FS3 FS3

Nru. tal-ID card/Reġ tat-Taxxa tal-Payee

A2

Nru. tas-Sigurtà Soċjali tal-Payee

A3

Nru. tal-ID card/Reċ tat-Taxxa tal-konjuġi

A4

B1 Minn

B2 Sa

Għas-sena li għalqet fil-31 ta’ Diċembru

Emolumenti Grossi (Metodu Prinċipali jew ieħor ta’ Tnaqqis ta’ Taxxa)

Emolumenti Grossi (Metodu Part-time ta’ Tnaqqis ta’ Taxxa)

Share Options fringe benefits intaxxati bil-15%

Total ta’ Emolumenti Grossi u Fringe Benefits

Cash Allowance tal-Karozza mhux taxxabbli (50% tal-Allowance sa massimu ta’ €1170)

Dettalji sħaħ dwar il-Fringe Benefits

A INFORMAZZJONI DWAR IL-PAYEE

B PERJODU

C EMOLUMENTI GROSSI

D TNAQQIS TA’ TAXXA

E INFROMAZZJONI DWAR IS-SIGURTA’ SOĊJALI U FOND TAL-MATERNITÀ

F1 Numru tal-P.E. tal-Pagatur

F2 Data

Tnaqqis tat-Taxxa (Metodu Prinċipali jew ieħor ta’ Tnaqqis ta’ Taxxa)

Tnaqqis tat-Taxxa (Metodu Part-time ta’ Tnaqqis ta’ Taxxa)

Tnaqqis ta’ Arretrati ta’ Taxxa (skont l-ammont fuq il-formola (PCU2(A))

15% taxxa fuq Share Options

Total tat-Tnaqqis tat-Taxxa

Total

Kontribuzzjoni jew pagament fi skema ta’ Pensjoni Okkupazzjonali Voluntarja

NB: Jekk it-taxxa fuq emolumenti Part-Time hija anqas mir-rata relattiva l-ammont sħiħ jiġi ntaxxat bir-rati normali.

Payee Pagatur Total KSS

Kontribuzzjonijiet tas-Sigurtà Soċjali Kontribuzzjonijiet tal-Fond tal-Maternità

E1

€

Ġimgħat bla Ħlas

Minn Sa Numru

Number

C C€ €€ C

Isem sħiħ tal-Prinċipal

Firma tal-Prinċipal

j j x x s s s s

Għandhom jimtlew erba’ kopji ta’ din il-formola. L-oriġinali tintbagħat lill-Uffiċċju tal-Kummissarju tat-Taxxi mal-formola FS7, żewġ kopji jingħataw lill-payee u l-kopja oħra tinżamm mill-Pagatur.

Indirizz

Kodiċi Postali

Numru tat-Telefon

Isem/Nru. tad-Dar

Triq

Belt/Raħal

Kunjom

Isem

F INFORMAZZJONI DWAR IL-PAGATUR

Kodiċi Postali

Numru tat-Telefon

Isem/Nru.

Triq

Belt/Raħal

Isem tan-Negozju

Indirizz tan-Negozju

A1

s s s s

Fringe Benefits - Eskludi Share Options (Total ta’ Kaxxi (C5+C6+C7)-C8)

C1

C2

C3

C3a

C4

Kat 1 C5

Kat 2 C6

Kat 3 C7

C8

€

D1

D2

D3

D3a

D4

€

€

Paga Bażika fil-ġimgħa

C Numru Kategorija€Pagatur€ C

Kariga tal-Prinċipal

FINAL SETTLEMENT SYSTEM (FSS)Dikjarazzjoni ta’ Qligħ tal-Payee

FS3

j j x x s s s sj j x x s s s s

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FS3

Payee’s ID Card/IT Reg. No.

A2

Payee’s Social Security No.

A3

Spouse’s ID Card/IT Reg. No.

A4

B1 From

B2 To

For Year Ended 31 December

Gross Emoluments (FSS Main or FSS Other applies)

Gross Emoluments (FSS Part-time method applies)

Share Options fringe benefits taxed at 15%

Total Gross Emoluments and Fringe Benefits

Non Taxable Car Crash Allowance (50% of Allowance up to a maximum of €1170)

Breakdown of Fringe Benefits

A PAYEE INFORMATION

B PERIOD

C GROSS EMOLUMENTS

D TOTAL DEDUCTIONS

E SOCIAL SECURITY AND MATERNITY FUND INFORMATION

F1 Payer PE Number

F2 Date

d d m m y y y y

Tax Deductions (FSS Main or FSS Other applies)

Tax Deductions (FSS Part-time method applies)

Tax Arrears Deductions (as per amount on PCU2(A))

15% tax on Share Options

Total Tax Deductions

Total

Voluntary Occupational Pension Scheme contribution or payment

NB: If part-time tax is less than the relative rate the whole emoluments will be charged at normal rates.

Payee Payer Total SSC

Social Security Contributions Maternity FundContributions

E1

€

Weeks Without Pay

From To Number

Number

C C€ €€ C

Principal’s Full Name

Principal’s Signature

d d m m y y y y

This form is to be completed in quadruplicate. The original is to be sent to the Office of the Commissioner for Revenue with the FS7, two copies are to be given to the Payee and the other copy is to be retained by the Payer.

Address

Postcode

Telephone Number

House No.

Street

Locality

Surname

First Name

F PAYER INFORMATION

Postcode

Telephone Number

House No.

Street

Locality

Business Name

Business Address

A1

y y y y

Fringe Benefits - Excluding Share Options (Total of Boxes (C5+C6+C7)-C8)

C1

C2

C3

C3a

C4

Cat 1 C5

Cat 2 C6

Cat 3 C7

C8

€

D1

D2

D3

D3a

D4

€

€

Basic Weekly Wage

C Number Category€Payer€ C

Principal’s Position

FINAL SETTLEMENT SYSTEM (FSS)Payee Statement of Earnings

FS3

d d m m y y y y

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