Form 104
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ScribdTranslationsForm 104
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ScribdTranslationsFORM 104
VALUE ADDED TAX DECLARATION No.
RESOLUTION N° NAC-DGERCGC13-00881
100 IDENTIFICATION OF THE DECLARATION IMPORTANT: PLEASE READ INSTRUCTIONS ON THE BACK
Form number that replaces
101 MES 01 02 03 04 05 06 07 08 09 10 11 12 102 YEAR 104
200 IDENTIFICATION OF THE TAXPAYER
RUC 202 COMPANY NAME OR FULL LAST NAME AND FIRST NAMES
201
0 0 1
SUMMARY OF SALES AND OTHER OPERATIONS FOR THE PERIOD BEING DECLARED GROSS VALUE NET WORTH (GROSS VALUE - N/C) GENERATED TAX
LOCAL SALES (EXCLUDING FIXED ASSETS) TAXED AT 12% RATE 401 + 411 + 421 +
SALES OF FIXED ASSETS SUBJECT TO 12% RATE 402 + 412 + 422 +
LOCAL SALES (EXCLUDING FIXED ASSETS) SUBJECT TO 0% RATE THAT DO NOT ENTITLE TO
403 + 413 +
TAX CREDIT
SALES OF FIXED ASSETS SUBJECT TO 0% RATE THAT DO NOT GIVE RIGHT TO CREDIT
404 + 414 +
Tax
LOCAL SALES (EXCLUDING FIXED ASSETS) SUBJECT TO 0% RATE THAT ENTITLE TO
405 + 415 +
TAX CREDIT
SALES OF FIXED ASSETS TAXED AT 0% RATE THAT ENTITLE TO CREDIT
406 + 416 +
TAX
EXPORTS OF GOODS 407 + 417 +
EXPORTS OF SERVICES 408 + 418 +
TOTAL SALES AND OTHER OPERATIONS 409 = 419 = 429 =
TRANSFERS NOT SUBJECT TO VAT OR EXEMPT FROM VAT 431 + 441
CREDIT NOTES FEE 0% TO BE COMPENSATED NEXT MONTH (INFORMATION) 442
CREDIT NOTES 12% RATE TO BE COMPENSATED NEXT MONTH (INFORMATIVE) 443 453
INGRESOS POR REEMBOLSO COMO INTERMEDIARIO (INFORMATIVO) 434 + 444 454
VAT SETTLEMENT FOR THE MONTH
TAX TO BE SETTLED FOR THE MONTH
TOTAL TRANSFERS TOTAL TRANSFERENCIAS TAX TO BE SETTLED IN TAX TO BE SETTLED IN TOTAL TAX ON
TOTAL TAX GENERATED ANTERIOR
TAXED 12% RECORDED 12% THIS MONTH NEXT MONTH LIQUIDATE THIS MONTH
Move to field 429 (Transfer field 485 of the
IN CASH THIS MONTH TO CREDIT THIS MONTH (Minimum 12% of field 480) (482 - 484) SUMAR 483 + 484
declaration of the previous period)
480 481 482 483 484 485 499
SUMMARY OF ACQUISITIONS AND PAYMENTS FOR THE DECLARED PERIOD GROSS VALUE NET WORTH (GROSS VALUE - N/C) GENERATED TAX
PURCHASES AND PAYMENTS (EXCLUDES FIXED ASSETS) TAXED AT 12% RATE (WITH RIGHT
500 + 510 + 520 +
A TAX CREDIT
LOCAL ACQUISITIONS OF FIXED ASSETS TAXED AT 12% (WITH RIGHT TO
501 + 511 + 521 +
TAX CREDIT
OTHER ACQUISITIONS AND TAXED PAYMENTS RATE 12% (WITHOUT RIGHT TO CREDIT
502 + 512 + 522 +
TAX
IMPORTATIONS OF TAXED SERVICES RATE 12% 503 + 513 + 523 +
IMPORTS OF GOODS (EXCLUDING FIXED ASSETS) SUBJECT TO 12% RATE 504 + 514 + 524 +
IMPORTS OF TAXED FIXED ASSETS RATE 12% 505 + 515 + 525 +
IMPORTS OF GOODS (INCLUDING FIXED ASSETS) SUBJECT TO 0% RATE 506 + 516 +
ACQUISITIONS AND PAYMENTS (INCLUDING FIXED ASSETS) TAXED AT 0% RATE 507 + 517 +
Acquisitions made from taxpayers RISE 508 + 518 +
TOTAL ACQUISITIONS AND PAYMENTS 509 = 519 = 529 =
ACQUISITIONS NOT SUBJECT TO VAT 531 + 541
ACQUISITIONS EXEMPT FROM VAT PAYMENT 532 + 542
CREDIT NOTES 0% FEE TO BE OFFSET NEXT MONTH (INFORMATIVE) 543
