Application Form for claiming Dependent Parent or ... - ç¨ å‹™å±€

稅 務 局
ਉᤜӒثѓԚᄐ5
໔௭ѕፔ
來 函 請 敘 明 本 局 檔 案 號 碼
IN ANY COMMUNICATION PLEASE QUOTE OUR FILE NO.
ഴؑᎳ ʚ
Section Code :
INLAND REVENUE DEPARTMENT
REVENUE TOWER,
5 GLOUCESTER ROAD, WAN CHAI,
HONG KONG
ሻ ؿ Web Site : http://www.info.gov.hk/ird
‏ˉ֯ᏮబˈਉཡङᘔٝཡᎣ132໔௭ٝٝ‎ܤܐ
ALL CORRESPONDENCE SHOULD BE ADDRESSED TO:­
COMMISSIONER OF INLAND REVENUE,
G.P.O. BOX 132, HONG KONG.
ᖾૂ᎘ :
File No.:
ᄽჩ᎘ : 187 8088
Telephone No.:
ᅹҮྚଟ :
Faxline No.:
Ҳ ๚ :
Date :
գԳ̯іѓʥ
申 請 供 養 父 母 及 祖 父 母 或 外 祖 父 母 免 稅 額 ̯
扣 除 長 者 住 宿 照 顧 開 支
課 稅 年 度
ռݩ࠱ӀԦ/ଲӀԦ/ԆଲӀԦ —ʚ
( 1 )
( 2 )
( 3 )
Dear Sir/Madam,
Claim for Dependent Parent and
Dependent Grandparent Allowance/
Deduction of Elderly Residential Care Expenses
Year of Assessment /
Name of Parent(s) or Grandparent(s) : —
( 1 )
( 2 )
( 3 )
໔ᜰ؍࠱‎؃ԹᏮт৪ܹᑆгѓߍែ
၃ིҭʔԡгহт࠱ჷ܀Ԣ࿄ٔʖ
మװࡃை‏֬‏
Referring to your claim for Dependent Parent
ॡұԡг
ჷ࿄෴ʖ࠱‎9ˉ‏ˈߔጞრྈԹᏮʔᏮ؃లևহт༯ו
Allowance / Dependent Grandparent Allowance / Deduction of
Elderly Residential Care Expenses
in respect of the
abovenamed, I find that the overleaf items are incomplete. To
enable me to consider the claim, you are requested to furnish
the relevant details ticked overleaf.
Ꮾలԡ࿄ٔ ʔ ӠҲܤևԡ܀ 14Қ҃ ՝Ռ
փԡгʖ ਣѬᗧʔ ԡٝలѬѲּྈ؍໔ᜰ ིҭ
֬ງʖ
Please complete and return this form intact to me
within 14 days. In the absence of a reply, no allowance /
deduction will be granted for the dependant(s).
Yours faithfully,
ണвঝ༱໔ӌ՚ Assessor, Unit 2
I.R.ണ687 (6/2002)
I.R.687 (6/2002)

ʚ໔௭ٝٝ‎ ী
To : The Commissioner of Inland Revenue
ਉཡङᘔٝཡᎣ132
G.P.O. Box 132, Hong Kong.
ᅹҮྚଟ
Faxline No. : 2877 1232
ᖾૂ᎘ ʚ
File No. : _________________________________
ԹᏮᑆӀԦ0ଲӀԦ0
Claim for Dependent Parent / Grandparent Allowance or Deduction of Elderly Residential Care Expenses
మ၃ིҭװࡃ໔ᜰި֬ை؍ԆଲӀԦ
/ Ᏸ໔֣࣫
Year of Assessment /
ണ1ܹᑆг
Dependant 1
ണ2ܹᑆг
Dependant 2
ണ3ܹᑆг
Dependant 3
(1) ܹᑆгݩռ(ᏮԴԥဒ࿄ጊ)
Full name of dependant ( Please Use Block Letters)
(2) ܹᑆг࠱ਉ۪҉ឞ᎘
Dependant’ s H.K. Identity Card No. ( ) ( ) ( )
(3) ܹᑆгӠԳҲ๚ (ӽ࿄ጊҴ՝җ֣՝); ܹ֕ᑆгևԡ֣࣫҃Ѭ۩
60ဣՍᏮ࿄ጊണ 7 ྈ
Date of birth of dependant (enter month and year only); if the
dependant was less than 60 years old during the year, please also
complete item 7 below
Ҵ
Month
֣
Year
Ҵ
Month
֣
Year
Ҵ
Month
֣
Year
ែ࠱ቖԡгިԡг (4)
Relationship with me / my spouse
ӀԦ
parent
ଲӀԦި
ԆଲӀԦ
grandparent
ӀԦ
parent
ଲӀԦި
ԆଲӀԦ
grandparent
ӀԦ
parent
ଲӀԦި
ԆଲӀԦ
grandparent
請 填 寫 第 (5) 或 第 (6) 其 中 一 項
Complete EITHER Item (5) OR Item (6)
(5)
(i) ӑӠм۩ངԴʖ܀זװᑆгևԡ֣࣫҃එᡛቖԡгյ‏ܹ‏
‏(࠼‎6ਡҴʔᏮߍҟװյ‏)‏
The dependant resided with me continuously during the year
without paying full cost. (Leave blank if residing period was less
than 6 months)
դ֣ ҟ6ਡҴן
װյ
װյ
for full for at least
year 6 months
դ֣ ҟ6ਡҴן
װյ
װյ
for full
year
for at least
6 months
դ֣ ҟ6ਡҴן
װյ
װյ
for full
year
for at least
6 months
‎$12,000‎ߍևԡ֣࣫҃ѲܹᑆгѬҟ࠱ԡгިԡг (ii)
(1998 / 99֣࣫Ӑॡ $1,200) ᕒ؂Գ॒ངʖ࠱
I / my spouse contributed not less than $12,000 in money during
the year ($1,200 prior to year of assessment 1998 / 99) towards
the dependant’ s maintenance.
ढ
Yes
ء
No
ढ
Yes No
ढ ء
Yes
ء
No
(6) (i) ռሠה֜࠱װݺᑆг‏ܹ‏
Name of the residential care home at which the dependant resided
(ii) ҭ‏ི࠱הևԡ֣࣫҃ެҭӑт৪֜‎࠱ԡгިԡг
ᜰ (Է՚гѓިᒲᇌӑᙫ࠱ፇᜰʔѬᖨৠሩև҃)
Amount of expenses paid by me / my spouse to the above
residential care home during the year (excluding any amount
subsequently reimbursed by any person or organization)
$ $ $
(7) ्ཀʖ‏ྞތᑆгևԡֶ֣࣫҃ჷԹङ‏ܹ‏
The dependant was eligible to claim an allowance under the
Government’ s Disability Allowance Scheme during the year.
ढ
Yes
ء
No
ढ
Yes
ء
No
ढ
Yes
ء
No
Ꮾևᐞၝ࠼҃ӣтˈ 9 ˉ
9!in the appropriate box
ᡆ᎔ᆔൽʖفჷ࠱ʔӐтެ෴ެ࠵ฉԡгެ‎ߔᘢ
I declare that to the best of my knowledge and belief, all the above statements are true and correct.
႟
Signature ʚ
Ҳ๚
Dateʚ . Name ʚ
ռݩ
.
.
I.R.ണ687 (6/2002)
I.R.687 (6/2002)