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Receipt for Wage & Salary Income Taxes Withholding,Statement on Wage & Salary Income Payment
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[Tax Form 24(1)] (page1)
Control
No.
□ Receipt for Wage & Salary Income Taxes Withholding
□ Statement on Wage & Salary Income Payment
(Copy to report by issuer)
Residency
Resident 1/Non-Resident 2
Nationality
Citizen 1/Foreigner 9
Application of Flat tax rate
Yes 1/ No 2
State of Residence
State Code
Employer
① Company Name
② Representative Name
③ Tax Reg. No.
④ Resident Reg. No.
⑤ Address
Employee
(Taxpayer)
⑥ Name
⑦ Resident(Alien) Reg. No.
⑧ Address
⑨ Period Attributable (mm/dd/yy)
From To
⑩ Period of Tax Exemption
From To
Details
of
Income
by
Company
Description
Current Job
Previous Job
Previous Job
Taxpayer Association
Total
⑪ Company Name
⑫ Tax Reg. No.
⑬ Gross Payroll
⑭ Gross Bonus
⑮ Deemed Bonus
Total
Non-taxable
Income
Overseas Allowances
Night time Allowances
Other Allowances
Total (++)
Items
Gross Wage & Salary ()
Special
Deduction
by
Special
Taxation
Per'l Pension Savings Deduction
Deduction for Wage & Salary Income
Pension Savings Deduction
Adjusted Wage & Salary Income
Investment Assn Deduction
Deduc-
tion
Basic
Deduction
Employee
Credit Card Usage Deduction
Spouse
Employee Stock Ownership Deduction
Dependents
Retirement Pension deduction
Additional
Deduction
The Aged
Sub-Total
The Handicapped
Taxable Income (Tax Base)
Women
Calculated Income Tax
under 6 years old
Tax
Exemption
Income Tax Act
For Small Dependents
RSTA
For Pension Contribution
Special
Deduction
Insurance
Total Exemptions
Medical Expenses
Tax
Credit
Tax Credit for Class A
Education Expenses
Taxpayer Assn. Credit
Housing Fund
Home Mortgage Interests
Donation
Foreign Tax Credit
Marriage,Funeral,Moving
Political Money Donation
Sub-Total
Standard Dedcution
Sub-Total
Income after Deduction
Final Tax Liability (--)
Tax
Classification
Income Tax
Inhabitant Tax
Special Tax for Agriculture
Total
Cash receipt
Usage
Final Tax Liability
Prepaid
Tax
Previous Job
￦
Current Job
Taxes Due
List names of dependents subject to deduction. (For each dependent, mark ○ on the column to indicate the type of deduction. The employee filling out this form should not be included in the dependent list. Use and attach a separate sheet when rows run out)
Relation
ship
Name
Resident Reg. No.
Basic Deduction
Handicapped
Under 6 years old
Insurance
Medical Expense
Education Expense
Credit Card Usage
-
-
-
-
-
※ Relationship Code : Linear ascendant of employee=1, Linear ascendant of spouse=2, spouse=3, Linear descendent=4, Brother and Sister=5, others=6
(Please state relationship to employee and spouse for 4,5,6,)
We acknowledge the withholding (or payment) of above taxes (or payroll income).
(yy/mm/dd)
Taxes withheld by (Signature or seal)
Under Cash receipt Usage list only the amount that was issued a cash receipt.
210㎜×297㎜(일반용지 54g/㎡(재활용품))
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2008.01.11
1페이지
