF ASSESSMENT ALLOWANCE DISREGARDED / ABSORBED IN THE
PRECEDING THE CURRENT YEAR OF ASSESSMENT CURRENT YEAR OF ASSESSMENT
(g) (h) (j) (k) (m) (n) (p) (q) (r) (s)
FIRST TYPE OF AMOUNT OF AMOUNT AMOUNT AMOUNT BALANCE OF AMOUNT AMOUNT AMOUNT AMOUNT BALANCE
YEAR OF RA * ALLOWANCE WITHDRAWN CANNOT BE ABSORBED ALLOWANCE WITHDRAWN CANNOT BE DISREGARDED ABSORBED CARRIED
ASSESSMENT PURSUANT CARRIED PURSUANT CARRIED UNDER FORWARD
FOR THE * TO FORWARD TO FORWARD PARAGRAPH 4B
PURPOSE OF (ORDINARY PARAGRAPH DUE TO PARAGRAPH DUE TO OF SCHEDULE
PARAGRAPH / PENJANA) 2A OF CESSATION 2A OF CESSATION 7A
4B OF SCHEDULE OF BUSINESS SCHEDULE OF BUSINESS
SCHEDULE 7A 7A OF THE 7A OF THE (s=m-n-p
(m=g-h-j-k)
QUALIFYING QUALIFYING -q-r)
PROJECT PROJECT
2018 & before
2019
2020
2021
 UNTUK TUJUAN SPC SAHAJA

Item C4 (Attachment)
SUMMARY OF INVESTMENT ALLOWANCE FOR SERVICE SECTOR UNDER SCHEDULE 7 B

SCHEDULE 7B ALLOWANCE DURING THE QUALIFYING PERIOD

(a) (b) (c) (d) (e) (f)
BALANCE AMOUNT OF ALLOWANCE AMOUNT AMOUNT BALANCE
BROUGHT ALLOWANCE WITHDRAWN CANNOT BE ABSORBED IN CARRIED
FORWARD ENTITLED TO CARRIED THE CURRENT FORWARD
BE CLAIMED FORWARD DUE YEAR OF
IN RESPECT TO CESSATION ASSESSMENT
OF CAPITAL OF BUSINESS
EXPENDITURE OF THE
INCURRED IN QUALIFYING
THE CURRENT PROJECT
(f=a+b-c-d-e)
YEAR OF
ASSESSMENT

SCHEDULE 7B ALLOWANCE AFTER THE QUALIFYING PERIOD

ALLOWANCE CANNOT BE CARRIED FORWARD AND ALLOWANCE ALLOWANCE CANNOT BE CARRIED FORWARD AND
DISREGARDED / ABSORBED UNTIL THE YEAR OF ASSESSMENT ALLOWANCE DISREGARDED / ABSORBED IN THE CURRENT
PRECEDING THE CURRENT YEAR OF ASSESSMENT YEAR OF ASSESSMENT
(g) (h) (j) (k) (m) (n) (p) (q) (r) (s)
AMOUNT OF ALLOWANCE AMOUNT AMOUNT BALANCE OF ALLOWANCE AMOUNT AMOUNT AMOUNT BALANCE
FIRST
ALLOWANCE WITHDRAWN CANNOT BE ABSORBED ALLOWANCE WITHDRAWN CANNOT BE DISREGARDED ABSORBED CARRIED
YEAR OF
CARRIED CARRIED UNDER FORWARD
ASSESSMENT
FORWARD DUE FORWARD DUE PARAGRAPH 5A
FOR THE
TO CESSATION TO CESSATION OF SCHEDULE
PURPOSE OF
OF BUSINESS OF BUSINESS 7B
PARAGRAPH 5A
OF THE OF THE
OF SCHEDULE (m=g-h-j-k) (s=m-n-p-q-r)
QUALIFYING QUALIFYING
7B
PROJECT PROJECT
2018 & before
2019
2020
2021
 UNTUK TUJUAN SPC SAHAJA
Part E (Attachment)

SUMMARY OF LOSSES FOR BUSINESS AND PARTNERSHIP THAT SUBJECT TO RESTRICTION UNDER SECTION 44(5F)
LOSSES OF CURRENT YEAR OF ASSESSMENT
(a) (b) (c) (d) (e) (f)
Amount Absorbed From Tax Balance Unabsorbed Balance Carried Forward
Current Year Of Assessment Amount Surrendered Under Group
Exempt Income Of Other Pioneer Amount Absorbed
Losses Relief Provision
Business / Approved Business (d = a - b - c ) (f = d - e)

