Expatriate Employee Tax Withholding Certificate

Employee Information
Full Name
Nationality
Passport Number
Position/Title
Work Permit Number
Employer Name
Employer Tax ID
Certification Details
Period Covered
Total Taxable Income
Tax Withheld
Date of Payment
Declaration
I hereby certify that the information provided above is true and correct to the best of my knowledge and that the stated tax has been withheld and remitted in accordance with applicable laws and regulations.
Employee's Signature
Date:
Authorized Representative
Date: