ETHIOPIAN REVENUES AND CUSTOMS SCHEDULE A-PAYE

AUTHORITY (MONTHLY)

Section 1 - Taxpayer Information

Taxpayer's Name: TIN: Tax Period:

Mirka Motors Manufacturing And Trading Plc 0075911146 May, 2023

Registration Addresse: Tax Account Number: (Official Use Only)

House No.: NEW 17977541429

Kebele: WOREDA 10 Po.Box: Tax Centre:
Woreda: NO WOREDA-148 Document Number: 1723726850010
Zone/Sub-City: GULLELE MOR- NORTH
Document Date: 20/06/2023
Region: ADDIS ABABA Ethiopia WEST SMALL TAX
Telephone Number: Fax Number:
PAYERS OFFICE
(STO) Submission Number: 23450581429
+251931313141 Submission Date: 20/06/2023

Section 2 - Electronic Tax Declaration

Number of Employees on Your PayRoll for this Tax Period 10 19.00

Total Taxable Income 20 191,183.88

Total Tax Withheld 30 40,814.22

Section 3 - Taxpayer Certification

I declare that the above declaration and all information provided here-with is correct and complete. I understand that any misrepresentation
is punishable as per the Tax Law and the Penal Code. Declaration of preparer (other than the taxpayer) is based on all information of
which the preparer has any knowledge.
Printed Taxpayer Name or Authorized Date Company Seal For Official Use Only
Representative

Date of Payment Receipt Number

Signature of Taxpayer or Authorized
Representative

Amount of Payment Check Number

Printed Name of Preparer Date

Cashier's Signature
Signature of Preparer

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