u›=ƒÄåÁ ôÅ^L© Ç=V¡^c=Á© ]øwK=¡

¾›=ƒÄåÁ Ñu=­‹“ Ñ<U\¡ vKeM×”

The Federal Democratic Republic of Ethiopia
Ethiopian Revenues and Customs Authority

¾}ÚT] እc?ƒ ታ¡e Td¨mÁ

VALUE ADDED TAX DECLARATION
¾c’É lØ`
Document No:

¡õM 1 ¾Ów` Ÿó¿ SKÁ/ Part 1 Taxpayer Identification

1.1 ¾Ów` ŸóÃ eU SdÃ

Name of Taxpeyer

1.2 ¾Ów` ŸóÃ SKÁ lØ` / Taxpayer Identification Number ( TIN)

1.3 ¾}ÚT] እc?ƒ ታ¡e lØ` / VAT Registration Number

¾ ¨` ¯.U For the Month of

¡õM 2 ¾}ÚT] እc?ƒ ታ¡e eK?ƒ / Part 2 Computation of Value Added Tax

2.1 u²=I ¨` ¾T>Ád¨<lƒ ŸK?K ( ) If the return for the period is NIL ( ) Here

2.2 ¾U`ƒ ¨<Ö?ƒ ታ¡e eK?ƒ / Computation of Output Tax

ታ¡e ¾T>ŸðMv†¨< °n­‹ u°n“ u›ÑMÓKAƒ iÁß Là Sታcw

እ“ ¾›ÑMÓKA„‹ ›p`xƒ /iÁß ªÒ Áለuƒ ¾}ÚT]
Value of Taxabel Goods and supplies እc?ƒ ታ¡e
5 VAT on Taxabel Goods and 10
Supplies [15% of the line 5]
- -
¾²?a U×’@ ÁL†¨< °n­‹
“ ›ÑMÓKA„‹ iÁß ªÒ 15
Value of Zero - Rated Goods
-

Ÿ}ÚT] c?ƒ ¡e ’í ¾J’ iÁß / ›p`x„‹ ªÒ

Value of Exempt Supplies /Sales 20
-
¾¡e UI[ƒ ÁÑ–< ›p`x„‹ ªÒ
Value of Remitted Supplies 25
-

ÖpLL ›p`xƒ / iÁß ¾¨\ }Ÿóà ¾}ÚT]

Total Supplies/ sales
30 እc?ƒ ታ¡e 35
VAT Charge for this
[ Lines 5+15+20+25] - period [=line 10] -
 ¾¨\ }Ÿóà ¾}ÚT]
ÖpLL ›p`xƒ / iÁß
30 እc?ƒ ታ¡e 35
Total Supplies/ sales VAT Charge for this
[ Lines 5+15+20+25] - period [=line 10] -

2.3 ¾Ów¯ƒ ታ¡e eK?ƒ / Computation of Input Tax

በ›Ñ` ¨<eØ Ó»­‹ Ów¯ƒ Là ¾}ŸðK

¾›Ñ` ¨<eØ Ó»­‹ Ów›ƒ ªÒ ¾}ÚT] እc?ƒ ታ¡e
Value of Local Purchases Input 50 VAT of Local Purchases Input
55
[15% of line 50]
70,000.00 10,500.00
በ¨<ß GÑ` Ó» የÓw›ƒ ªÒ LÃ
¾}ŸðK የተጨማሪ እc?ƒ ታ¡e
¾¨<ß GÑ` Ó» Ów›ƒ ªÒ 60 Value of Imported Inputs [ 15% of
Value of Import Inputs line 60]
- 65 -
¾M¿ M¿ ¨Ü­‹ Ów¯ƒ ªÒ Là ¾}ŸðK
¾M¿ M¿ ¨Ü­‹ Ów¯ƒ ªÒ ¾}ÚT] እc?ƒ ታ¡e
Value of General Expences Inputs 70 Value of General Expense
Inputs [ 15 % of line 70]
- 75 -
}ÚT] እc?ƒ ታ¡e ÁM}ŸðKuƒ Ó»
¨ÃU }Sላi
¾TÃÖ¾pv†¨< Ów¯ƒ ªÒ 80
Value of Purchases with no VAT or
Uncliaimed Inputs -

ÖpLL ¾Ów¯ƒ ­Ò 85
Value of Total Inputs
[lines 50+60+70+80] -
ታ¡e ¾}ŸðKuƒ የÓw¯ƒ ­Ò uÓw¯ƒ ªÒ Là የተከፈለ
Value of Taxabel Input 90 }ÚT] እc?ƒ ታ¡e 95
[Lines 50+60+70] Total Inputs Tax Credit
70,000.00 [ lines 55+65+75] 10,500.00
¾¨\ ¾}×^ ¾}ÚT] እc?ƒ ታ¡e }ŸóÃ
Net VAT Due for Month ( before other Credits) [ Lines 35-95] 110
(10,500.00)
¾¨\ }SLi ¾}ÚT] እc?ƒ ታ¡e
VAT Credit for Month ( before other Credits) [ Lines 95-35] 115
10,500.00
K?KA‹ u¨\ ¨<eØ ¾T>ታcu< ( ¡õÁ iÁß ታ¡e uእÏ ÁK ዕn)
Other Credit for Month ( Payments, SalesTAx,Goods on Hands)
120