LOSSES OF PRIOR YEARS OF ASSESSMENT

UNABSORBED LOSSES POSITION LOSSES ABSORBED / DISREGARDED IN THE
AT THE BEGINNING OF THE CURRENT YEAR OF ASSESSMENT CURRENT YEAR OF ASSESSMENT
(g) (h) (j) (k) (l) (m) (n) (p) (q) (r)
Year Of
Assessment
No. Amount Of Loss Amount Absorbed
In Which Loss Is Amount Amount Balance Amount Amount Balance Carried
In The Year Of From Tax Exempt
Incurred Disregarded Amount Absorbed Surrendered Unabsorbed Disregarded Disregarded Forward
Assessment Income Of Other Amount Absorbed
Under Subsection (Accumulated) Under Group Relief Under Subsection Under Subsection
In Which Loss Is Pioneer Business /
44(5A) Provision 44(5A) 44(5F)
First Incurred Approved Business
(m = g - h - j - k - l) (r = m - n - p - q)
1. 2018 & before
2. 2019
3. 2020
4. 2021
5.
6.
7.
8.
9.
10.
11.
 Item F2 (Attachment)

PARTICULARS OF COMPANY DIRECTOR

A B C D E F G H I J K L M
No. Director’s Name Service Address Identification Date of Income Tax Telephone Shareholding Salary / Fees / Total Loan Total Loan
Director / Passport Birth No. No. Bonus Commission To Directors From
Enter '1' = Yes No. / Allowances Directors
or
'2' = No
(dd/mm/yyyy) (%) (RM) (RM) (RM) (RM)
1.
2.
3.
4.
5.
 Item F3 (Attachment)

PARTICULARS OF COMPANY’S MAJOR SHAREHOLDERS

A B C D E F G H
No. Name of Shareholder Address Identification / Date of Birth Country of Origin Income Tax No. Direct Shareholding
Passport /
Registration No.

(dd/mm/yyyy) (Use country code) (If F = MY) (%)

1.

2.

3.

4.

5.
 Item F7 (Attachment)

PARTICULARS OF HOLDING COMPANY

F7a Name of Ultimate Holding Company Country Code Income Tax No.
(If Country Code = MY)

Income Tax No.

F7b Name of Immediate Holding Company Country Code
(If Country Code = MY)
 UNTUK TUJUAN SPC SAHAJA
Item F8 (Attachment)

INFORMATION ON CONTROLLED TRANSACTIONS

PART A: COMPANY INFORMATION

1. Are you required to prepare a Transfer Pricing 1 = Yes 2 = No

Documentation?
2a Manufacturing activities performed 1 = Yes 2 = No (if yes, fill in 2b)
2b Characterization of manufacturing activity 1 = Toll manufacturer 2 = Contract manufacturer 3 = Full-fledge
4 = Others manufacturer

3a. Distribution activities performed 1 = Yes 2 = No (if yes, fill in 3b)

3b. Characterization of distribution activity 1 = Full-fledge distributor 2 = Commissionaire distributor 3 = Agent distributor
4 = Limited risk distributor 5 = Licensed distributor 6 = Others
4a. Service activities performed 1 = Yes 2 = No (if yes, fill in 4b)
4b. Characterization of service activity 1 = Management service provider 2 = IT service provider 3 = Treasury
4 = Others
5a. Business restructuring during the basis period 1 = Yes 2 = No (If yes, fill in 5b)
5b. State the nature of business restructuring ☐ 1 = Conversion of full-fledge manufacturer into contract/toll manufacturer
☐ 2 = Conversion of contract/toll manufacturer into full-fledge manufacturer
☐ 3 = Conversion of full-fledge distributor into limited risk/commissionaire/agent/licensed distributor
☐ 4 = Conversion of limited risk/commissionaire/agent/licensed distributor into full-fledge distributor
☐ 5 = Transfer of intellectual property rights to foreign associated person
☐ 6 = Other
6a Performed any research and development activity? 1 = Yes 2 = No (If yes, fill in 6b)
6b State the types of R&D activity ☐ 1 = Systematic, investigative and experimental study that involves novelty
☐ 2 = Technical risk carried out in the field of science or technology with the object of acquiring new knowledge
☐ 3 = Study for the production or improvement of materials, devices, products, produce, or processes
☐ 4 = Others
7. Do you own any trade/ brand name/ intellectual 1 = Yes 2 = No
property?
8a. Are you involved in any cash pooling activities? 1 = Yes 2 = No (If yes, fill in 8b below)
8b. Role in the cash pooling activitiy 1 = cash pool leader 2 = cash pool member
9. Has the company declared or paid any dividend? 1 = Yes 2 = No
10a. Are you a PE as defined under the TP Rules? 1 = Yes 2 = No (If yes, fill in 10b)
10b. Do you make any interest, royalties and service 1 = Yes 2 = No (if yes, fill in B17 below)
payments to your head office?
11. Are you involved in any Cost Contribution 1 = Yes 2 = No (if yes, fill in B15 below)
Arrangement (CCA)

