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RETURN FORM OF AN INDIVIDUAL
RESIDENT WHD 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

Tax Identification No. (TIN)

Current passport no. no. registered with LHDNM
Citizen
Type of assessment
Date of birth

Statutory income from sources of rents in Malaysia

Statutory income from sources of interest, discounts, royalties, premiums, pensions, annuities,
and other gains or profits pursuant to paragraph 43(1)(c) in Malaysia
Aggregate of other statutory income from sources outside Malaysia received in

AGGREGATE INCOME
LESS : Approved investment under angel investor tax incentive

TOTAL

LESS : Approved donations I gifts I contributions

TOTAL
TOTAL INCOME (SELF)
TOTAL INCOME TRANSFERRED FROM HUSBAND I WIFE •
MALAYSIA AND OUTSIDE MALAYSIA
*Type of income transferred from
INCOME FROM SOURCES
30.06.2022

authority I religious body I public university or gift of money in the form of

TOTAL Restricted to 10% of aggregate income

f..---__:__~

Restricted to 20,000
1------i
Gift of money or contribution in kind for the provision of facilities in public places for the benefit of disabled persons
Gift of money I cost I value of gift of medical equipment to any heatthcare 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 I gifts I contributions

Medical treatment, special needs and carer expenses for parents (certified by medical practitioner)
r - - R~strJct~d t~ --
8,000
1-- - - - - - - --- - - +-----1
Basic supporting equipment for disabled self, spouse, child or parent Restricted to
6,000
Disabled individual 6,000

