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Bir 1902 form 2008 2019 To be filled up by BIR DLN: Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas For Individuals Earning Purely Compensation Income, and Non-Resident Citizens / Resident Alien

Bir form 0605 Mark all appropriate boxes with an X For the Calendar Fiscal 3 Quarter Due Date MM / DD / YYYY 5 Year Ended 1st 2nd 3rd 4th BCS No./Item No. To be filled up by the BIR Tax Type Code Part I Background Taxpayer Identification No. Information 10 RDO Code 11 Taxpayer Classification I Taxpayer s ATC Attached MM / YYYY Return Period MM / DD / YYYY No. of Sheets 12 Line of Business/Occupation N 14 Telephone Number Name Last Name First Name Middle Name for Individuals / Registered Name for Non-Individuals 15 Registered Address 16 Zip Code 17 Manner of Payment Voluntary Payment Self-Assessment 18 Type of Payment Per Audit/Delinquent Account Installment Preliminary/Final Assessment/Deficiency Tax Tax Deposit/Advance Payment No. of Installment Accounts Receivable/Delinquent Account Penalties Partial Income Tax Second Installment Payment Individual Full Others Specify Computation of Tax Basic Tax / Deposit / Advance Payment Add Penalties Surcharge 20A 20B Interest Compromise 20C 20D Total Amount Payable Sum of Items 19 20D For Voluntary Payment For Payment of Deficiency Taxes Stamp of Receiving From Audit/Investigation/ I declare under the penalties of perjury that this document has been Office Deliquent Accounts and Date of Receipt APPROVED BY 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. 22B 22A Signature over Printed Name of Title/Position of Signatory Head of Office D e t a i l s of P a y m e n t Particulars Drawee Bank/Agency Number MM DD YYYY 23 Cash/Bank Amount Debit Memo 24A 24B 17C 24C 24D 25B 25C 26C 26D 24 Check 25A 25 Tax Debit Memo 26A 26B 19C 26 Others Machine Validation/Revenue Official Receipt Details If not filed with the bank N - Non-Individual BIR Form 0605 ENCS - PAGE 2 NATURE OF PAYMENT II 011 II 012 II 013 MC 180 MC 190 MC 090 MC010 MC020 MC 040 MC 050 MC 060 MC 031 MC 030 FP 010 - FP 930 MC 200 XA010-XA040 XA051-XA053 Pure Compensation Income Pure Business Income Mixed Compensation and Business Vat/Non-Vat Registration Fee Travel Tax Tin Card Fees Tax Amnesty Income from Forfeited Properties Proceeds from Sale of Rent Estate Energy Tax on Electric Power Consumption Deficiency Tax Fines and Penalties Excise Tax on Goods Alcohol Products Distilled Spirits Wines Fermented Liquor XT010 XT020 XT030 XT040 XT050-XT130 XT080 XT090 XT100 XT110 XT120 XP070 XP060 XP080 XP090 XP100 XP110 XP140 XP180 Tobacco Products XP120 Smoking and Chewing Tobacco XP130 XP131 Cigars XP170 Cigarettes Packed By Hand XP150 XP160 XP010 XP020 Tobacco Inspection Fees XP190 XP040 Cigarettes XP030 Leaf Tobacco Other Manufactured Tobacco Monitoring Fees XG020-XG090 Petroleum Products XG100-XG120 Premium Leaded Gasoline Premium Unleaded Gasoline XM010 Regular Gasoline XM020 Naptha Other Similar Products XM030 Aviation Gasoline XM040 Diesel Gas XM050 Bunker Fuel Oil XM051 TAX Code Description RF TR ET QP MC XV XS XF REGISTRATION FEE TRAVEL TAX-PTA ENERGY TAX QUALIFYING FEES-PAGCOR MISCELLANEOUS TAX EXCISE-AD VALOREM EXCISE-SPECIFIC TOBACCO INSPECTION AND MONITORING FEES INCOME TAX CAPITAL GAINS TAX - Real Property IT CG CS ES DN VT PT ST SO SL DS WB Avturbo Jet Fuel Kerosene Asphalts LPG Gas Basetocks Lubes and Greases Waxes and Petrolatum Processed Gas Miscellaneous Products/Articles Automobiles Non Essential Goods Mineral Products Coal Coke Non Metallic Quarry Resources Gold and Chromite Copper Other Metallic Minerals Indigenous Petroleum TYPE ESTATE TAX DONOR S TAX VALUE-ADDED TAX PERCENTAGE TAX DOCUMENTARY STAMP TAX WITHHOLDING TAX-BANKS AND OTHER FINANCIAL INSTITUTIONS WC WE WF WG WO WR WW GAINS TAX ON WINNING AND PRIZES BIR Form No. 0605 - Payment Form Guidelines and Instructions Who Shall Use Every taxpayer shall use this form in triplicate to pay taxes and fees which do not require the use of a tax return such as second installment payment for income tax deficiency tax delinquency tax registration fees penalties advance payments deposits installment payments etc. When and Where to File and Pay This form shall be accomplished Everytime a tax payment or penalty is due or an advance payment is to be made Upon receipt of a demand letter/assessment notice and/or collection letter from the BIR and Upon payment of annual registration fee for new business and for renewals on or before January 31 of every year. To be filled up the BIR DLN PSIC PSOC BIR Form No. Republika ng Pilipinas Kagawaran ng Pananalapi Payment Form Kawanihan ng Rentas Internas July 1999 ENCS Fill in all applicable spaces. One set of form shall be filled-up for each kind of tax and for each taxable period. Attachments Duly approved Tax Debit Memo if applicable Copy of letter or notice from the BIR for which this payment form is accomplished and the tax is paid whichever is applicable a. Pre-Assessment / Final Assessment Notice/Letter of Demand b. In places where there are no AABs this form shall be filed and the tax shall be paid directly with the Revenue Collection Officer or duly Authorized City Or Municipal Treasurer of the Revenue District Office where the taxpayer is required subject to excise tax/having taxable transactions who shall issue Revenue Official Receipt BIR Form No. 2524 therefor. Where the return is filed with an AAB the lower portion of the return must be properly machine-validated and stamped by the Authorized Agent Bank to serve as the receipt of payment.

