Documente Academic
Documente Profesional
Documente Cultură
PSIC:
2551M
September 2005 (ENCS)
Number of sheets attached
12
2012
(MM/YYYY)
Background
01
2012
Yes
No
Part I 6 9 TIN
Information
Occupation Taxpayer's Name (For Individual)Last Name, First Name, Middle Name/(For Non-individual) Registered Name
000
7 RDO Code
008
11 Registered Address
12
Zip Code
2600
13 Are you availing of tax relief under Special Law or International Tax Treaty? Yes Part II Taxable Transaction/ Industry Classification 14A 15A 16A 17A 18A 19 Total Tax Due 20 Less: Tax Credits/Payments 20A 20B 21 Creditable Percentage Tax Withheld Per BIR Form No. 2307 (See Schedule 1) Tax Paid in Return Previously Filed, if this is an Amended Return 14B 15B 16B 17B 18B ATC No If yes, specify Taxable Amount Tax Rate Tax Due
Computation of Tax
3%
0.00
20A 20B 21 22
22 Tax Payable (Overpayment) (Item 19 less Item 21) 23 Add: Penalties Surcharge 23A 23B
Interest 23C
Compromise 23D
0.00 0.00
24
If overpayment, mark one box only: To be Refunded To be issued a Tax Credit Certificate I declare, under the penalties of perjury, that this return has been made in good faith, verified by me, and to the best of my knowledge, 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. 25
0
President/Vice President/Principal Officer/Accredited Tax Agent/ Authorized Representative/Taxpayer (Signature Over Printed Name) PROP. Title/Position of Signatory TIN of Signatory Date of Issuance Date of Expiry
26
Treasurer/Assistant Treasurer (Signature Over Printed Name)
Stamp of YYYY
27D 28D 29C 30D
Agency
MM
DD
Amount
0.00
Receiving Office/AAB and Date of Receipt (RO's Signature/ Bank Teller's Initial)
Machine Validation/Revenue Official Receipt Details (If not filed with an Authorized Agent Bank)
2551M
September 2005 (ENCS)
2600
Tax Due
0.00
0.00 0.00
Stamp of Receiving Office/AAB and Date of Receipt (RO's Signature/ Bank Teller's Initial)