About the document
- Who files:
- A certifier (ผู้รับรอง) — a relative of the incapacitated person, the กำนัน, ผู้ใหญ่บ้าน or a local council member — in favour of the taxpayer
- Where to submit:
- Attached with the doctor's certificate and ล.ย.04 to the ภ.ง.ด.90/91 return
- Authority:
- Thai Revenue Department (กรมสรรพากร)
- Country:
- Thailand
- Category:
- Personal income tax
- How to fill:
- Cards with hints → original form → PDF
- Price:
- Free
- Last updated:
- Official source:
- https://www.rd.go.th/67335.html
What this document is
ล.ย.04-1 is a Thai Revenue Department (กรมสรรพากร) certificate in which a certifier (ผู้รับรอง) confirms that the taxpayer supports an incapacitated person (คนทุพพลภาพ). The form is 1 page.
Without it, the 60,000 baht allowance for an incapacitated person in section 1.2 of ล.ย.04 is not granted. It is attached, together with the doctor's certificate and ล.ย.04, to the ภ.ง.ด.90 or ภ.ง.ด.91 return.
Who signs it and why
- the certifier may be the incapacitated person's spouse, legitimate or adopted child or grandchild (หลาน), father or mother, full sibling, half sibling (same father or same mother), grandparent, uncle or aunt;
- or the kamnan (กำนัน), the village head (ผู้ใหญ่บ้าน) or a member of the local administrative organisation where the incapacitated person lives;
- the certifier must be of legal age (บรรลุนิติภาวะ) and may certify only one taxpayer for any one incapacitated person;
- the certifier signs in the presence of two witnesses; a certificate is needed for each tax year of the claim.
Conditions for the allowance
- a licensed physician certifies that the person has been unable to perform normal daily activities for at least 180 days, or has been incapacitated for at least 180 days; the doctor's certificate is issued in the tax year of the claim;
- the incapacitated person's income in the tax year is no more than 30,000 baht (exempt income under section 42 of the Revenue Code is not counted), and they have a Thai 13-digit ID number;
- the allowance is 60,000 baht per person for the full tax year; if several taxpayers hold doctor's certificates, they agree in writing who claims;
- a non-resident taxpayer may claim only persons residing in Thailand.
What to have at hand
- the certifier's ID card: number, issuing office and expiry date; their address (house no., moo, soi, road, tambon, amphoe, province);
- the certifier's date of birth — FoxDocs works out the age;
- the names of the taxpayer and the incapacitated person, the tax year, and how they are related;
- the doctor's certificate and two witnesses for the signing.
How to fill it in with FoxDocs
- Answer the chat questions: details of the certifier, the taxpayer and the incapacitated person, the year and the relationships.
- FoxDocs computes the certifier's age, places the ID digits in the boxes, ticks the relationship and prints the names under the signature lines.
- Download the PDF: the certifier signs by hand in front of two witnesses.
Source
Official Revenue Department forms page for 2568: rd.go.th — personal income tax forms 2568 (item «ลย.04-1»); the 2569 forms page rd.go.th/68191.html links the same file. Conditions per the 2568 ภ.ง.ด.90 instructions, item «อุปการะเลี้ยงดูคนพิการหรือคนทุพพลภาพ». Checked 2026-10-15. This is not tax advice.