1906 bir form To be filled up by the BIR DLN: Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas Application for Authority to Print Receipts and Invoices BIR Form No. 1906 January 2000

Bir form 1707 Mark all appropriate boxes with an X. Date of Transaction 2 Amended Return MM / DD / YYYY Yes Part I 5 TIN Seller Seller s Name 3 No. of Sheets Attached No 4 ATC Code Background Information 6 RDO 7 TIN Buyer 10 Buyer s Name Registered Address II IC 1 1 0 Individual Corporation 8 RDO 13 Zip Code Are you availing of tax relief under an International Tax Treaty or Special Law Description of Transaction Cash Sale Installment Sale Foreclosure Sale Details of Installment Sale 17A Selling Price/Fair Market Value If yes specify Others specify 17B Cost and Expenses 17C Mortgage Assumed 17D No. of installments 17E Amount of Installment for this Payment Period 17F Date of Collection of Installment for this Payment Period MM/DD/YYYY 17G Total Collection Downpayment and Installments during the Year of Sale PART II Compu tation of Tax Taxable Base - For Cash Sale/ Foreclosure Sale Schedule 1 Less Cost and Other Allowable Expenses Schedule 2 Tax Due on the Entire Transaction 5 on the first 100 000 10 over 100 000 Cash Sale/Foreclosure Sale or Tax Due for this Payment Period Less Tax Paid in Return Previously Filed if this is an Amended Return Tax Payable/ Overpayment Item 21 or 22 less Item 23 Add Penalties Surcharge Interest 25A 25B Compromise 25D 25C Total Amount Payable/ Overpayment Sum of Items 24 25D Schedule 1 Name of Corporate Stock Stock Certificate No. Selling Price or FMV whichever is higher No. of Shares 27 Total To Item 18 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. Particulars 30 Cash/Bank Debit Memo 31 Check 31A 32 Tax Debit Memo 33 Others 33A Taxpayer/Authorized Agent Signature over Printed Name D e t a i l s of P a y m e n t Drawee Bank/ Date Agency Number MM DD YYYY Title/Position of Signatory Amount 31B 31C 31D 32A 32B 32C 33B 33C 33D Machine Validation/Revenue Official Receipt Details If not filed with the bank Stamp of Receiving Office and Date of Receipt BIR FORM 1707 ENCS -PAGE 2 Schedule of Cost and Other Allowable Expenses BIR Form 1707 - Capital Gains Tax Return Guidelines and Instructions Who shall file This return shall be filed in triplicate by every natural or juridical person resident or non-resident for sale barter exchange or other onerous disposition of shares of stock in a domestic corporation classified as capital assets not traded through the local stock exchange. To be filled up by the BIR DLN BIR Form No* Capital Gains Tax Return Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas July 1999 For Onerous Transfer of Shares of Stock Not Traded Through the Local Stock Exchange ENCS Fill in all applicable spaces. barter exchange or other disposition of shares of stocks in a Not over P100 000 On any amount in excess of P100 000 The term Capital Asset shall mean property held by the taxpayer whether or not connected with his trade or business but does not include stock in trade of the taxpayer or other property of a kind which would properly be included in the inventory of the taxpayer if on hand at the close of the taxable year or property held primarily for sale to customers in the ordinary course of trade or business or property used in the trade or business of a character which is subject to the allowance for depreciation or real property used in trade or business.

