APPLICATION FOR PREPAYMENT AND FOR CHANGE IN WITHHOLDING TAX PERCENTAGE 2016 This form is for individual taxpayers, businesses or self-employed, farmers or partners in partnership for appliations for a tax ard and/or prepayment. Leased employees who are nonresident taxpayers must use another appliation form (Form 5057). You an request hanges to your tax ard or prepayments via Taxard Online at tax.fi/taxard. I am applying for new tax ard/hange of tax ard Taxpayer's name (last name and first names) prepayment / hange of prepayment I am submitting information onerning prepayment and/or tax ard for the year 2017 Personal identity number or Business ID To be effetive from / 20 A EARNED INCOME SUBJECT TO WITHHOLDING TAX (ontinued on page See artile "The tax ard shows your withholding rate" at tax.fi Inome eiling for eah pay period B Inome eiling for whole year Earned inome subjet to withholding tax prinipal oupation Estimated inome for the urrent year Inome reeived up to the date of hange (the whole amount) Tax withheld up to the date of hange Expense allowanes Dedutions prior to tax withholding (e.g. hain saw osts for forestry workers) seondary employment Seafarer's pay and benefits road ferry work, Åland Islands Employee stok options/grants Employee stok options or employee stok grants from: Prinipal employment Inome from a wage earner's fund (taxable inome) Seondary employment Seafaring I no longer reeive pay from the ompany giving stok options Soial benefits (inluding unemployment and sikness allowanes, hild home are allowane and support for adult eduation) Write the name of the payer next to the "Name of soial benefit" below, if the payer is other than Kela. Name of soial benefit I request a tax-prepayment for the stok options Start and end dates 3) Name of soial benefit VEROH 5010e 9.2015 1/7 Start and end dates 3) Study grant (institutions of higher eduation) Other earned inome subjet to withholding Even if you only wish to make a hange in your prepayment you must fill in all the neessary fields and report all your inome and dedutions for the entire year. Please explain how your inomes and dedutions have hanged and on whih grounds, ompared with your urrent prepayment. Be sure to report any inome subjet to withholding tax. If you have not tiked the "tax ard/hange of tax ard" box, you will not reeive a revised tax ard. Do not return or disregard your urrent prepayment invoies; these must be paid as they fall due until suh time as your prepayment has been revised and you have reeived new invoies. For details on inome reeived and tax withheld, see your latest pay slip or a similar doument issued to you by a payer. 3) The Start date is the date this year when you reeived your first payment, and the End date is the date this year when you reeive your last one.
Earned inome subjet to withholding tax and related dedutible expenses Oupational pension from private-setor/publi-setor/other Estimated inome for the urrent year Inome reeived up to the date of hange (the whole amount) Tax withheld up to the date of hange Pension and other payments from private insurer / other insurane ontrat National pension Guarantee pension Compensation for losure of farm Pension or other payment taxable as apital inome Compensation for foster are provider Related dedutible expenses to above Compensation for family aregiver Copyright payments Compensation for work (VAT, no prepayment register) Related dedutible expenses to above Compensation for work (no VAT, no prepayment registration) Sportsperson's fee Grants reeived (rereational purposes) Pay for work abroad serving as basis for insurane premiums (six-month rule, health insurane ontributions only) Inome from selling timber For details on benefits reeived and taxes withheld, see doumentation from payer. If you start reeiving a new pension during the alendar year, enlose the agreement (eläkepäätös in Finnish; pensionsbeslut in Swedish), and report in addition any inome from paid employment, soial benefits and other types of inome for the year onerned. If you arry a MYEL insurane for reeiving grants, enter the grant subjet to tax under Grants reeived, and your annual MYEL work inome under Annual work inome as set out in MYEL on page 4. VEROH 5010e 9.2015 2/7 ESTIMATED INCOME SUBJECT TO PREASSESSMENT Personal earned inome Wages (if employer does not withhold tax) Grants (MYEL insurane) Pension benefits Nonwage ompensation Other inome (private hild are inome, tips) Other earned inome subjet to prepayment Personal apital inome net of osts Rental inome, net of dedutible osts (enlose Form 7H as neessary) Rental inome from real estate or other rental property (enlose Form 7K as neessary) Capital gains (enlose Form 9 as neessary) Capital gains from sale of seurities (enlose Form 9A as neessary) Other apital inome
