DATA BAHAN LAPORAN PAJAK PRIBADI TAHUNAN TAHUN 2018

NAMA : ................................................................
NIP : ....................................................................
NPWP : ....................................................................
EPIN : ....................................................................
NIK :.....................................................................
E-MAIL : ....................................................................
PENGHASILAN 1 BULAN:
1. GAJI POKOK : Rp ...............................................................................
2. TUNJ. ISTRI/SUAMI : Rp ...............................................................................
3. TUNJ. ANAK : Rp ...............................................................................
4. TUNJ. FUNGSIONAL(ks) : Rp ...............................................................................
5. TUNJ.KHUSUS : Rp 0,00
KELUARGA
1. ............................................. (ISTERI)/(Suami)
NIK : ..........................................................
PEKERJAAN : ..............................................................

2. ............................................. ( Anak)
NIK : ..........................................................
PEKERJAAN : .............................................................

3. ............................................. (Anak)
NIK : ..........................................................
PEKERJAAN : ..............................................................

4. ............................................. (Anak)
NIK : ..........................................................
PEKERJAAN : ..............................................................

PENGHASILAN PER TAHUN:

1. GAJI : 12 BULAN X Rp .............................. = Rp ..........................
2. SERTIFIKASI : 12 BULAN X Rp .............................. = Rp ..........................
3. TUNJANGAN DAERAH(KS) : 4 X Rp ..................................... = Rp ..........................
--------------------------------------------------------------------------------------------------------------------------------
JUMLAH Rp .......................................

HARTA
1. RUMAH
1. DI ....................................RUMAH+ TANAH SENILAI Rp .............................. DIBELI
TAHUN/DI BUAT TAHUN .......................
NO. SERTIFIKAT : .................................... ( ATAS NAMA ...................................)
2. -DI ............................. (TANAH) SENILAI Rp .....................................
NO. SERTIFIKAT : ( ATAS NAMA ....................................................)
-------------------------------------------------------------------------------------------------------------
TOTAL : Rp .......................................................

2. MOBIL 1
1. .................................................... (cc), TAHUN …........................., Rp ...............................
NO. POLISI .................................... ( NO. BPKB : ...............................
( NILAI JUAL 2016 : Rp ..............................................
 2. SEPEDA MOTOR
1. ............................................. (..............cc) TAHUN ................................. Rp
.......................... No. POLISI ............................... ( No. BPKB : ................................... )
Nilai Jual tahun 2018 ............................................................

UTANG
1. KE BANK ................................ BULAN X Rp........................... = Rp ...................................................
2. KE ................................. Rp ................................................ (ISTERI)
3. .......................................................................
-------------------------------------------------------------
TOTAL UTANG Rp ...........................................................................................................................

REKAPITULASI KEUANGAN DAN ASET PRIBADI DAN KELUARGA:

PERTAHUN 2016.
PENGHASILAN PERTAHUN PAJAK 15%
1. GAJI 12 BULAN X Rp 1.Rp .......................................................
...................... 2. Rp ......................................................
= Rp ....................... 3.Rp .................................................
2. TUNJ. SERTI 12 X 4. Rp
.........................,-= Rp .....................................................................
................... 5.Rp ............................................................
3. TUNDA KS 4 X Rp
........................ = Rp
......................
4. GAJI KE- 13
Rp ...........................
5. GAJI KE – 14
Rp ............................

Poin 1,...........................

Total= Rp ........................
 DATA BAHAN LAPORAN PAJAK PRIBADI TAHUNAN TAHUN 2016

NAMA : SRI ASTUTI S.Pd.I

NIP : 198706082010012008
NPWP : 77.120.284.3-405.000
EPIN :
NIK :3203184806870011
E-MAIL : sryastuty668@gmail.com
PENGHASILAN 1 BULAN:
6. GAJI POKOK : Rp 2.724.400
7. TUNJ. ISTRI/SUAMI : Rp 272.440
8. TUNJ. ANAK : Rp 108.976
9. TUNJ. FUNGSIONAL : Rp 327.000
10. TUNJ.KHUSUS : Rp 289.680
KELUARGA
5. Abdul Aziz s.Pd.I (SUAMI )
NIK : 3202271806760001
PEKERJAAN : .Guru Honor

6. Zakia Humaerotuzzahra(ANAK)
NIK : 3203185003080004
PEKERJAAN : Pelajar

7. Zulfa Aulia Aziz (ANAK)

NIK : 3203186006100005
PEKERJAAN : PELAJAR

PENGHASILAN PER TAHUN:

1. GAJI : 12 BULAN X Rp 3.405.000 = Rp 40.860.000
2. SERTIFIKASI : 12 BULAN X Rp 2.724.400 = Rp 32.692.800
3. Gajih 13 : Rp = Rp 3.405.000
4. Gajih 14 : Rp = Rp 2.724.400
------------------------------------------------------------------------------------------------------------
JUMLAH =Rp. 79.682.200

HARTA
3. RUMAH
1. ( RUMAH+ TANAH) SENILAI Rp.60.000000 DIBELI TAHUN 2015
NO. SERTIFIKAT : ............-........................
2 SEPEDA MOTOR
(Honda Vario) TAHUN 2012 Rp 16.500.000,- No. POLISI F 4039 QD

UTANG
1. SISA UTANG KE BANK = Rp 76.500.000
4. SISA UTANG KE KOPRASI = Rp 3.000.000
5. SISA UTANG KE ...................... = Rp ............................................
Jumlah = Rp. 79.500.000