INCOME TAX

Simulated Tax Assessment Results

Enquiries should be addressed to SARS

Contact Centre
ALBERTON

K SENGWAYO 1528
1447 SHENGE DRIVE Tel: 0800007277 Website: www.sars.gov.za
JABULANI
Details
1868
Reference number: 1222864140
Date Simulated: 2021-07-29
Tax year: 2021

The South African Revenue Service (SARS) selected you for auto assessment, and this simulated assessment tax result -16919.54 is based on the information received from third party data
submitted to SARS.

Below are your bank account details currently at the disposal of SARS. Any refund due to you will be paid into this account.

Bank Account Details

Account Holder Name: K SENGWAYO
Bank Name: STANDARD BANK S.A.

Account Number: 001994182

Account Type: Cheque

Branch Code: 000155

Income
Code Source Code Description Rand
3915 Retirement fund lump sum benefit on / after 1/10/2007 52924.00

3901 Gratuities on/after 1/09/1995 7241.00

3601 Income - taxable 148311.00

3605 Annual payment - taxable 27156.00

3825 Provident fund contributions Fringe Benefit (defined contribution) 23268.00

3810 Medical Scheme Fees Fringe Benefit 15690.00

3808 Payment of employee debt 1045.00

4201 Interest excluding SARS Interest (Local) 1269.00

Married in community of property - 50% adjustment -634.00

Investment exemption -634.00

Total 275635.00

Deductions
Code Source Code Description Rand
4029 Retirement fund contributions -28408.00
Amount b/f from previous year 0.00
4006 Retirement annuity fund contributions 5140.00
4003 Provident fund contributions 23268.00
Total -28408.00
Taxable Income 247227.00
Taxable income - subject to retirement fund lump sum benefit tax rates 0.00
Taxable income - subject to retirement fund lump sum withdrawal benefit tax rates

Medical Aid Contributions

Code Source Code Description Rand
4005 Medical fund contributions 15690.00

Tax Calculation by SARS

Normal tax on taxable income 33671.16
Rebates -16872.00

Primary 14958.00

Medical Scheme Fees Tax Credits 1914.00

Reference Number 1222864140 SIM01_RO 2021.09.00 01/02

Tax Calculation by SARS
Number of dependant(s)
Mar Apr May Jun Jul Aug
1 1 1 1 1 1

Sep Oct Nov Dec Jan Feb

0 0 0 0 0 0

Retirement fund lump sum benefit tax liability 0.00

Subtotal 16799.16
Employees' tax -33718.70
Simulated Tax Assessment Results -16919.54

Notes
1. SARS prepared this simulated tax result i.r.o. the 2021 year of assessment based on third party data returns received from your
employer(s)/retirement fund(s) / (IRP5(s) and/or IT3(a)), select "View Return" to display this information on eFiling.

2. If the information is complete and correct, you should proceed by selecting "Accept", by doing so, you will not be required to submit a tax
return for the current year of assessment. SARS will now confirm your tax assessment and issue a Notice of Assessment (ITA34) to you. You
may watch a video of how to accept or edit your auto-assessment on SARS TV via YouTube.

3. However, if you disagree with any information or there is additional information that is not reflected, select "Edit Return", update the
information and file your return.

4. Adjustments and carryover amount(s) from previous years not displayed on this tax simulation and impacting on your simulated tax results,
will be displayed on the Notice of Assessment (ITA34) upon assessment.

5. If the Simulated Tax Assessment Result is displayed with a minus (-) sign, it means that the amount is refundable/payable to you, however if
the amount does not have a minus sign, it means the amount is payable by you.

Disclaimer
- This simulation is based on information at the disposal of SARS as at the date of this notice, and it is only applicable to the year of assessment
stated above.

- Should you disagree with the information or there is any additional information that is not reflected in this notice, it is your responsibility to
declare this information to SARS by selecting "Edit Return."

- You are not relieved from your obligation to inform the Commissioner, by way of submitting provisional tax returns (IRP6), when you become
liable for provisional tax.

Reference Number 1222864140 SIM01_RO 2021.09.00 02/02