PART B: CONTROLLED TRANSACTIONS

In Malaysia Outside Malaysia

Transaction Sales / Revenue / Purchases / Expenditure Sales / Revenue / Purchases /
Item
Type Assets / Liabilities Assets Expenditure /
(RM) (RM) (RM) Liabilities
(RM)
B1 Sales
B2 Purchases
B3 Other income
B4 Payment on the use of
intangibles:
i) Royalties
ii) Licence fees
iii) Other payments
B5 Management fees including fees
/ charges for financial,
administrative, marketing and
training services
B6 Research and development
B7 Advertisement, marketing and
promotion (AMP)
B8 Tangible assets
B9 Rent / Lease of assets

1
 UNTUK TUJUAN SPC SAHAJA
In Malaysia Outside Malaysia
Transaction Sales / Revenue / Purchases / Expenditure Sales / Revenue / Purchases /
Item
Type Assets / Liabilities Assets Expenditure /
(RM) (RM) (RM) Liabilities
(RM)
B10 Loans to associated person
B11 Loans from associated person
B12 Interest to associated person
B13 Interest from associated person
B13a Interest from associated person
remitted to Malaysia
B14 Guarantee fee
B15 Cost Contribution Arrangement
(CCA) amount
B16 Dividends

B17 Payments to head office (only for

PE):
i) Interest
ii) Royalties
iii) Service payments
B18 Sale of IP
B19 Others not specified above

2
 UNTUK TUJUAN SPC SAHAJA

Item F9 (Attachment)

RECEIVES INCOME FROM SOURCES OUTSIDE MALAYSIA WHICH IS EXEMPTED FROM TAX
No. Country Received From Type of Income 1 Tax Paid In The Headline Tax Rates Amount Of Tax Amount of Income
Related Entity(ies) Country Of Origin In The Country Of Charged In The Remitted
Origin 3 Country Of Origin 4
(Use country code) (Enter: 1 = Yes (Enter: 1 = Yes 2 = No 2) (%) (RM) (RM)
2 = No)

(i)
(ii)
(iii)
(iv)
(v)
RECEIVES INCOME FROM SOURCES OUTSIDE MALAYSIA WHICH IS EXEMPTED FROM TAX

Notes:
1
Type of Income:
(a) Dividends
(b) Capital gains

2 Tax not paid in the country of origin due to enjoying tax incentives or dividends paid from Capital Gains / Underlying Profit (for companies / LLPs) /
tax consolidated regime.

3 The headline tax rate in the country of origin refers to the highest corporate tax rate in the country of origin in a year in which the foreign dividend is
received in Malaysia. The headline tax rate must be at least 15% to qualify for exemption for dividend income.

4 The amount of tax charged in the country of origin in respect of the part of income remitted to Malaysia. Use the foreign currency exchange rate on
the date of remittance of income is made to fill in this item.
 Item F13 (Attachment)

FINANCIAL PARTICULARS OF COMPANY [ MAIN BUSINESS ]

Business code

Type of business activity

BALANCE SHEET

TRADING PROFIT AND LOSS ACCOUNT FIXED ASSETS:

Sales / turnover .00 Motor vehicles .00

LESS: Plant and machinery .00

Opening stock .00 Land and buildings .00

Purchases .00 Other fixed assets .00

Cost of production .00 TOTAL FIXED ASSETS .00

Total cost of fixed assets
Closing stock .00 .00
acquired in the basis period
Cost of sales .00 Investments .00
( Enter ‘X’ if value is negative ) CURENT ASSETS:

GROSS PROFIT / LOSS .00 Trade debtors .00

( Enter ‘X’ if value is negative ) .00
Sundry debtors

Foreign currency exchange gain .00 Stock .00

Other business income .00 Loans to directors .00

Cash in hand
Other income .00 .00
and cash at bank
.00 ( Enter ‘X’ if value is negative )
Non-taxable profits

EXPENDITURE: Other current assets .00

Interest .00 TOTAL CURRENT ASSETS .00

Professional, technical,
management and legal fees .00 TOTAL ASSETS .00

Technical fee payments to .00 LIABILITIES AND OWNERS’ EQUITY

non-resident receipients
Contract payments .00 CURRENT LIABILITIES:

Directors’ fee .00 Loans and overdrafts .00

Salaries and wages .00 Trade creditors .00

Cost of Employee Stock Options .00 Sundry creditors .00

Royalties .00 Loans from directors .00

Rental / lease .00 Other current liabilities .00

TOTAL
Maintenance and repairs .00 .00
CURRENT LIABILITIES

Research and development .00 Long-term liabilities .00

Promotion and advertisement .00 TOTAL LIABILITIES .00

Travelling and accommodation .00 SHAREHOLDERS’ EQUITY:

