EXHIBIT 1

BORANG PCB/TP3 (1/2015)

INLAND REVENUE BOARD OF MALAYSIA (IRBM)

FORM FOR PREVIOUS EMPLOYMENT REMUNERATION INFORMATION IN CURRENT YEAR FOR MONTHLY TAX
DEDUCTION (MTD PURPOSES)
(KAEDAH-KAEDAH CUKAI PENDAPATAN (POTONGAN DARIPADA SARAAN) 1994)
BORANG DITETAPKAN DI BAWAH SEKSYEN 152, AKTA CUKAI PENDAPATAN 1967

BAHAGIAN A : MAKLUMAT MAJIKAN

A1

1ST EMPLOYER NAME

A2

EMPLOYER REFERENCE NO

A3

2ND EMPLOYER NAME

A4

EMPLOYER REFERENCE NO

*(Please use additional sheets for the third and subsequent employer)

PART B: EMPLOYEE INFORMATION

B1

NAME

B2

NRIC NO

B3

PASSPORT NO

B4

EMPLOYEE TAX NO

PART C: GROSS SALARY, EPF, FEE/ ZAKAT AND MTD (PLEASE STATE THE GRAND TOTAL FROM PREVIOUS

EMPLOYERMENTS)
ACCUMULATED AMOUNT

C1 Total monthly gross salary and additional salary including taxable allowance/ perquisites/ gifts/ benefits
C2 Total allowance/ perquisites/ gifts/ benefits which are tax exempted
i

Travel allowance, petrol card, petrol allowance for travelling between home and place of work

RM

ii Child care allowance

RM

iii

Consumable business products of the employer provided free of charge or at a partly discounted
price
RM

iv Perquisite whether in money or otherwise provided to the employee pursuant to his employment in
respect of past achievement award, service excellence award and long service award that the
employee has exervised an employment for more than 10 year with the same employer.

Other allowance/ perquisites/ gifts/ benefits which are tax exempted. Please refer to the
explanation note of BE for further reference.

C3 Total EPF contribution

RM

RM

RM

C4 Total Zakat/ Fee

RM

C5 Total MTD (not included CP38)

RM

PART D: DEDUCTION INFORMATION (PLEASE STATE THE GRAND TOTAL FROM THE PREVIOUS EMPLOYMENTS
ACCUMULATED

YEARLY LIMIT

D1 Medical expenses for own parents certified by medical practitioners

DEDUCTION

LIMITED TO RM5,000

RM

LIMITED TO RM6,000

RM

LIMITED TO RM5,000

RM

D2 Basic supporting equipment for disable self, spouse, child or parents

D3 Education fees (self):
(i) other than a degree at Master or Doctor level for acquiring law,
accounting, Islamic financing, technical, vocational, industrial, scientific or
technological skills or qualification.
(ii) Degree at Master or Doctor Level for acquiring any skill or
qualification
D4 Medical expenses on serious diseases for self,
Spouse or child
D5 Complete medical examination for self, spouse or
child

RM

LIMITED TO
RM6,000

LIMITED
RM500

RM

RM

D6 Purchase of books/ magazines/ journals/ similar publications

(except newspaper and banned reading materials) for self, spouse and child

LIMITED RM1,000

D7 Purchase of personal computer for individual (deduction allowed once in every

3 years)

LIMITED RM3,000

D8 Net savings in the National Education Savings Scheme (the amount of deposits
in the current year minus total expenditure in the current year)

LIMITED RM6,000

D9 Purchase of sports equipment for any sports activity as defined under the
Sport Development Act 1997

LIMITED RM300

RM

RM

RM

RM

D10 Husband/ wife/ payment of alimony to former spouse

LIMITED RM3,000

D11 Life insurance

LIMITED RM6,000
(Including EPF)

D12 Education of medical insurance

LIMITED RM3,000

D13 Private Retirement Scheme and Deferred Annuity (deferred annuity)

LIMITED RM1,000

D14 Interest on housing loan (conditions for eligibility to claim must be fulfilled)

LIMITED RM10,000

D15 Contributions to Social Security Organisation (SOCSO)

LIMITED RM250

RM

RM

RM

RM

RM

PART E: DECLARATION of employee

I, hereby declare that the information which stated in this form is true, correct and complete. If the given information is not true, court
action can be taken against me under paragraph 113 (1) (b) Income Tax Act 1967.

Date
Day

Month

---------------------------------------------------------------------------Year

Signature

NOTE
1. This form has to be filled by employee and submitted to employer without providing receipts and supporting documents for the
purpose of the adjustment calculation MTD.
2. Employer has to request employee to submit this form if the employee has worked with other employment within the current year.
3. Employer needs to keep this form for up to 7 years. This form must be presented upon request from IRBM.