FEDERAL REPUBLIC OF NIGERIA
RIVERS STATE INCOME TAX FORM FOR RETURN OF INCOME AND 
CLAIMS FOR ALLOWANCES AND RELIEFS

Abridged Form A
INCOME TAX FORM FOR RETURN OF INCOME, CLAIMS FOR ALLOWANCES AND RELIEFS
(ABRIDGED FORM A)

IF MARRIED, PROVIDE SPOUSE DETAILS BELOW
Kindly Provide Information Full Name of Children | Date of Birth

Section One


Each section of this part should be completed. IF YOU HAVE NO SUCH INCOME, WRITE "NONE" AGAINST THE SECTION IN QUESTION

1. Trade, Business profession or Vocation Etc...
N

2. Employment :
N
N
N
3. Others :
N
N
4. Income received in or brought into Nigeria from all sources outside Nigeria.
N
5. Dividends from Nigerian Companies Other Dividends

(Enter the gross Amount before deduction of tax.)

N
6. Interest

(Annex a list giving details of each source therefrom) and the gross income received.

N
7. Rents

(Annex a list showing for each property the amount of gross and other expenses) rent and or premium received therefrom and their repair rates.

N
8. Income arising from sources not included above:

(Annex details of each source and the income therefrom)

N
 
Aggregate earned income from all sources (X)
N
K

Note: When any sources of income have been acquired or have ceased during the year ended:
(Annex particular with dates.)

INCOME AND TAX OF THE PREVIOUS YEARS

N
K
N
K
N
K
N
K
N
K
N
K

PENALTY AND DEFAULT
Please note that in accordance with the relevant laws, making false statements and returns or unlawful refusal/neglect to pay tax will attract up to ve (5) years imprisonment.