Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698838152705.pdf (Saint Kitts and Nevis)
SAINT CHRISTOPHER AND NEVIS INLAND REVENUE DEPARTMENT OBJ-001 NOTICE OF OBJECTION Note: Where applicable, enter complete names, addresses, and assessment information.

Failure to complete all applicable sections can cause delays in the processing of your objection.

SECTION 1 - TAXPAYER IDENTIFICATION TAXPAYER NO.

: LAST NAME: MIDDLE NAMES: OR COMPANY NAME: MAILING ADDRESS: CITY / TOWN / VILLAGE: COUNTRY: SOCIAL SECURITY NO.
: FIRST NAME: STATE: CODE: HOME PHONE: WORK : MOBILE : E-MAIL ADDRESS: NATIONALITY: SECTION 2 - ASSESSMENT DETAILS Check the box relevent to the tax for which you are objecting.

TYPE OF TAX: INCOME TAX (CORPORATION) WITHHOLDING TAX UNINCORPORATED BUSINESS TAX INSURANCE REGISTRATION/PREMIUM FEES OTHER: Check the box indicating the nature of your dispute.

NATURE OF DISPUTE: INCOME TAX INTEREST OTHER: DEDUCTION PENALTY ASSESSMENT PERIOD: ASSESSMENT NO.
: AMOUNT IN DISPUTE: ASSESSMENT DATE: PAGE 1 OF 2 SECTION 3 - REASONS FOR OBJECTION MISCALCULATION ON ASSESSMENT CONTRIBUTION TO APPROVED PENSION FUND EXPENSES ARE BUSINESS RELATED GRATUITY ON TERMINATION OF CONTRACT AMOUNT NOT SUBJECT TO SOCIAL SECURITY COMPANY ON TAX HOLIDAY APPEAL OF COMPTROLLER DECISION OTHER DETAILED EXPLANATION: SECTION 4 - DECLARATION I declare that the information given on this form is to the best of my knowledge and belief true and correct and that I have the authority to disclose the information provided.
I understand that the Saint Christopher and Nevis Inland Revenue Department reserves the right to review and adjust or reassess the information provided for a period of up to six years and the vendor and/or purchaser and/or their representatives will be held responsible for (i) understating, overstating or omitting data and (ii) the payment of any fees fines and penalties associated with their actions, as defined under the Tax Administration and Procedures Act and The Perjury Act, which will affect any subsequent tax related assessment.
Please be aware that a person who makes a false declaration commits an offence under Section 5 of the Perjury Act, 2005 of the laws of Saint Christopher and Nevis and that person is liable to imprisonment for a term of seven (7) years or to a fine of thirty-thousand ($ 30,000.00) dollars.
SIGNATORY FULL NAME: TITLE IF INCORPORATED SIGNATURE OF PERSON OBJECTING OR REPRESENTATIVE / / DAY / MONTH / YEAR SECTION 5 - INLAND REVENUE DEPARTMENT USE ONLY DOCUMENT NO: DATE RECEIVED: / / DAY / MONTH / YEAR DATE REVIEWED: REVIEWED BY: / / DAY / MONTH / YEAR PAGE 2 OF 2