CREDIT NOTES FEE 12% TO BE OFFSET NEXT MONTH (INFORMATION) 544 554
NET PAYMENTS PER REFUND AS INTERMEDIARY (INFORMATIVE) 535 + 545 555
PROPORTIONALITY FACTOR FOR TAX CREDIT (411+412+415+416+417+418) / 419 563
TAX CREDIT APPLICABLE IN THIS PERIOD (According to the Proportionality Factor or its Accounting) (520+521+523+524+525) x 563 564 =
TAX SUMMARY: WITHHOLDER OF VALUE ADDED TAX
TAX GENERATED (If the difference between field 499-564 is greater than zero) 601 =
TAX CREDIT APPLICABLE IN THIS PERIOD (If the difference between field 499-564 is less than zero) 602 =
(-) BALANCE FOR ACQUISITIONS AND IMPORTS (Transfers field 615 from the previous period declaration) 605 (-)
CREDIT
TAXPAYER OF
MY PREVIOUS FOR WITHHOLDINGS AT THE SOURCE OF VAT THAT HAVE BEEN MADE TO YOU (Transfers the field 617 from the declaration of the previous period) 607 (-)
Withholding of VAT that has been made during this period 609 (-)
(+) ADJUSTMENT FOR VAT REFUND AND REJECTED VAT ATTRIBUTABLE TO THE TAX CREDIT IN THE MONTH (For VAT refund purposes) 611 +
(+) ADJUSTMENT FOR RETURNED VAT AND REJECTED VAT ATTRIBUTABLE TO THE TAX CREDIT IN THE MONTH (For withholding tax on VAT) 612 +
(+) ADJUSTMENT FOR VAT REFUNDED BY OTHER PUBLIC SECTOR INSTITUTIONS ATTRIBUTABLE TO THE TAX CREDIT IN THE MONTH 613 +
CREDIT BALANCE FOR ACQUISITIONS AND IMPORTS 615 =
TAX
FOR THE
NEXT MONTH FOR WITHHOLDINGS AT SOURCE OF VAT THAT HAVE BEEN MADE TO YOU 617 =
Subtotal to pay If 601-602-605-607-609+611+612+613 > 0 619 =
PRESUMPTIVE VAT FOR GAMING HALLS (MECHANICAL BINGO) AND OTHER GAMES OF CHANCE (Applies to Fiscal Years Prior to 2013) 621 +
TOTAL TAX TO BE PAID FOR WITHHOLDING (619 + 621) 699 =
VALUE ADDED TAX WITHHOLDING AGENT
30% WITHHOLDING 721 +
70% WITHHOLDING 723 +
100% RETENTION 725 +
TOTAL TAX TO BE PAID FOR WITHHOLDING 721 + 723 + 725 799 =
TOTAL CONSOLIDATED VALUE ADDED TAX (699 + 799) 859 =
PREPAYMENT (Informative) 890
DETAIL OF ALLOCATION TO PAYMENT (For substitute declarations)
INTEREST 897 USD TAX 898 USD FINE 899 USD
DIRECT PAYMENT IN THE SINGLE ACCOUNT OF THE NATIONAL TREASURY (Exclusive Use for Authorized Public Sector Institutions and Companies) 880 USD
VALUES TO PAY AND METHOD OF PAYMENT (after allocation to payment in substitute declarations)
TOTAL TAX TO BE PAID 859-898 902 +
Interest for default 903 +
FINE 904 +
TOTAL PAID 999 =
BY CHECK, BANK DEBIT, CASH OR OTHER PAYMENT METHODS 905 USD
THROUGH COMPENSATIONS 906 USD
BY MEANS OF CREDIT NOTES 907 USD
CREDIT NOTE DETAILS
DETAIL OF CREDITS NOTE CARDS DETAIL OF COMPENSATIONS
DE-MATERIALIZED
908 N/C No 910 N/C No 912 N/C No 916 Resolution No. 918 Resolution No.
909 USD 911 USD 913 USD 915 USD 917 USD 919 USD
I DECLARE THAT THE DATA PROVIDED IN THIS DOCUMENT IS ACCURATE AND TRUE, THEREFORE I ASSUME THE LEGAL RESPONSIBILITY DERIVED FROM IT (Art. 101 of the L.R.T.I.)
SIGNATURE OF THE TAXPAYER / LEGAL REPRESENTATIVE ACCOUNTANT SIGNATURE
NOMBRE : NOMBRE :
