Form 04/TKQT-TNCN Personal Income Tax Declaration (Issued 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 individuals receiving inheritance or gifts that are not real estate)
[01] Tax period: Occurrence date … month … year…
[02] First time: [03] Supplement for the [X]th time: …
Individuals eligible for tax exemption/reduction under the Double Taxation Avoidance Agreement (*)
I. INFORMATION OF THE PERSON RECEIVING INHERITANCE OR GIFT
[04] Full name: ............................................................
[05] Tax identification number:
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[06] ID/CCCD/Passport number: .............................................................
[07] Nationality: ............................................................
[08] Address: ............................................................
[09] District/County: ............................ [10] Province/City: ...................................
[11] Phone: .................................. [12] Fax: .................. [13] Email: ....................
[14] Tax agent name (if applicable): ............................................................
[15] Tax identification number:
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[16] Tax agent contract number: .................................... Date: .....................................
II. DOCUMENT FOR RECEIVING INHERITANCE OR GIFT
[17] Made at: .................................... Date: ....... month ..... year .....
Certified by the Notary Agency on .... month ..... year ....
III. INFORMATION ABOUT THE PERSON GIVING INHERITANCE OR GIFT
[18] Full name: ..........................................................
[19] Tax identification number:
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[20] ID/CCCD/Passport number: .............................................................
[21] Nationality: ............................................................
[22] Address: ............................................................
[23] Phone: .................................. [24] Fax: .......................... [25] Email: .............
IV. TYPE OF ASSET RECEIVED AS INHERITANCE OR GIFT
[27] Capital contribution
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[28] Assets that need to be registered for ownership or use
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V(a). CERTIFICATE OF RIGHT TO USE OR OWN INHERITED OR GIFTED ASSETS
Number: ............ Issued by: .......... Date of issue: .............................................
V(b). INFORMATION ABOUT THE ORGANIZATION ISSUING SECURITIES OR THE ORGANIZATION WHERE THE PERSON HAS CAPITAL CONTRIBUTIONS
[30] Organization name: ...........................................
[31] Tax identification number:
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[32] Address: ............................................................
[33] District/County: ............................ [34] Province/City: ....................................
[35] Phone: .................................. [36] Fax: .................. [37] Email: ............
VI. INCOME FROM INHERITANCE OR GIFT
[38] Amount: .......................................... VND
(Write in words: ..........................................................)
VII. INCOME EXEMPTED OR REDUCED UNDER THE DOUBLE TAXATION AVOIDANCE AGREEMENT
[39] Amount: .......................................... VND
(Write in words: ..........................................................)
I confirm that the data provided is correct and take full legal responsibility for the declared information.
NTAX AGENT EMPLOYEE
Full name: …………………..
Professional certification number: ......
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Date: ....... month ..... year ....
TAXPAYER or LEGAL REPRESENTATIVE OF THE TAXPAYER
(Signature, full name, title, and stamp (if applicable)/Electronic signature)
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Note:
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(*) In cases where an individual is entitled to tax exemption or reduction under the Double Taxation Avoidance Agreement, they must submit the tax declaration form along with the exemption/reduction notification according to the agreement as stipulated.
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Individuals receiving inheritance or gifts in the form of securities or capital contributions must submit their tax declarations at the tax authority managing the company issuing securities or holding capital contributions. If the individual receives inheritance or gifts of multiple types of securities or capital contributions, the tax declaration must be submitted to the Tax Department where the individual resides.