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RBHraCaNacRkkm<Ca

TRmg;
Gtb 200
Form VAT 200

Cati sasna RBHmhakSRt

GKnaykdanBndar
nksYgesdkic nig hirBavt

sRmab;mnIBndar For Tax Official


fTI
Ex
qaM
DD
MM
YY
elxcUl N ........
htelxa
0

llixxi ititRRbbkkaassGGaakkrreellItItmmbb EEnnmm bbnnkkrrbbss;rr; dd


Return for Value Added Tax (State Charge)

Signature

eQraHmnIBndar

sUmGanesovePACMnYysrartIelx 03 munnwgbMeBjTRmg;enH .

..........................

Tax official Name

Read VAT leaflet No. 03 before completing this form.

kariybriecTsareBIBnsRmab;lixitRbkasenH Period covered by this return


0 qaM>>>>>>>>>>>>>>>>>>>>>>>
0
0 Ex....................
20
3 Ex......................
20
BIfTI.................
dl;fTI ................
qaM.........................
02

From (DD)

From (DD) Month (MM) Year (YYYY)

Month (MM)

elxGtsBaaNkmrsareBIBn

01

Year (YYYY)

TIN

 )

eQraHshRKas Name of Enterprise
..............................................................................................................................................................................................
 ( )
skmrPaBGaCIvkmr Business Activities .................................................................................................................................................................................................................
3
222
Gasydan Address: No...................................vifI Street.....................................................
Rkum Group................. PUmi Village ..........................................................


XMu/sgat; Sangkat.................................................
Rkug/Rsuk/xN District .............................................ext/raCFanI Municipality .................................................

12 94 7000
TUrsBTUrsar Fax/Phone ......................................................
sareGLicRtUnik E-mail ...................................................................................................................
RbsinebIelak/elakRsIKranskmrPaBTijblk;eT sUmsresrfa :Kran : kgRbGb;enH

03

04

If you have made no purchases and no sales, fill " NIL " in this box.

RbsinebIKranTinnyGVIRtUvbMeBjkgRbGb;NamYyeT sUmsresrfa : Kran : kMuTukRbGb;ecalTMenr elIkElgEtelak/elakRsIsresrfa : Kran : kgRbGb;elx

04

If you have no entry for a box, fill " NIL ". Do not leave any box blank unless you fill " NIL " in box 04.

\NTanGakrelIFatucUlBIExmun

05

Input tax credit from previous month.

karTijTMnijbesvakgEx ( FatucUl ) Month's purchases of goods and services ( Input) tmminrYmbBalGakr Value exclusive of VAT

karTijminCab;GakrbkarTijEdlminGnuBaat\NTan Non-taxable or non-creditable purchases 06
 08

karTijkgRsuktamGRtaFmrta 10% Standard rated local purchases
07
 10
karnaMcUlCabnkrbs;rdminGackat;kg)an State charges imports(non-deductible)

09

srubTwkR)ak;GakrelIFatucUl Total amount of input tax ( 05+08 ) 11
karlk;TMnijnigesvabkarnaMecjkgEx ( Fatuecj ) Month's sales of goods and services or exports ( Output ) tmminrYmbBalGakr Value exclusive of VAT

karlk;minCab;Gakr Non-taxable sales
12

karlk;tamGRta 0% Exports
13
 15

karlk;tamGRtaFmrta 10% Standard rated sales
14

RbsinebIcMnYnkgRbGb;elx 15 elIsBIcMnYnkgRbGb;elx 11 RtUvbg;cMnYnlemg If box 15 exceeds box 11, pay the difference
16
RbsinebIcMnYnkgRbGb;elx 11 elIsBIcMnYnkgRbGb;elx 15 RtUvesIsMucMnYnlemgedIm,I If box 11 exceeds box 15, claim the difference for :

bgiVlsg Refund
Ca\NTansRmab;eyageTAmux Credit carried forward 18
17
eyIg)anBinitRKb;cMNucTaMgGs;enAelIlixitRbkasenH nigtarag]bsm<nPab;mkCamYy . eyIgmanskIbRtbBaak;c,as;las; RtwmRtUv eBjelj EdlFana)anfa Btman
TaMgGs;enAelIlixitRbkasenH BitCaRtwmRtUvR)akdEmn ehIyKranRbtibtikarNamYymin)anRbkasenaHeT . eyIgsUmTTYlxusRtUvTaMgRsugcMeBaHmuxc,ab;TaMgLayCaFrman
RbsinebIBtmanNamYymankarEkgbnM . We have examined all items on this return and the annexes attached here with. We have clear, correct, and full supporting
documents to ensure that all information on this return is true and accurate and there is no business operation undeclared. We are fully responsible due to the existing
Laws for any falsified information.

