PSOC:

PSIC: 7290

Guidelines and Instructions | Help

Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas

BIR Form No.

Payment Form

0605
September 2003(ENCS) 5 No. of Sheets Attached 6 ATC
2014 0 MC180

1 For the 2 Year

Ended (MM/YYYY)

Calendar

Fiscal

3 Quarter Clear Quarter

2014

4 Due Date
(MM/DD/YYYY) 01 31

12 - December

1st 2nd 3rd 4th 31 2014 8 Tax Ty pe Code RF

7 Return Period (MM/DD/YYYY) Part I 9 Taxpayer Identification No.

316 622 156 000

12

Ba ckground Informa tion 10 RDO Code

54B

11 Taxpayer Classification 12 Line of Business/Occupation

I N

13 Taxpayer's Name(Last Name, First Name, Middle Name for Individuals)/(Registered Name for Non-Individuals) 14 Telephone Number
MORALES, ELEAZER DELA PAZ 09179932633

15 Registered Address
46 SANTULAN - SANTULAN NAIC, CAVITE

16 Zip Code
4110

17 Manner of Payment
Voluntary Payment Self-Assessment Penalties Tax Deposit/Advance Payment Income Tax Second Installment(Individual) Others(Specify) Tax Accounts Receivable/Delinquent Account Preliminary/Final Assess/Deficiency Per Audit/Delinquent Account

18 Type of Payment

Installment No. of Installment Partial Payment Full Payment

Part II

Computation of Tax 19
Interest 0.00 20B 0.00 20C Compromise 0.00 500.00

19 Basic Tax/Deposit/Advance Payment 20 Add

Penalties Surcharge

20A

20D 21

0.00

21 Total Amount Payable(Sum of Items 19 & 20D)

For Voluntary Payment I declare, Under the penalties of perjury, that this document has been made in good faith, verified by me, and to the best of my know ledge and belief, is true and correct, pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof.

500.00

Payment of Deficiency Taxes From Audit/Investigation Delinquent Accounts

Pre-approved by Investigating Office Not approved by Investigating Office

Print

Validate

Edit

Subm it

[ BIR Main | eFPS Login | User Menu | Guidelines and Instructions | Help ]