Bir form 1904 To be filled up by BIR DLN: BIR Form No. 1904 Application for Registration Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas January 2000 ( ENCS ) For One-time Taxpayer and

Bir form 1903 1903 ENCS - PAGE 2 Tax Types choose only the tax types that are applicable to you FORM TYPE ATC Income Tax Value-added Tax Percentage Tax - Stocks Other Percentage Taxes Under the National Internal Revenue Code Specify Withholding Tax - Compensation subject to Capital Gains Tax Racetrack Operators Excise Tax - Ad Valorem Excise Tax - Specific Tobacco Inspection and Monitoring Fees Documentary Stamps Tax Capital Gains Tax - Real Property Donor s Tax Miscellaneous Tax Others Specify TYPE OF BOOKS TO BE REGISTERED VOLUME QNTY. FROM 21 DECLARATION I declare under the penalties of perjury that this application 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. NO. OF PAGES TO Stamp of BIR Receiving Office and Date of Receipt Attachments complete TAXPAYER/AUTHORIZED AGENT Signature over printed name TITLE/POSITION OF SIGNATORY Yes No ATTACHMENTS Photocopy only 1. Mark all appropriate boxes with an X. REGISTERING OFFICE Head Office DATE OF REGISTRATION Branch Office MM / DD YYYY TAXPAYER TYPE Partnership in General International Carrier General Professional Partnership Government Agency and Instrumentality GAI Offshore Banking Unit/ Foreign Joint Venture Insurance - mutual life Currency Deposit Unit OBU/ FCDU Domestic Corporation in General Non-profit Hospital Non-stock Non-profit Organization Resident Foreign Corporation in General Government Corporation Proprietary Educational Institutions Local Government Unit LGU TAXPAYER IDENTIFICATION NUMBER TIN For Non-Individual Taxpayer with existing TIN or applying for a branch TAXPAYER S NAME RDO CODE DATE OF INCORPORATION OR ORGANIZATION SEC Registered Name/ Agency/ LGU Charter Name 8 DESCRIPTION OF MAIN ACTIVITY Engaged in Business Not Engaged in Business NATIONALITY Domestic 10 PRIMARY/ SECONDARY INDUSTRIES Attach additional sheets if necessary Facility Type PSIC Industry Primary Trade/Business Name with no independent tax types Number of WH Facilities PP SP Line of Business Secondary 11 TAXABLE YEAR/ ACCOUNTING PERIOD Calendar Year Fiscal Year Starting Date of Fiscal Year 12 LOCAL ADDRESS No. Include Building Name Street District/Municipality 13 ZIP CODE Barangay/Subdivision City/Province 14 MUNICIPALITY CODE 15 TELEPHONE NUMBER 16 FOREIGN BUSINESS ADDRESS State PHONE NUMBER City Country Zip Code 17A 17B Country Code Area Code 18 CONTACT PERSON / ACCREDITED TAX AGENTS if different from taxpayer Last Name First Name Middle Initial if individual / Registered Name if non-individual Telephone Number FAX Number 19 TELEPHONE NUMBER BIR FORM NO. 1903 ENCS - PAGE 2 Tax Types choose only the tax types that are applicable to you FORM TYPE ATC Income Tax Value-added Tax Percentage Tax - Stocks Other Percentage Taxes Under the National Internal Revenue Code Specify Withholding Tax - Compensation subject to Capital Gains Tax Racetrack Operators Excise Tax - Ad Valorem Excise Tax - Specific Tobacco Inspection and Monitoring Fees Documentary Stamps Tax Capital Gains Tax - Real Property Donor s Tax Miscellaneous Tax Others Specify TYPE OF BOOKS TO BE REGISTERED VOLUME QNTY.

