Unka Beeksisa VAT

Bulchiinsa Mootummaa Naannoo Oromiyaatti Abbaa Taayitaa Galiiwwan Oromiyaa
The National Regional Government Of Oromia

Revenues Authority
Lakk. Sanadaa/ Document Number ___________________
Beeksisa Taaksii Dabalata Qabeenyaa/ VALUE ADDED TAX DECLARATION
Ragaawwan Tokkoon Tokkoo Yeroo Taaksii Ilaallatan/ DETAILS OF TAX PERIOD
Guyyaa Itti Beeksisan/ DATE OF FILING __________________
Akaakuu Beeksisa T.D.Q/ VAT RETURN TYPE Kan Duraa/ ORIGINAL Kan Fooyya’e/ REVISED
Yeroo Taaksii/Tax Period Irraa/FROM ______________________ Hanga/ TO ____________________________
Ibsa Tokkoon Tokkoo Kaffalaa Taaksii/ TAX-PAYER DETAILS
Maqaa Kaffalaa Taaksii Ykn Dhaabbata Galmaa’e/ _________________________________________________________________
NAME OF REGISTERED ORGANIZATION OR TAXPAYER/
Lakk. Eenyummeessaa Kaffalaa Taaksii/ TAX-PAYER IDENTIFICATION NUMBER (TIN) ______________________________
Lakk. Eenyummeessaa Xiqqaa (Yoo Jiraate)/ SUB-TIN, IF ANY/ _____________________________________________________
Lakk. T.D.Q Kaffalaa Taaksii/ VAT REGISTRATION NO __________________________________________________________
Ragaa Tokkoon Tokkoo Bakka Bu’aa Taaksii/ DETAILS OF TAX AGENT
Beeksifni Taaksii Qaama Biroon (Bakka Bu’aa Taaksii) Kan Guutame Yoo Ta’e Ragaawwan Tokkoon Tokkoo Kanatti Aanan Guutaa/ IF
THE RETURN HAS BEEN PREPARED BY TAX INTERMEDIARY (TAX AGENT), THEN PLEASE PROVIDE THE FOLLOWING
DETAILS
Lakk. Eenyumeessaa Kaffalaa Taaksii Bakka Bu’aa Kaffalaa Taaksii/ AGENT TIN _________________________________________
Miseensa Waldaalee/ Dhaabbilee Bakka Bu’aa Taaksii Yoo Ta’an/ IF YOU ARE A PART OF ANY TAX AGENT
ASSOCIATION/ ORGANIZATION
Lakk. Eenyumeessaa Kaffalaa Taaksii Dhaabbata Bakka Bu’aa Taaksii/ ORGANIZATION TIN _________________________________
Lakk. Eenyumeessaa Kaffalaa Taaksii Bakka Bu’aa Kaffalaa Taaksii / AGENT TIN __________________________________________
Mirkaneessa/ CERTIFICATION
Ragaawwan Guuca Kana Irratti Guutaman Hundi Sirrii Fi Guutuu Ta’u Nan Mirkaneessa/ I HEREBY CERTIFY THAT THE
INFORMATION GIVEN IN THIS FORM IS TRUE AND COMPLETE. I UNDERSTAND THAT ANY MIS-REPRESENTATION IS
PUNISHABLE BY LAW
Mallattoo/SIGNATURE ___________________________________________
Duwwaa Kan Beeksisan/ NIL FILER DECLARATION
Kan Beeksisan Duwwaadhaa? /ARE YOU A NIL FILER? Eeyyee/YES Lakkii/NO
Shallaggii Taaksii Gurgurtaa/ COMPUTATION OF OUTPUT TAX
Hanga Waliigalaa/ Total amount Taaksii Gurgurtaa/ Output VAT
Dhiyeessii/gatii gurgurtaa taaksiin itti kaffalamu/
5 10
Taxable sales/ supplies
Dhiyeessii/gurgurtaa taarifa zeeroo qaban /Zero-
15
Rated sales/ supplies
Gurgurtaa/dhiyeessiiwwan taaksii irraa bilisa
20
ta’an/ Tax-exempt sales/ supplies
Dhiyeessii/gatii gurgurtaa sassaabamee bitataan
qabame/ Services or Supplies subject to reverse 25 30
taxation
Dhiyeessaaf gatii gurgurtaa sanada deebitii
taaksii ittiin sirrate/ Tax adjustment with debit 35 40
note for suppliers
Dhiyeessaaf gatii gurgurtaa sanada kireediti
taaksii ittiin sirrate/ Tax adjustment with credit 45 50
note for suppliers
Dhiyeessii/ Gurgurtaa Waliigalaa/ Total
55 60