"Kð¨< ¨` ¾µ[ wMÝ ¡õÁ

credit Carried forward from Pervious Month
125
100,000.00
ÖpLL }ŸóÃ
Amount to be Paid [ 110-120-125]
150
(110,500.00)
K}Ÿታ¿ ¨` ¾T>ታcw }SLi H>dw
Credit Available for carry forward[115+120+125]
160
(89,500.00)

¡õM 3 ¾ƒ¡¡K—’ƒ T[ÒÑÝ / Part 3 commitment

u²=I pî Là ¾cð\ƒ G<K<ም S[Í­‹ ƒ¡¡M“ ¾}TEL SJ’<” ›[ÒÓ×KG<:: I here by
certify that the information given in this from is ture and complete

TI}U
S<K< eU/Name ò`T/signatue k”/Date

¡õM 4 K}ÚT] እc?ƒ ታ¡e SUሪÁ ›ÑMÓKAƒ w‰ / Part 4 For VAT Department Use Only

Á[ÒÑÖ¨</Checked By
¾c^}—¨< eU/ Officer's Name ò`T/signatue k”/Date
2.3 ¾Ów¯ƒ ታ¡e eK?ƒ / Computation of Input Tax

በ›Ñ` ¨<eØ Ó»­‹ Ów¯ƒ Là ¾}ŸðK ¾}ÚT]

¾›Ñ` ¨<eØ Ó»­‹ Ów›ƒ ªÒ
Value of Local Purchases Input
¾¨<ß GÑ` Ó» Ów›ƒ ªÒ
Value of Import Inputs
¾M¿ M¿ ¨Ü­‹ Ów¯ƒ ªÒ
Value of General Expences Inputs
እc?ƒ ታ¡e
50 VAT of Local Purchases Input
55
[15% of line 50]
- -
በ¨<ß GÑ` Ó» የÓw›ƒ ªÒ LÃ
¾}ŸðK የተጨማሪ እc?ƒ ታ¡e
60 Value of Imported Inputs [ 15% of line 60]
- 65 -
¾M¿ M¿ ¨Ü­‹ Ów¯ƒ ªÒ Là ¾}ŸðK ¾}ÚT]
እc?ƒ ታ¡e
70 Value of General Expense
Inputs [ 15 % of line 70]
- 75 -

}ÚT] እc?ƒ ታ¡e ÁM}ŸðKuƒ Ó»

¨ÃU }Sላi 80
¾TÃÖ¾pv†¨< Ów¯ƒ ªÒ
Value of Purchases with no VAT or
Uncliaimed Inputs -

ÖpLL ¾Ów¯ƒ ­Ò 85
Value of Total Inputs
[lines 50+60+70+80] -
ታ¡e ¾}ŸðKuƒ የÓw¯ƒ ­Ò uÓw¯ƒ ªÒ Là የተከፈለ
Value of Taxabel Input 90 }ÚT] እc?ƒ ታ¡e 95
[Lines 50+60+70] Total Inputs Tax Credit
- [ lines 55+65+75] -
¾¨\ ¾}×^ ¾}ÚT] እc?ƒ ታ¡e }ŸóÃ
Net VAT Due for Month ( before other Credits) [ Lines 35-95] 110
-
¾¨\ }SLi ¾}ÚT] እc?ƒ ታ¡e
VAT Credit for Month ( before other Credits) [ Lines 95-35] 115
-
K?KA‹ u¨\ ¨<eØ ¾T>ታcu< ( ¡õÁ iÁß ታ¡e uእÏ ÁK ዕn)
Other Credit for Month ( Payments, SalesTAx,Goods on Hands)
120
-
"Kð¨< ¨` ¾µ[ wMÝ ¡õÁ
credit Carried forward from Pervious Month
125
-
ÖpLL }ŸóÃ
Amount to be Paid [ 110-120-125]
150
-

K}Ÿታ¿ ¨` ¾T>ታcw }SLi H>dw

Credit Available for carry forward[115+120+125]
160
-

¡õM 3 ¾ƒ¡¡K—’ƒ T[ÒÑÝ / Part 3 commitment

u²=I pî Là ¾cð\ƒ G<K<ም S[Í­‹ ƒ¡¡M“ ¾}TEL SJ’<” ›[ÒÓ×KG<:: I here by certify
that the information given in this from is ture and complete

TI}U
S<K< eU/Name ò`T/signatue k”/Date

¡õM 4 K}ÚT] እc?ƒ ታ¡e SUሪÁ ›ÑMÓKAƒ w‰ / Part 4 For VAT Department Use Only

Á[ÒÑÖ¨</Checked By
¾c^}—¨< eU/ Officer's Name ò`T/signatue k”/Date