3

8.—15b

Deductions. Losses, outgoings, and expenses incurred in the production of the gross income stated above ... ... ... ... ... ... ... ... ...£ (See Schedule P, page 3.) Net income derived from business ... ... ... ... ...£ N.B.—lnterest on mortgages cannot be deducted. Land and Income tax paid cannot be deducted. Gross Income derived from Employment or Emolument. (See Schedule E, page 3.) £ 1. From the profession, employment or vocation of 2. From salary, wages, allowances, bonus, pension, stipend, fees, charge, or annuity of any kind 3. From commissions or share of profits by way of or in lieu of salary 4. From any other source not coming within any of the foregoing heads Total ... ... ... ... ... ...£ Deductions. Losses, outgoings, and expenses incurred in the production of the gross income stated above ... ... ... ... ... ... ... ... ...£ (See Schedule P, page 3.) Net income derived from employment or emolument ... ... ...£ I claim deduction on account of amount actually paid by me during the year as life insur-"" ance premiums on my own life (not to include accident insurance) ... ...£ N.B.—This deduction is limited to £50, and if the amount paid be less than that sum the exact figures should be entered. Note.—The exemption of £300 allowed by law will be deducted in the office of the Commissioner of Taxes. Income derived or received by the owner or occupier of land in New Zealand from or out of land, or from the use or produce of such land derived by such owner or occupier, or from mortgages of land in New Zealand, except where otherwise specially provided, should not be included in the gross income; and losses, outgoings, and expenses incurred in the production of such income from land or mortgages cannot be deducted. I, the person making the foregoing return, do solemnly and sincerely declare that the same, and the statements therein referred to or accompanying such return, contain true and accurate details of the several matters and things set forth, and in particular contain a true and accurate account of all income derived by me during the year ending 31st March, 18 ; and the deductions claimed by me are those which lam legally entitled to deduct. And I make this declaration under the provisions of " The Land and Income Assessment Act, 1891," and its amendments. Dated this day of , 18 . (Usual signature :)

Deduction claimed on account of Liability to pay Land-tax in respect of Land occupied for Business or Employment, such Deduction being equal to 5 per Cent. on the Amount upon which I am liable to pay Land-tax on such Land.

N.B. —No deduction can be Claimed by the owner in respect of premises or portion of premises let to a tenant.

Names, Addresses, and Shares of Partners. (To be filled up in the case of Returns made by or on account of a Firm.)

Assessment No. Description of Land used as Place of Business or Employment. Actual Value. Value of Improvements. Amount of Mortgage. Amount on which Land-tax payable.

Name in full of each Partner. Address. Share in Firm.