2008 bir form DLN To be filled-up by BIR BIR Form No. Certificate of Update of Exemption and of Employer s and Employee s Information Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas July 2008 ENCS Fill in all applicable spaces. Mark all appropriate boxes with an X. 1 Type of Filer Employee for update of Exemption and other employer s and employee s information Effective Date Self-employed for update of Exemption MM/ DD/ YYYY Taxpayer/Employee 4 RDO Code Part I 3 TIN Information Sex Male Female 6 Taxpayer s Name Last Name First Name Middle Name 6A Date of Birth 7 Residence Address 7A 7B Zip Code Business Address for Self-Employed 7C I declare under the penalties of perjury that this certificate 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 National Internal Revenue Code as amended and the regulations issued under authority thereof* Taxpayer/Authorized Agent Signature over Printed Name Personal Exemptions Civil Status Single Legally separated Widow/Widower Married with qualified dependent child/ren without qualified dependent child/ren Employment Status of Spouse Unemployed Employed Locally Employed Abroad Engaged in Business/Practice of Profession Claims for Additional Exemptions / Premium Deductions for husband and wife whose aggregate family income does not exceed P250 000. 00 per annum* Husband claims additional exemption and premium deductions Wife claims additional exemption and premium deductions Attach Waiver of the Husband Spouse Information Spouse Taxpayer Identification Number 12A Spouse Name if wife indicate maiden name 12B Last Name Spouse Employer s Taxpayer Identification Number First Name Middle Name 12C Additional Exemptions Names of Qualified Dependent Child/ren refers to a legitimate illegitimate or legally adopted child chiefly dependent upon living with the taxpayer not more than 21 years of age unmarried and not gainfully employed or regardless of age is incapable of selfsupport due to mental or physical defect. Mark if Mentally/ Physically Incapacitated 13A 13B 13C 13D 13E 14A 14B 14C 14D 14E 15A 15B 15C 15D 15E 16A 16B 16C 16D 16E For Employee With Two or More Employers Multiple Employments Within the Calendar Year Type of multiple employments Successive employments Concurrent employments If successive enter previous employer s if concurrent enter main employer Previous and Concurrent Employments During the Calendar Year Name of Employer/s Part V Employer Information If self-employed please do not accomplish this part Employer s Name For Non-Individuals Registered Address No* Include Building Name District/Municipality Date of Certification Street Subdivision City/Province 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* Title/Position of Signatory Employer/Authorized Agent Signature Barangay Stamp of Receiving Office and Date of Receipt.

Sample filled up bir form 2000 (To be filled up by the BIR) DLN: PSOC: Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas PSIC: Documentary Stamp Tax Declaration/Return BIR Form No. 2000-OT (ONE- TIME TRANSACTIONS)

Bir form 2551m sample To be filled up by the BIR DLN PSIC BIR Form No. Monthly Percentage Tax Return Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas 2551M April 2002 ENCS Fill in all applicable spaces. Mark all appropriate boxes with an X. For the Calendar Fiscal Year ended MM/YYYY 3 For the month Part I Amended Return Yes Background 5 Number of sheets attached No Information TIN 7 RDO Code Occupation Taxpayer s Name For Individual Last Name First Name Middle Name/ For Non-individual Registered Name 8 Line of Business/ 11 Registered Address 13 Are you availing of tax relief under Special Law or International Tax Treaty Telephone Number Zip Code If yes specify 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 Less Tax Credits/Payments 20A 20B Creditable Percentage Tax Withheld Per BIR Form No. 2307 See Schedule 1 Tax Paid in Return Previously Filed if this is an Amended Return Total Tax Credits/Payments Sum of Items 20A 20B 22 Tax Payable Overpayment Item 19 less Item 21 Add Penalties Surcharge 23A 23B Interest Compromise 23C 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. Signature over Printed Name of Taxpayer/ Title/Position of Signatory Taxpayer Authorized Representative TIN of Tax Agent if applicable Tax Agent Accreditation No. if applicable Details of Payment Drawee Bank/ Particulars Stamp of Date Agency Number MM DD 27 Cash/Bank Debit Memo Receiving Office YYYY Amount 28 Check 28A 28B 28C 28D 29 Tax Debit 29A 29B 29C 30B 30C 30D Memo 30 Others 30A Machine Validation/Revenue Official Receipt Details If not filed with the bank jbd and Date of Receipt BIR FORM 2551M ENCS -PAGE 2 Schedule 1 Tax Withheld Claimed as Tax Credit Period Covered Name of Withholding Agent Income Payments Applied Total To Item 20A PT 010 PT PT 101 PT 102 PT 103 Percentage Tax On ALPHANUMERIC TAX CODE ATC Persons exempt from VAT under Sec. 109z Sec. 116 Domestic carriers and keepers of garages Franchises on electric utilities gas and water utility Franchises on radio/TV broadcasting companies whose annual gross receipts do not exceed P 10 M Tax on banks and non-bank financial intermediaries 1 On interest commissions and discounts paid to banks and non-bank financial intermediaries arising out of lending activities as well as financial leasing on the basis of the remaining maturities of the instrument 2 On dividends 3 On royalties rentals of property real or personal profits from exchange and all other gross income PT 111 PT 112 PT 120 PT 130 PT 131 PT 132 PT 210 Tax on finance companies 1 On interest discounts and other items of gross income paid to finance companies and other financial intermediaries not performing quasi-banking functions transactions from finance companies as well as financial leasing based on the remaining maturities of the instruments Life Insurance premium Agents of Foreign Insurance Companies a Insurance Agents c Owners of property obtaining insurance directly with foreign insurance companies On services rendered by stock real estate commercial customs and immigration brokers BIR Form No. 2551M Percentage Tax Return Guidelines and Instructions Who Shall File This return shall be filed in triplicate by the following I.

