New Zealand Gazette – 1895 – No. 24

Page 582

✨ Tax Return Form



582
THE NEW ZEALAND GAZETTE.
[No. 24

Gross Income derived from Employment or Emolument.

  1. From the profession, employment, or vocation of
  2. From salary, wages, allowances, bonus, pension, stipend, fees, charge, or annuity of any kind
  3. From commissions or share of profits by way of or in lieu of salary
  4. From any other source not coming within any of the foregoing heads (State source).

Total

Deductions.

Losses, outgoings, and expenses incurred in the production of the gross income stated above

Net income derived from employment or emolument

I claim deduction on account of amount actually paid by me during the year as life insurance premiums
on my own life
[N.B.—The deduction is limited to £50, and if the amount paid be less than that sum the exact figures should be entered.]
[Note.—The exemption of £300 allowed by law will be deducted in the office of the Commissioner of Taxes.]

I, the person making the foregoing return, do solemnly and sincerely declare that the same, and the statements therein
referred to or accompanying such return, contain true and accurate details of the several matters and things set forth, and
in particular contain a true and accurate account of all income derived by me during the year ending 31st March, 189 ;
and the deductions claimed by me are those which I am legally entitled to deduct. And I make this declaration under the
provisions of "The Land and Income Assessment Act, 1891,"
Dated this day of , 189 .
Usual signature :

I claim to have a deduction made from net income shown on page 1 on account of liability to pay land-tax in respect of land
occupied for business or employment, such deduction being equal to 5 per cent. on the amount upon which I am liable to
pay land-tax on such land under Schedule A, "Land and Income Assessment Act, 1891."

Assessment No. Description of Land used as Place of Business or Employment. Unimproved Value. Amount of Mortgage. Amount on which Land-tax payable.

[N.B.—No deduction can be claimed by the owner in respect of premises or portion of premises let to a tenant.]

Names, Addresses, and Shares of Partners (to be filled up in the case of returns made by or on account of a Firm).

Name in Full of each Partner. Address. Share in Firm.

Statement to be made by Persons acting as Attorneys or Agents.

Description of every Person for whom I act as Attorney or Agent where Principal is permanently or temporarily absent
from the Colony.

Name in Full. Occupation. Residence.

STATEMENT to be made by Government Departments, Local Authorities, Persons, Firms, Companies, and Societies
employing Officers, Managers, Travellers, Clerks, Foremen, Workmen, Servants, and Others in New Zealand, whether
paid by Salary, Weekly Wage, or otherwise.

List of Persons in my Service or Employ.

Name in Full. In what Capacity employed. Place of Residence. Amount of Pay received, including Salary, Wages, Bonus, Commissions, and Allowances.

[Note.—In the case of any person the total payment to whom does not exceed £160 a year an entry need not be made.]
[If there should not be sufficient space in any of the above forms, a sheet giving the required information may be attached.]



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Online Sources for this page:

VUW Te Waharoa — PDF NZ Gazette 1895, No 24




✨ LLM interpretation of page content

💰 Land and Income Assessment Act Return (continued from previous page)

💰 Finance & Revenue
Tax Return, Employment Income, Deductions, Commissioner of Taxes