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| 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
①Company Name
②Representative Name
③Tax Reg. No.
④R.. |
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| [Tax Form 24(1)] [2004.3.5.Amended] （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 Na.. |
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 |
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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 Re.. |
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