DIVIDENDS AND DISTRIBUTIONS OF PROFIT SURPLUS Dividends and distributions treated as earned inome Reeipts of dividends from unlisted ompanies (enter gross amount to be treated as earned inome) The above dividends are from a ompany for whih I arry YEL or MYEL pension insurane. Reeipts of profit surplus from non-listed ooperatives (enter gross amount to be treated as earned inome) The above reeipts are from a ooperative operation for whih I arry a YEL or MYEL pension insurane. Dividends and distributions treated as apital inome Reeipts of dividends from listed ompanies (enter gross amount) Reeipts of dividends from listed ompanies, fully taxable Reeipts of dividends from unlisted ompanies (enter gross amount to be treated as apital inome) Reeipts of profit surplus from listed ooperatives (enter gross amount) Reeipts of profit surplus from non-listed ooperatives (enter gross amount to be treated as apital inome) Dividends, EU/EEA state or tax treaty state, from listed ompanies Dividends, EU/EEA state or tax treaty state, from unlisted orporations - gross amount, apital inome - gross amount, earned inome Dividends, Non-EU/EEA state or non-tax treaty state Taxes paid on foreign dividends Costs for the prodution of foreign dividend inome Give details on amount, ountry, payer (stok-exhange listed ompany or not). OTHER INCOMES AND TAXES FROM ABROAD Other foreign apital inome Taxes paid on other foreign apital inome Inome from employment from abroad Seafarer's inome from abroad VEROH 5010e 9.2015 3/7 Foreign pension/other inome Tax on inome from employment/seafarer's inome from abroad Tax on foreign pension/other inome Give details of amount, ountry, payer, and type of inome (suh as type of work for whih pension has been granted). Note: If you reeive other taxable inome or have other assoiated expenses whih this form does not appear to over, please give details of the type of inome, the estimated amount and related dedutible expenses on another sheet.
BUSINESS INCOME Estimated taxable inome for the entire year/aounting period, showing earned inome and apital inome separately Reasons for submitting the appliation for prepayment hanges Terminating business Aounting period Other reasons, please speify Business or self-employed Farming/Agriultural taxpayer Earned inome from business Earned inome from farm/agri Capital inome from business Capital inome from farm/agri The Tax Administration has divided your inome between earned inome and apital inome on the basis of either your 2014 net assets as shown in your 2014 assessment deision or your 2015 net assets as stated on your 2015 tax return. Go to page 2 "Inome from selling timber", if neessary. Reindeer farming Earned inome from reindeer farming Capital inome from reindeer farming List of your interests in partnerships Business ID, partnership/similar Business ID, partnership/similar Business ID, partnership/similar Business ID, partnership/similar Taxable inome derived from above; split between earned inome/apital inome Earned inome - business Capital inome - business Capital inome from partnerships treated as personal inome Earned inome from foreign partnerships Earned inome - agriulture Capital inome from foreign partnerships Capital inome - agriulture Details for determining health insurane and daily allowane ontributions for self-employed persons Annual work inome as set out in YEL Annual work inome as set out in MYEL Inome reeived as a self-employed person 3) 3) This inome refers to ash pay, benefits and expenses paid to you by your own ompany for whih you hold YEL or MYEL insurane. Enter these and any other earnings from employment paid by other employers also under "Earned inome subjet to withholding tax". Installments of prepayment My business is seasonal on a regular basis. For this reason, I apply for regular prepayments during the ative season only. VEROH 5010e 9.2015 4/7 Desription of business (suh as summertime kiosk business) and its seasonal harateristis: Start and end dates of business season: / 20 / 20
DEDUCTIONS FOR THE TAX YEAR Dedutions against apital inome Costs for seurities management and safekeeping, gross amount Other expenses for the prodution of inome (use "Additional information") Interest on home loan, your own share Interest on first-time homebuyer loan, your own share (permanent home aquired on 1 Jan 1993 or later, max 10 years) Interest on work-related and apital-related debts, your own share Repayment of shareholder loans (use "Additional information") Voluntary pension insurane / long-term savings payments Interest on debt to purhase shares in your own ompany Name and Business ID of your ompany in whih you are a shareholder: Tax redit for apital inome defiit should be split: Appliant hild(ren) Spouse hild(ren) Dedutions against earned inome Trade union / unemployment fund membership fees Dedution for temporary aommodation (details on Form 19, Veroh 3019) Other expenses for the prodution of inome (use "Additional information") Statutory YEL/MYEL pension insurane premiums (unless dedutible as business osts to your business) MYEL insurane premiums, if based on reeipt of an aademi grant Premiums for olletive additional pension ontrats Do not enter any TyEL and unemployment insurane premiums or daily allowane ontributions. The Tax Administration will alulate them. Travel expenses A. Commuting (between home and work) Start and end dates Mode Km per Km Total Publi transport Other VEROH 5010e 9.2015 5/7 Value of employer-provided ommuter tikets B. Weekend trips home from temporary assignments Publi transport Other C. Travel to work loations in speifi industries D. Travel to seondary plaes of work 1 2 1 2 Tik the boxes as appropriate: 1 = Temporary work in another region; the employer has not made arrangements for weekend aomodation 2 = Temporary work in another region; journeys in onnetion with vaations or sik leave.
