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DEPARTMENT
OF ZAKAT AND INCOME TAX
Monthly
Withholding Tax Form
Month
..
Year
(1)
Tax Payer Name:
Fiscal Year:
.
Financial No.
|
Serial
|
Type
of payment
|
Beneficiarys
name
|
Date
of
|
Total
|
Tax
rate
|
Amount
of tax
|
|
No.
|
|
(Withheld
From)
|
payment
|
amounts
|
|
withholding
|
|
|
|
|
|
paid
|
|
|
|
|
|
|
|
|
|
|
|
1.
|
Rent
(lease)
|
|
|
|
5%
|
|
|
2.
|
Royalty
|
|
|
|
15%
|
|
|
3.
|
Managements
fees
|
|
|
|
20%
|
|
|
4.
|
Payments
against
|
|
|
|
5%
|
|
|
|
air
tickets or
|
|
|
|
|
|
|
|
maritime
or air freight
|
|
|
|
|
|
|
5.
|
Payments
against
|
|
|
|
5%
|
|
|
|
International
|
|
|
|
|
|
|
|
telecommunication
|
|
|
|
|
|
|
|
Services
|
|
|
|
|
|
|
6.
|
Payments
against
|
|
|
|
15%
|
|
|
|
Services
paid to the
|
|
|
|
|
|
|
|
Head
office or related
|
|
|
|
|
|
|
|
Company
|
|
|
|
|
|
|
7.
|
Dividends
distributed*
|
|
|
|
5%
|
|
|
8.
|
Payments
against
|
|
|
|
5%
|
|
|
|
advisory
or
|
|
|
|
|
|
|
|
technical
services
|
|
|
|
|
|
|
9.
|
Interest
on loan
|
|
|
|
5%
|
|
|
10.
|
Insurance
or
|
|
|
|
5%
|
|
|
|
reinsurance
premiums
|
|
|
|
|
|
|
11.
|
Any
other payments
|
|
|
|
15%
|
|
|
12.
|
Total
monthly
|
|
|
|
|
|
|
13.
|
Delay
penalty 1% for
|
|
|
|
|
|
|
|
every
30 days delay
|
|
|
|
|
|
|
14.
|
Total
tax and delay
|
|
|
|
|
|
|
|
Penalty
due (12+13)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
*
With
the exception of the dividends paid by the companies working
in the field of natural gas investment or oil and
hydrocarbon production.
DECLARATION
I
the undersigned hereby certify that all the amounts stated
in this declaration is
correct, and reflects the amount due regarding tax
withheld during the month, that are calculated in accordance
with the Article No.68 of Income Tax Regulation in the
Kingdom of Saudi Arabia.
Name:
(four names)
. Signature
Date:
/
/
Stamp
|
For
|
It
has been paid as per
No.
.
Date
/
/
|
|
official
|
|
|
use
|
Name
.
Signature
|
(1)
This form is to be presented to DZIT within the first
ten days of the month that follows the month that has been
paid to the beneficiary.
(2)
If the
beneficiary of any of the above mentioned payments is more
than one person, a detailed statement to be enclosed showing
the name of each beneficiary, the date of payment (s) and
its amounts.
ZAKAT & INCOME TAX DEPARTMENT (DZIT)
Withholding
Tax Form for the year ended
/
/
*
Tax
Payer Name:
..
Finance No.
..
|
Serial
|
Name
of
|
Address
|
Finance
|
Type
of
|
Amount
|
Tax
paid
|
|
No.
|
withheld
form
|
|
No.
(if
|
payment
|
Paid
|
|
|
|
|
|
available)
|
|
|
|
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|
|
|
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|
|
|
1.
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2.
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3.
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4.
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5.
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6.
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7.
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8.
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9.
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10.
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11.
|
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12.
|
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13.
|
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14.
|
|
|
|
|
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|
15.
|
|
|
|
|
|
|
|
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Total
|
|
|
|
|
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DECLARATION
I the undersigned hereby certify that all the amounts
declared in this declaration is correct and reflects the
withholding tax due during the financial year mentioned
above and are calculated in accordance with the Article
No.68 of Income Tax Regulation in the Kingdom of Saudi
Arabia.
Name:
Signature:
.
Date
/
/
Stamp
______________________________________________________________________________
*This
form to be presented to DZIT during (120) days from the end
of the financial year, except for the partnership companies
to submitted within (60)
days from the end of the financial year.
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