Application For Tax Clearance Certificate :: Benue State internal Revenue Service

Application For Tax Clearance Certificate

Kindly ensure that all the information provided are accurate and true. All fields with asterisk (*) must be completed

Part A: Official Info

BNTIN or TIN * (Don't have a BNTIN or TIN? Create One)

Title *

Surname *

Middle Name

First Name *

House Address *

State of Residence *

City *

Business/Employer Address *

Contact No.

Email Address

Occupation *

Tax Office *

Type of Application Individual Non-Individual

If Married, State Spouse's Information

First Name

Last Name

Date of Birth

Occupation

Employer Address/Business

Employer

Names of Children

Part B: Source of Income

Salary Per Annum (₦)

Allowances (₦)

Consolidation Gross Income (₦)

Trade, Businesses, Profession, Vocation (₦)

Commission, Bonuses, Gratuities, etc. (₦)

Part C: Income and Tax For The Current and Previous Years

Assessment Type Year 1 *

Assessment Year 1 *

Income Year 1 *

Tax Paid Year 1

Assessment Type Year 2

Assessment Year 2

Income Year 2

Tax Paid Year 2

Assessment Type Year 3

Assessment Year 3

Income Year 3

Tax Paid Year 3

Upload Evidence of Tax Paid (Should be less than 300kb)

Penalty for Default

Please note that in accordance with the relevant law, making false statement and returns or unlawful to pay tax will attract up to five (5) years imprisonment

Declaration

I Hereby declare that information supplied in this form contain a true and correct statement of the amount of my income from all sources.

First Name *

Last Name *

Check the box if you agree *

Upload Passport (Should be less than 300kb) *