Schedule Fourth Clause 47

FEDERAL REPUBLIC OF NIGERIA

PLATEAU STATE INTERNAL REVENUE SERVICE

PRESUMPTIVE TAX RETURNS FORM

Made pursuant to Clause 6 of the Personal Income Tax (Amendment) Act, 2011:

1) Name of Taxpayer Registered Name:____________________________

2) Nationality:_______________________________________________

3) Residential Address:_________________________________________

4) GSM Number:______________________________________________

5) Business type:______________________________________________

6) Business Name:_____________________________________________

7) Registered Business Name:____________________________________

8) Commencement Date:________________________________________

9) Means of Identification :______________________________________

10) Business Registration No:_____________________________________

11) Tax Payer Identification No (TIN) :_____________________________

_________________________ Date:___________________

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