sRmab;mnIBndar For Tax Official


EbbbTnkarbg;R)ak; sac;R)ak; mUlb,TanbRt bEgVr
cMnYnTwkR)ak;>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
bg;tambgan;delx>>>>>>>>>>>>>>>>>>>>>>>>>cuHfTI>>>>>>>>/>>>>>>>>/>>>>>>>>>
lr>ln KNenykmr>>>>>>>>>>>>>>>>>>>>>>>>>feFVI>>>>>>>>/>>>>>>>>/>>>>>>>>>
RbePTTinanub,vtiCMnYy>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
eQraHmnIBndar>>>>>>>>>>>>>>>>>>>>>>>>>>>htelxa>>>>>>>>>>>>>>>>>>>>>>>>>>

kMNt;smal;

eFVIenA ............................................fTI $
Filed in

$
DD

$ Ex $

$ qaM $

MM

$
YYYY

GPi)albNaFikarkmqsiTikr shRKas
Director/Manager/Owner of Enterprise
Signature & Seal)
(

htelxa nigRta

Please note :

1.elak /elakRsIRtUvdak;lixitRbkasenHRBmTMagbg;R)ak;Gakrya:gyWtbMputRtwmfTI 20 nExbnab;BIExEdlcuHkgRbGb;elx 2.


This return and payment must be presented by the 20th day of the month following the month of box 02.
2.elak /elakRsI nwgTTYlrgkarpakBiny eTAtamc,ab;sIBIsareBIBn RbsinebIelak /elakRsI You will be, according to the Law on Taxation, subject to penalties if you :

min)andak;lixitRbkasenArd)alsareBIBn eTaHbICaKranR)ak;GakrRtUvbg;k_eday Fail to file the


minbg;bbg;yWtya:v nUvR)ak;GakrEdl)anRbkas Do not pay or pay the tax declared late.
- eFVIkarRbkasEkgbnM Making a false declaration.
-

tax return to the Tax Administration even it is a nil return.

segbRbtibtikar TijEdlGnuBaat\NTan nigkarlk;Cab;Gakr RbcaMEx *


SUMMARY OF CREDITABLE PURCHASES AND TAXABLE SALES FOR THE MONTH

20

lr
No

karnaMcUlbkarTij TMnijbesvaEdl)anesIsMu\NTan GOODS OR SERVICES IMPORTED OR PURCHASED ON WHICH A CREDIT IS CLAIMED


briyaymuxTMnijbesva
brimaN
kalbriecTTij
elxvikybRtRbtievTn_Ky
tmminrYmbBalGakr
Gkpt;pg;
Description of Goods or
Services

Quantity

Date of purchase

Invoice / Customs Declaration number

Suppliers

Value exclusive of VAT

srub Total
*sUmKUsrgVg;CuMvijelxerogmuxTMnijNaEdl)anTijbnaMcUledIm,IeRbIR)as;CaRTBskmrrbs;shRKas
Please circle any serial No of the items purchased or imported for the enterprises fixed assets.

21

srubkarnaMecjRbcaMEx Edl)anesIsMuGRtasUn GOODS OR SERVICES EXPORTED ON WHICH ZERO RATE IS CLAIMED

lr

briyayBImuxTMnijbesva

brimaN

kalbriecTnaMecj

elxRbtievTn_Ky

RcknaMecj

tmnaMecj

No

Description of Goods or
Services

Quantity

Date of Export

Customs Declaration number

Exit Point

Export Value

srub
22

lr
No

Total

karpt;pg;TMnij besvakgRsuktamGRtaFmrta GOODS OR SERVICES LOCALLY SUPPLIED AT STANDARD RATE


TMnij GOODS
esva SERVICES
briyaymuxTMnij
brimaN
tmminrYmbBalGakr
briyay
vikybRtBIelxdl;elx
tmminrYmbBalGakr
Description of Goods

srub

Quantity

Value exclusive of VAT

Total

kMNt;smal; RbsinebIsresrminGs; sUmPab;CamYykgRkdasedayELk .


Notes : Use separate sheets if the space is insufficient.

Invoice from No to No

Description

srub

Total

Value exclusive of VAT