TAX CREDITS FOR THE TAX YEAR Domesti tax redit from tax (details on Form 14, Veroh 3086 and 3026) Qualifying expenses Child maintenane (tax redit equals 1/8 of total, max 80 per hild) Dedution for repayment of soial benefit (whih benefit, how muh you have paid bak, and for whih year) Tax redit for student loans, repayments (tax redit must be endorsed by Kela) INCOME SUBJECT TO PREASSESSMENT I request that these inomes be onsidered in alulating my personal withholding rate shown on my tax ard. I request that these inomes be disregarded when alulating my personal withholding rate shown on my tax ard, and that prepayments be determined instead. CHANGES IN PERSONAL DATA Street address Post ode and loation Domiile, 31 Deember 2015 Adherene: Churh Tax 1 Jan 2016 German Rikssvenska Ev.luth. Orthodox no payer of ongregation Olaus Petri Churh Tax in Finland -församlingen Marital status single married registered ouple ohabitant separated divored widowed Name of spouse or ohabitant Personal identity number of spouse or ohabitant Years of birth of hildren, adopted hildren and foster hildren who have been in your are and ustody and were under 17 years of age on Deember 31 before the beginning of the tax year Mark ohabitation only if you have had a hild with your partner or have been married to eah other earlier. Separation means that the spouses ease to live together as a married ouple. VEROH 5010e 9.2015 6/7 ENCLOSURES List of enlosures Form 14, Tax redit for domesti osts Form 9, Capital gains, apital losses Form 19, Tax dedution for temporary aommodation Form 9A, Seurities trading: apital gains, apital losses Form 7, Rental inome Other enlosures FURTHER PREPAYMENTS GUIDANCE If you are terminating your business, please enlose information on the final losing of the aounts. If you are not terminating your business, no interim balane sheet or finanial statements are neessary unless the Tax Administration has asked for them. You must file requests for prepayment or for inreased or dereased prepayments in good time, before the end of the alendar year. Any undue prepayment an be removed by the end of August 31st the next year.
INFORMATION TO BE SUBMITTED FOR PREPAYMENTS FOR 2017 Earned inome from farm/agriulture Earned inome from business Capital inome from farm/agriulture Earned inome - agri. partnerships Capital inome - agri. partnerships Earned inome from foreign partnerships Capital inome from foreign partnerships Earned inome from reindeer farming Capital inome from reindeer farming Capital inome from business partnerships, personal soure of inome Capital inome from tax partnerships, other soure Capital inome from business Earned inome - business partnerships Capital inome - business partnerships Other inome (private hild are inome, tips) Other earned inome subjet to prepayment Rental inome, flat/apartment, net of dedutible osts Rental inome, real property, net of dedutible osts Other apital inome subjet to prepayment Enter ompany name and Business ID under "Additional information". INFORMATION TO BE SUBMITTED FOR YOUR TAX CARD FOR 2017 Inome prinipal oupation seondary employment Soial benefits Seafarer's pay and benefits Study grant Foster are provider's fee and ompensation Compensation for family aregiver Trade inome (enter under "Additional information") Gross reeipts of dividend (earned / apital (use "Additional information") Profit surplus, earned and apital inome (use "Additional information") Wages from abroad (use "Additional information") Pension from abroad (use "Additional information") Dedutions and redits Interest on home loan Interest on first-time homebuyer loan Interest on work-related and apital-related debts Daily travel osts between work and home, gross (use "Additional information") Trade union / unemployment fund membership fees Expense dedutions (e.g. forestry workers) Expense dedutions (e.g. family dayare) Expense dedution for foster are provider Other expenses for the prodution of apital inome Voluntary pension insurane / long-term savings payments Enter any interest payable on loans to buy shares in a ompany in whih you are a shareholder-entrepreneur. Inlude ompany name and Business ID. Additional information, inluding explanation of hanges in inome for 2017 ompared to 2016. VEROH 5010e 9.2015 7/7 Date Signature Telephone number during offie hours