Income Tax Return Worksheet

To which tax year does this return apply?
First Name
Last Name

Section A

Were you unemployed for the full year of assessment and received no income and realised no income and realised no capital gain / loss?
Did you receive income that is reflected on an IRP5 or IT3(a) certificate?
How many certificates did you receive?
Did you incur any medical expenditure (including medical scheme contributions made by you or your employer)?
Did you make any Retirement Annuity Fund or Income Protection contributions?
Did you receive income from interest (local and foreign) and/or foreign dividends?
Did you receive local dividend income?
Are you a director of a company or a member of a close corporation?
Did you receive any other income and / or incur any other allowable expenses not addressed above?

Section C

Did you or your minor child make any donations during this year of assessment?
If yes, please state the amount donated
Did you or your minor child pay donations tax on the amount donated?
Are you or your minor child beneficiaries of trust registered in or outside the Republic?
Did you claim any depreciation on an asset?
If yes, was the asset owned by you or acquired by you as a purchaser in terms of “instalment credit agreement”?
Was the asset used for the purpose of your trade?
Did you claim any “home office expenses”?
If yes, is your income derived mainly from commission or other variable payments based on your work performance?
Is the home office regularly and exclusively used for the purpose of your trade and is it specifically equipped for such purpose?
Are your duties mainly performed otherwise than in an office provided by your employer?
If you did not receive a travel allowance from your employer (not reflected on your IRP5), was your claim for travel expenditure based on a logbook?