Printed date and time : 20-04-2023 10:27.41 Page 115

 Other than a degree at masters or doctorate level~ Course of study in law, accounting, Islamic financ1ng,
vocational, industrial, scientific or technological skills or qualifications
§ 0 Restncted to
7,000

~~~~-e-~f-s~~~y-~~d_e_~~~~ ~r-~~ ~~:_o~~ _o~~~~~l~i~~ ~~~~~~~~~"-~~-e-n~ :n:~~~~~e_d_t~-2~~~0! _______ __ ___ 0 ___________ +----4
l><tic:al coxpcenses on:
serious diseases for self, spouse or child

fertility treatment for self or spouse Restricted to

8,000
i) Vacccination for self, spouse and child (restricted to 1,000)

(Restricted to 1 ,000) on:

c_ocm~l~temedical examination for self, spouse or child
9 detection test induding purchase of self-detection test kit for self, spouse or child
Mental heatth examination or consultation for self, spouse or child

- Purchase for self, spouse or child Restricted to

2,500
2,500
'- ------------ +----1
-Additional relief for the use I benefrt of self, spouse or child : Restricted to 500 0
:- - R~~tri~te_d_ t~- - +----.- -1
-Purchase of personal computer, smartphone or tablet for self, 2 5 00

Restricted to
1,000
Restricted to
3,000
0
'------ ------ -+----1
Restricted to
0
8,000
----------------------:-- R~~tride_d_t~-- +-----1
0
4,000
,____ --------- +----1
5,000
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - L___ _:j
50% eligibility
0 X 1,000 = 0
0 X 1,000 = 0
0 X4,000 = 0
ox 6,000=0 0 X 3,000 = 0
OX 14,000 = 0 0 X 7,000 = 0

co•ntribute to EPF /approved scheme- life insurance premium ,. - R~~b;~tei t~-­

' - - - - _7,000 - -

N~ Restricted to
,, 0" --fqr- /~U,+-_ .,•. __ --------
3,000
-- -+--c--:-::-1
Restricted to 4,000
y-ur YA~a-1 4,000
----------------------------------------------------------------------- -·-------------+----1
retirement scheme and deferred annuity Restricted to 0
' 3,000
and medical insurance b t>fu' S'~u ~-R-e--'s"'tn"'ct:::ed-t--o=l=--3-,0-00-1
---N e<>.,,,'f>Yl 3,000
>ntribultlon to the Social Security Organization (SOCSO) according to Employees Social Security Act 1969 or Employment :.-~:s~~~~~ ;~ ;~~ -1---3-50-1
System Act 2017
1--------------1------1
Restricted to 1,000
1,000
>-------------+---~
of installation, rental, purchase including hire-purchase of equipment or subscription for use of electric vehicle charging Restricted to 0
for own vehicle (Not for business use) • ____ 2,500

Page 2/5
date and time : 20-04-2023 10:27.41
Name TAN HAN CHUAN (IG 4110146040)

TOTAL INCOME
Totalrelief (II.ICLVD!71v"<...t;C;Q W(.<.Oo!rt-~ ~"-§of Rh\3.¥.)
CHARGEABLE INCOME
Tax on the first 1,000,000 At rate (%)
Tax on the balance ~--------2-2-3-,3-5~~ ~
Tax on income from sources outside Malaysia received in
Malaysia for the period from 01.01.2022- 30.06.2022
TOTAL INCOME TAX
LESS : TOTAL REBATrE~--------::-~
Self L-----,--.,-,---0'-'1 Husband/wife
Departure levy for umrah traveVreligious travel for other L _ _ _ _ _ _ _O_jl Zakat and fitrah
religions
TOTAL TAX CHARGED 299,988.001
0.00
Section 110 (others)
Section 132
I
LESS: Total tax deductions/Relief (Section 132 and 133 tax relief restricted to total tax

_
0.001
O.oo_Section 133
TAX PAYABLE FOR THE YEAR OF ASSESSMENT 2022 - - ~--------------=2:::9:::9,::::98:::8:::.0:::j0 I
Payment made for 2022 income - SELF and HUSBAND I WIFE for joint . 237,884.10
Monthly Tax Deductions (MTD} I Section 237,884.
S107D
- . - - - - - - . - - - - - - • • - - - - - - - - - - - . _L___ _ _.J.

- ... - . - - - . -- - -~L___________ ...;<l>:::'._62_.1_o_3._eo.J\

Printed date and time : 20-04-2023 10:27.41 Page 3/5

 borne by employer

19/01/1972

date and time : 20-04-2023 10:27.41 Page 4/5

Name TAN HAN CHUAN

hereby dedare 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.

date to furnish this form and pay tax or balance of tax payable: 30 April 2023

IS!JbnliSllion through e-Filing (e-BE) can be made via http://mytax.hasil.gov.my

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.
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.
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 of tax payable. Bill Number can be
obtained as follows:
• e--Filing Acknowledgement Receipt for submission via
Generate Bill Number at MyTax portal at httlps://m•YI'•x.tlas•il.gc
manually.
Printed on Notice of Asssement and letter of d'li~a11ds
ii. Payment using Bill Number can be made as
ByrHASil service at hltjos,llbcvmasi'l.h••si,f.g<>v'
LHONM Payment Centre counter

iii.

b)
i.

Pos Malaysia Berhad counter, write down the name, address, telephone number, TIN, year of
number of installments on the reverse side of the financial instrument. Check the payment receipt(s) before

Printed date and time : 20-04-2023 10:27.41 Page 5/5

 'J-IL[ ccpy
QtU /-. y
RETURN FORM OF AN INDIVIDUAL
RESIDENT WHO DOES NOT CARRY ON BUSINESS
BE
YEAR OF ASSESSMENT
UNDER SECTION 77 OF THE INCOME TAX ACT 1967
This form is prescribed under section 152 of the Income Tax Act 1967 2021

Name
Income tax no.
Current passport no.
Citizen
Type of assessment
Date of birth

Statutory income from rents

Statutory income from interest, discounts, royalties, premiums, pensions, annuities, other periodical payments and others
gains or profits
AGGREGATE INCOME
'iS : Approved investment under angel investor tax incentive
\....-
TOTAL

LESS : Approved donations I gifts I contributions

TOTAL
TOTAL INCOME (SELF)
TOTAL INCOME TRANSFERRED FROM HUSBAND I WIFE • FOR JOINT ASSESSMENT
*Type of income transferred from Husband I Wife

