Form 04
DECLARATION WITHIN THE SYSTEM OF THE SUBSIDIARY TAX ON WASTE COLLECTION AND PROCESSING (TSCGD)Decree of March 22, 2007 in favour of waste prevention and recovery in the Walloon Region, modifiying the decree of May 6, 1999 on fixing, levying and litigation regarding the regional direct taxes.
RESERVED TO THE SERVICE
2008Taxation period: 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter
OWD company code:
(OWD: Walloon Région Waste Department)
Declaration received on (date):
VisaDateName and signature of the
(OWD Stamp)DIE agent(DIE: Department of Economic Instrments)
Remarks:
Form 04
TO BE FILLED IN BY THE TAXPAYER
I. TAXPAYER’S IDENTITYCompany registration number:......
Company name:......
Bank account nomber(in case of due repayment) :...... IBAN number:
BIC number:......
II. PAYMENT RELATED DATA
Principal’s standard reference: ......III. COLLECTED WASTE RELATED DATA AND TAX CALCULATION
A Total quantity of waste collected in the Walloon Region :
Tons
Of which tons are being processed in the Walloon Region and tons are being processed outside the Walloon Region.B. Total quantity of waste being processed in the Walloon Region (Appendix 1 regarding the subsidiary elimination in the Walloon Region)
Total amount (Appendix 1) = ……………………€.
C. Waste being «exported» and processed outside the Walloon Region (One Appendix 2 per code and per 1st destination)
Total amount (Appendix 2)= ……………………€.
Remark: if the number of destinations is higher than the number of lines on this table, an extra table can be enclosed to the déclaration.IV. AMOUNT OF THE DUE TAX (Total B + total C)°
...... (amount and currency in letters).
...... (amount and currency in figures)
We, the undersigned……………………………….(the taxpayer) certify that the present declaration, including the enclosed documents and the data that have been encoded on the available instrument on the web in compliance with the indications it provides is true and sincere and can be used to check the tax amount. We enclose ………………..numbered appendix(ces) to the present declaration.
Done in……………………………………………Date……………………………….……The taxpayer's name, position and signature
Remark: In pursuance of the regulations, the duly filled in, certified true, dated and undersigned declaration has to be delivered to the service which is mentioned on the present form at the latest on the 20th day of the month following the concerned quarter.
APPENDIX 1 TO THE QUATERLY DECLARATION WITHIN THE SYSTEM OF THE SUBSIDIARY TAX ON WASTE COLLECTION AND PROCESSING
Wastecode / name / eliminated
quantities / Rate on dumping in
«CET» (landfill site for
industrial waste) / Tax
Total to be inserted under B of the Déclaration in front of the concerned appendix / ………………
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APPENDIX 2 / TO THE QUATERLY DECLARATION WITHIN THE SYSTEM OF THE SUBSIDIARY TAX ON WASTE COLLECTION AND PROCESSING
Rem.: One appendix per collected wastecode
Waste code ...... – Name : ......
First destination : Name......
Street :………………………………. Nr : ......
PostCode :...... Place : ......
Country : ......
Company registration number or
V A T registration number:......
Total quantity of “exported” waste under this code: ………………………………… tons
Description of this waste’s route :1. WASTE CODE / 2. QUANTITIES / 3. PROCESSING CODE / 4. PAID RATE (outide the WR) / 5. RATE IN WR / 6. RATE DIFFERENCE / 7. TAX PER PROCESSING MODE
(2. x 6.)
Total to be inserted under C of the Declaration in front of the concerned appendix / ......
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