Foreign currency exchange loss .00 Paid-up capital .00

Profit and loss
Other expenditure .00 .00
appropriation account
( Enter ‘X’ if value is negative )
TOTAL EXPENDITURE .00

NET PROFIT / LOSS .00 Reserve account .00

( Enter ‘X’ if value is negative ) ( Enter ‘X’ if value is negative )

Non-allowable expenses .00 TOTAL EQUITY .00

( Enter ‘X’ if value is negative )

TOTAL LIABILITIES
.00
AND EQUITY
( Enter ‘X’ if value is negative )
 Item F14 (Attachment)
PARTICULARS OF LABUAN ENTITIES
No. Name Registration No. Income Tax No. Transaction With Related
Company
( Enter ‘1’ = Yes or ‘2’ = No )

( F14a ) ( F14b ) ( F14c ) ( F14d )

(i)
(ii)
(iii)
(iv)
(v)
(vi)
(vii)
(viii)
(ix)
(x)
 UNTUK TUJUAN SPC SAHAJA

Item F15 (Attachment)

MADE PAYMENTS TO LABUAN ENTITY(IES) WHICH ARE EXEMPTED FROM THE PROVISIONS OF
PARAGRAPH 39(1)(r)
No. Type of Payment* Payment to
Amount
Related Companies
(Enter: 1 = Yes 2 = No) (RM)

(i)
(ii)
(iii)
(iv)
(v)
(vi)
TOTAL PAYMENTS

* Type of Payment:
a) Interest payment
b) Lease rental
c) Other payments
 Item G5b_1 (Attachment)

PEMBERITAHUAN SEBAGAI ENTITI PELAPOR / NOTIFICATION AS A REPORTING ENTITY

Pemberitahuan sebagai entiti pelapor di bawah Kaedah-Kaedah Cukai Pendapatan (Pelaporan Mengikut Negara) 2016.
Notification as a reporting entity under the Income Tax (Country-by-Country Reporting) Rules 2016.

1. Nama syarikat
Name of company

2. No. rujukan (No. pendaftaran)

Reference no. (Registration no.)

3. No. cukai pendapatan

Income tax no.

4. E-mel CbCR
CbCR e-mail

5. Nama Kumpulan MNE

Name of MNE Group

hh-bb-tttt hh-bb-tttt
dd-mm-yyyy dd-mm-yyyy
6. Tempoh perakaunan dari
Accounting period from - - hingga - -
to

7. Bilangan entiti konstituen di dalam Malaysia

Number of constituent entities in Malaysia <>>?
8. Bilangan entiti konstituen di luar Malaysia
Number of constituent entities outside Malaysia <>>?
9. Status entiti pelapor
Status of reporting entity
1 = Entiti pemegangan muktamad, atau
Ultimate holding entity, or

2 = Entiti pemegangan pengganti

Surrogate holding entity

Jika ‘2’ isi juga Ruang 10 / If ‘2’ complete Item 10

10. Maklumat entiti pemegangan muktamad

Ultimate holding entity information

1 = Maklumat sama seperti F7a, atau

Same as F7a

2 = Maklumat selain F7a

Other than F7a

a) Nama entiti pemegangan muktamad

Name of ultimate holding entity

b) Negara mastautin
Country of residence
Gunakan kod negara
Use country code
 Item G5b_2 (Attachment)

PEMBERITAHUAN SEBAGAI BUKAN ENTITI PELAPOR / NOTIFICATION AS A NON-REPORTING ENTITY

Pemberitahuan sebagai bukan entiti pelapor di bawah Kaedah-Kaedah Cukai Pendapatan (Pelaporan Mengikut Negara) 2016.
Notification as a non-reporting entity under the Income Tax (Country-by-Country Reporting) Rules 2016.

Nama syarikat
Name of company

No. rujukan (No. pendaftaran)

Reference no. (Registration no.)

No. cukai pendapatan

Income tax no.

E-mel
E-mail

MAKLUMAT ENTITI PELAPOR

PARTICULARS OF REPORTING ENTITY

1. Maklumat entiti pelapor sama seperti F7a

Reporting entity information is the same as F7a

1 = Ya / Yes
2 = Tidak / No

2. Nama entiti pelapor

Name of reporting entity

3. Negara mastautin
Country of residence
Gunakan kod negara
Use country code

4. No. cukai pendapatan

Income tax no.

5. Tempoh perakaunan entiti pelapor

Accounting period of reporting entity

hh-bb-tttt hh-bb-tttt
dd-mm-yyyy dd-mm-yyyy
dari hingga
- - - -
from to

6. Nama Kumpulan MNE

Name of MNE Group

7. Status entiti pelapor 1 = Entiti pemegangan muktamad, atau

Status of reporting entity Ultimate holding entity, or

2 = Entiti pemegangan pengganti

Surrogate holding entity