Gift of money to approved institution I organization I 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 I religious body I public university or gift of money in the form of
endowment to public university
TOTAL Restricted to 10% of aggregate income

Gift of artefacts, manuscripts or paintings to the Government or State Government

-.,..of money for the provision of library facilities or to libraries
~of money or contribution in kind for the provision of facilities in public places for the benefit of disabled persons
Gift of money I cost I 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 I gifts I contributions

Printed date and time : 20-Q4~2022 11:47.15 Page 1/5

 I treatment, special needs and carer expenses for parents (certified by medical practiUoner) r - -R&stri~t~d t~ --
8,000
1------------- -e--------4
Restricted to
6,000
6,000
---------------------------------------------------------------------------------- -~------

than a degree at masters or doctorate level- Course of study in law, accounting, Islamic financing,
vocational, industrial, scientific or technological skills or qualifications
at masters or doctorate level - Any course of study Restricted to
7,000 0

diseases for self, spouse or child 7,000

treatment for self or spouse 0 Restricted to

8,000
1Vo>ccinaUon for self, spouse and child (restricted to 1,000) 1,000

(Restricted to 1 ,000) on:

~-~~~~~~~•lmedlcal examination for self, spouse or child 1,000
; detection test including purchase of self-detection test kit for self, spouse or child

- Purchase for self, spouse or child

- Additional relief for the use I benefit of self, spouse or child

Purchase of personal computer, smartphone or tablet for self, spouse or child use I benefit and not for business use
•...........•.............•..........•.•.........••••...........•..........•.•......... ·c---------~'::~~-- -------!--___;
of self breastfeeding equipment for own child up to 2 years of age
Restricted to
once every 2 assessment years)
1,000
care fees for child aged 6 years and below to a registered Child Care Centre or a Kindergarten Restricted to
3,000 0
deposit in Skim Simpanan Pendldikan Nasional
·- ---------- --l-----1
Restricted to
deposit in 2021 minus total withdrawal in 2021) 0
8,000
-- -- -- iP~Y~~~l~f -aii;;,~~Y i~ fo~~; ~f~--- -------- · · ·------ ----- -·- ------------- · · · -· ---- ----- --:-- R~~t~icled-to

,_ 4,000
5,000
100% eligibility 50% eligibility
- Under the age of 18 years ox 2,000=0 OX1,000=0

- 18 years & above and studying ox 2,000=0 OX1,000=0

2 X 8,000 = 16,000 0 X 4,000 = 0

- Disabled child
ox 6,000=0 0 X 3,000 = 0
ox 14,000 = 0 0 X 7,000 = 0
insurance and EPF
Pensionable public servant category - Life insurance premium .-.------------CJ
:
'
Restricted to
7,000
'----- --------
(b) Other than pensionable public servant category
life insurance Restricted to 0
3,000
1-------------
Contribution to EPF/approved scheme Restricted to 4,000
4,000
-----.-------------1---------
retirement scheme and deferred annuity Restricted to 0
3,000
1-------------
and medical insurance Restricted to 0
3,000
f-----~------

hnto<hulinn to the Social Security Organization (SOCSO) : Restricted to 250 250

hmoo<lirtn ..ori•m expenses Restricted to 1,000

1,000

dateandtime :20-04-202211:47.15 Page 215

 Total relief
CHARGEABLE INCOME
Tax on the first 1,000,0001 At rate (%)
Tax on the balance 272,050 28
TOTAL INCOME TAX
LESS:TOTALREBATE
Self I
,--------,-,0 Husband/wife
Departure levy for umrah travel/religious travel for other
1--------0'11 .
Zakat and fitrah
No. of trips
religions
TOTAL TAX CHARGED 313,624.001
LESS : Total tax deductions/Relief (Section 132 and 133 tax relief restricted to total tax charged) 0.00

Section 110 (others) 1 0.00 I~;~ion 132 and 1 o.ool

TAX PAYABLE FOR THE YEAR OF ASSESSMENT 2021 313,624.00
MTD /Installment I CP500 payment made for the year 2021 -SELF and HUSBAND I WIFE for joint assessment 248,324.00
~LANCE OF TAX PAYABLE FOR THE YEAR OF ASSESSMENT 2021 65,300.00
"--"

Printed date and time : 2Q-04-2022 11:47.15 Page 3/5

 bome by employer

of asset under the Real Property Gains Tax Act 1976

declared to LHONM
financial account(s) at financial institution(s) outside Malaysia
of payment for tax refund : Payment via bank account

Identification no.

CHAN WAN MOl 720119055240 19/01/1972

Page 4/5
date and time :20-04-202211:47.15
Name TAN HAN CHUAN (SG 04110146040)

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
• METHOD OF PAYMENT
1. Payment can be made as follows :
1.1 Bank Information regarding payment throught banks can be accessed at the LHDNM Official Portal, http://www.hasil.gov.my
1.2LHDNM ByrHASIL at the LHDNM Official Portal, https:llbyrhasiJ.hasil.gov.myl
a) Payment via FPX (Financial Process Exchange) at https:/lbyrhasi/.hasil.gov.mylfpx
b) Payment via Visa, Mastercard & American Express Credit Card at https:llbyrhasil.hasil.gov.mylcreditcard/
1.3 Pos Malaysia Berhad Counter only
2. If 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 '084' and instalment no. '99' on the reverse side of the financial instrument. Check the receipt(s) I bank payment slip(s) before leaving the payment
counter.

Printed date and time : 20-04-2022 11:47.15 Page 5/5

INCOME TAX VA 2022
BE 2022

Name : Dato' Sri Tan Han Chuan

2
3
4
5

limited to limited to
......... l. .......~~~:.?.OO)
RM350)

For BE Form
RM
Stautory income from
employment
(Salary + Fee + BIK)

- Spanco Sdn Bhd 639,900.00

- Ambang Agresif Sdn Bhd 483,000.00
- Jasa Kita Trading Sdn Bhd 17,800.00
- JKG Land Berhad 72,000.00
- JKG Central Park Sdn Bhd 60,000.00
1,272, 700.00