Form 04/NNG-TNCN Personal Income Tax Declaration (Issued together with Circular No. 80/2021/TT-BTC dated September 29, 2021 of the Ministry of Finance)
SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
PERSONAL INCOME TAX DECLARATION
(Applicable to non-resident individuals with income from business, individuals with income from capital investment, royalties, franchise rights, or lottery winnings paid from abroad)
[01] Tax period: Occurrence date … month … year …
[02] First time: [03] Supplement for the … time
[[04] Taxpayer's name: …………………………………....................................
[[05] Tax identification number:
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[06] Address: ……………………………………......................................................
[07] District/Commune: ……………… [08] Province/City: ………………………………
[09] Phone: …………………… [10] Fax: ……………… [11] Email: ………………………
[12] Name of tax agent (if any): …………………………...........................................
[13] Tax identification number:
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[14] Tax agent contract: Number: ........................................ Date: ................................
[15] Name of organization in Vietnam where the individual generates income: ………………
[16] Tax identification number:
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[17] Address: …………………………
[18] District/Commune: ………… [19] Province/City: ……………………………………
[20] Phone: …………………… [21] Fax: ……………… [22] Email: ………………………
Currency unit: Vietnamese Dong
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No. |
Indicator |
Code |
Amount |
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I |
Income from business of non-resident individuals |
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1 |
Total taxable income |
[23] |
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2 |
Tax rate |
[24] |
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3 |
Total personal income tax payable |
[25] = [23] * [24] |
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II |
Income from capital investment |
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1 |
Total taxable income |
[26] |
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2 |
Total tax payable |
[27] |
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3 |
Total tax paid abroad |
[28] |
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4 |
Tax payable left |
[29] = [27] - [28] |
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III |
Income from royalties, franchise rights |
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1 |
Total taxable income |
[30] |
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2 |
Total tax payable |
[31] |
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3 |
Total tax paid abroad |
[32] |
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4 |
Tax payable left |
[33] = [31] - [32] |
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IV |
Income from lottery winnings |
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1 |
Total taxable income |
[34] |
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2 |
Total tax payable |
[35] |
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3 |
Total tax paid abroad |
[36] |
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4 |
Tax payable left |
[37] = [35] - [36] |
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I confirm that the information declared above is correct and take full responsibility before the law for the accuracy of the declared data.
NTAX AGENT STAFF
Full Name: ……………………
Professional License No.: ……
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…, day .... month … year …
TAXPAYER or AUTHORIZED REPRESENTATIVE OF THE TAXPAYER
(Signature, full name, position, and seal (if any)/Digital signature)
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