TANZANIA REVENUE AUTHORITY

P.A.Y.E.
STATEMENT AND PAYMENT OF TAX WITHHELD
YEAR:

TIN:
Period: (Please tick the appropriate box)
From 1 January to 30 June

From 1 January to 31 December

Name of Employer:

Postal Address:

P. O. Box Postal City

Contact Numbers:

Phone number Second Phone

Third Phone Fax number

E-mail address:

Physical Address:

Plot Number Block Number

Street/Location

Name of Branch

ITX215.01.E - P.A.Y.E.-Statement
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 P.A.Y.E. - DETAILS OF PAYMENT OF TAX WITHHELD

Name of Employer: ………………………………………….. TIN

S/NO. NAME OF PAY POSTAL POSTAL BASIC HOUSING ALLOWANCE GROSS PAY DEDUCTIONS TAXABLE TAX DUE
EMPLOYEE ADDRESS CITY PAY AND BENEFIT AMOUNT
ROLL
NO.

TOTAL

ITX215.01.E - P.A.Y.E.-Statement
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