Sales/Supplies [Line 5+15+20+25+35-45]
Bittaa Meeshaalee Kaappitaalaa/ CAPITAL ASSET PURCHASES
Hanga Waliigalaa/ Total amount Taaksii Galtee/ Input VAT
Bittaa meeshaalee kaappitaalaa biyya keessaa/
65 70
Local purchase capital assets
Bittaa meeshaalee kaappitaalaa biyya alaa/
75 80
Imported capital assets purchase
Bittaa galtee taaksiin itti hin kaffalamin ykn
deebiin kan itti hin gaafatamne/ Purchase with 85
no VAT or Unclaimed inputs
Bittaa meeshaalee kaappitaalaa waliigalaa/
90 95
Total Capital assets [Lines 65+75+85]
Bittaa Meeshaalee Kaappitaalaa Hin Taane/ NON-CAPITAL ASSET PURCHASES
Hanga Waliigalaa/ Total amount Taaksii Galtee/ Input VAT
Galtee bittaawwan biyya keessaa/ Local
100 105
Purchase Inputs
Bittaa galtee biyya alaa/ Imported Inputs
110 115
purchase
Bittaa galtee baasiiwwan adda addaa/ General
120 125
Expense Inputs purchase
Bittaa galtee taaksiin itti hin kaffalamin ykn
deebiin kan itti hin gaafatamne/ Purchase with 130
no VAT or Unclaimed Inputs
T.D.Q bitataan qabamee hir’ifame/ Deductible
135 140
on VAT reverse taxation
Bitataaf gatii bittaa sanada deebitii taaksii ittiin
sirrate/ Tax adjustment with debit note for 145 150
buyers
Bitataaf gatii bittaa sanada kireeditii taaksii
ittiin sirrate/ Tax adjustment with credit note 155 160
for buyers
Gatii galtee waliigalaa/ Total Inputs [Lines
165 170
100+110+120+130+135+145-155]
175. T.D.Q herreega kaffaltii voocharii irraa/ VAT on Government Voucher ______________
180. Kaffaltii ji’a keessatti herregaman, meeshaa harka jiru/ other credits for month (payments, goods on hand) ______________
185. T.D.Q ji’aa waliigalaa kaffalamu / VAT due for month (Line 60 -95-170-175-180) ______________
190. T.D.Q ji’aa waliigalaa deebi’u/ VAT credit for the month (line 95+170+175+180-60) ______________
195. Kaffaltii caalmaa ji’a darbe irraa naanna’e/ Credit Carried forward from Previous Month ______________
200. T.D.Q waliigalaa kaffalamu/ Amount to be paid [Line 185-195] ______________
205. T.D.Q deebi’u ji’a itti aanuuf herreegamu/ Credit Available for carry forward (line 190+195-185) ______________
Duuka Deemtuu/ ATTACHMENT
Bittaa Tokkoon Tokkoo Gabatee A (lakk. eenyummeessaa bitataa, lakk. eenyummeessaa gurguraa, lakk. Nagahee, akaakuu
meeshaa/tajaajila bitame, akaakuu gurgurtaa, guyyaa gurgurtaa kkf) Annex A: Detailed breakdown of all purchases made including receipt
number, date of sale, type of goods/ service, VAT paid, TIN of supplier
Abbaa Taayitaaf Qofa Kan Hayyamame/ FOR USE ONLY TAX AUTHORITY/
Maqaa Ofiisaraa/ OFFICER’S NAME _______________________________ Mallattoo/ SIGNATURE _________________
Lakk. waraqaa eenyummaa hojjataa/ Employee ID _____________________ Guyyaa/ DATE _________________________
Giddugala taaksii/TAX CENTER ___________________________________

Unka Beeksisa VAT

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Bulchiinsa Mootummaa Naannoo Oromiyaatti Abbaa Taayitaa Galiiwwan Oromiyaa

The National Regional Government Of Oromia

200. T.D.Q waliigalaa kaffalamu/ Amount to be paid [Line 185-195] ______________

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