Quarterly Percentage Tax Return

Quarterly Percentage Tax Return

(To be filled up by the BIR) DLN: PSIC:

Fill in all applicable spaces. Mark all appropriate boxes with an “X”.

1 For the Calendar Fiscal   3 Quarter 1st 2nd 3rd 4th   4 Amended Return Yes No   5 Number of sheets attached

2 Year Ended (MM / YYYY) /

Part I - Background Information

6 TIN   7 RDO Code   8 Line of Business/Occupation

9 Taxpayer's Name   10 Telephone Number

11 Registered Address   12 Zip Code

13 Are you availing of tax relief under Special Law or International Tax Treaty? Yes No   If yes, specify

Part II - Computation of Tax

Taxable Transaction / Industry Classification, ATC, Taxable Amount, Tax Rate, Tax Due

14A 14B 14C 14D 14E

15A 15B 15C 15D 15E

16A 16B 16C 16D 16E

17A 17B 17C 17D 17E

18A 18B 18C 18D 18E

19 Total Tax Due

20 Less: Tax Credits/Payments

20A Creditable Percentage Tax Withheld Per BIR Form No. 2307

20B Tax Paid in Return Previously Filed, if this is an Amended Return

21 Total Tax Credits/Payments (Sum of Items 20A & 20B)

22 Tax Payable (Overpayment) (Item 19 less Item 21)

23 Add: Penalties

23A Surcharge 23B Interest 23C Compromise 23D

24 Total Amount Payable/(Overpayment) (Sum of Items 22 and 23D)

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.

Part III - Details of Payment

Machine Validation/Revenue Official Receipt Details (If not filed with the bank)

BIR Form No. 2551Q - Guidelines and Instructions

Who Shall File

This return shall be filed in triplicate by the following:

1. Franchise grantees sending overseas dispatch, messages or conversations from the Philippines, except on services involving the following:

a) Government of the Philippines - for messages transmitted by the Government of the Republic of the Philippines or any of its political subdivisions and instrumentalities;

b) Diplomatic services - for messages transmitted by any embassy and consular offices of a foreign government;

c) International organizations - for messages transmitted by a public international organization or any of its agencies based in the Philippines enjoying privileges and immunities pursuant to an international agreement; and

d) News Services - for messages from any newspaper, press association, radio or television newspaper, broadcasting agency, or newsticker services to any other newspaper, press association, radio or television newspaper broadcasting agency or newsticker services or to bonafide correspondents.

2. Proprietors, lessees or operators of cockpits, cabarets, night or day clubs, boxing exhibitions, professional basketball games, jai-alai and racetracks.

When and Where to File

The return shall be filed within twenty (20) days after the end of each quarter...

When and Where to Pay

Upon filing this return, the total amount payable shall be paid to the Authorized Agent Bank (AAB) where the return is filed...

Basis of Tax

For the purpose of the amusement tax, the term “gross receipts” embraces all the receipts of the proprietor, lessee or operator of the amusement place.

Penalties

There shall be imposed and collected as part of the tax: surcharge, interest, and compromise penalty.

Attachments Required

1. Certificate of Creditable Tax Withheld at Source, if applicable;

2. Duly approved Tax Debit Memo, if applicable;

3. Copy of Certificate of Registration issued by Cooperative Development Authority for cooperatives and from the National Electrification Administration for electric cooperatives;

4. For amended return, proof of the payment and the return previously filed.