Bir form 1701 63C/D/E/F/G/H Regular Allowable Itemized incurred during the taxable year. This is the total amount reflected in the Mandatory Attachment to BIR Form No. 1701. BIR FORM 1701 PRIMER ANNUAL INCOME TAX RETURN FOR SELF-EMPLOYED/PROFESSIONALS ESTATES AND TRUSTS INCLUDING THOSE WITH BOTH BUSINESS AND COMPENSATION INCOME Individuals who are engaged in trade or business or the practice of profession including those mixed income earners i.e. those engaged in the trade/business or profession who are also earning compensation income are required to file an annual income tax in accordance with Sec. 51 of the Code as amended. The annual income tax return summarizes all the transactions covering the calendar year of the taxpayer. This Form is to be accomplished by the taxpayer in three 3 copies. The first two 2 copies upon filing will be submitted to BIR for its File and Encoding Copies while the third copy is retained by the taxpayer for his/her/its File Copy. This Form is required to be filed whether or not resulting in taxable income or loss or no operations/transactions. The following are the general instructions in accomplishing this Form 1 All applicable spaces must be filled in 2 All information required by the Form must be written in capital fonts CAPITAL LETTERS 3 Mark with an X all applicable circles. A Contents and Instruction/Description of the Fields of Information/Data Required by the Form* Item No* Information/Data Description Part 1 Background Information For the year YYYY Indicate the taxable year covered by the return* Individual taxpayers are always on a calendar year basis i*e* 2012. Amended Return O Yes O No Mark the applicable circle with an X. This item shall indicate whether or not the tax return being accomplished and filed for the year is a correction or an amendment to a previously filed income tax return covering the same year. Joint Filing joint return of both their income. If no spouse mark the No circle with an X. TAXPAYER S BACKGROUND INFORMATION Taxpayer Identification Number Fill in the Taxpayer Identification Number TIN TIN issued to the taxpayer evidencing his/her/its registration with the Bureau. The TIN comprises of a nine to thirteen 9 to 13 digit numeric code where the first nine 9 digits is the TIN proper and the last four 4 digits is the branch code. The branch code shall always be 0000. RDO Code Indicate the Revenue District Office Code comprising of three 3 digits numeric or alphanumeric code where the taxpayer s head Page 1 of 22 office is registered* For example 001 for Laoag City 43A for East Pasig. Taxpayer s Name Last Name First Name Middle Name Write the name of the individual taxpayer beginning with the surname/last name followed by the first name and lastly the middle name. Registered Address Write the registered address of the principal place Unit/Room Number/Floor of business of the taxpayer. All applicable spaces Building Name must be filled in* Lot/Block/Phase/House/Building Number Street Name Subdivision/Village Barangay Municipality/City Province Zip Code Date of Birth MM/DD/YYYY Write the taxpayer s date of birth indicating the month day and year.

Bir 2316 form For the calendar year that taxes have been correctly withheld by my employer tax due equals tax withheld that the BIR Form No. 1604CF filed by my employer to the BIR shall constitute as my income tax return and that BIR Form No. 2316 shall serve the same purpose as if BIR Form No. 1700 had been filed pursuant to the provisions of RR No. 3-2002 as amended.. DLN Certificate of Compensation Payment/Tax Withheld Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas July 2008 ENCS For Compensation Payment With or Without Tax Withheld Fill in all applicable spaces. Mark all appropriate boxes with an X BIR Form No* For the Year YYYY Part I Employee Information 3 Taxpayer Identification No* 4 Employee s Name Last Name First Name Middle Name For the Period From MM/DD To MM/DD Details of Compensation Income and Tax Withheld from Present Employer Part IV-B Amount A. NON-TAXABLE/EXEMPT COMPENSATION INCOME 5 RDO Code 32 Basic Salary/ Statutory Minimum Wage 6 Registered Address 6A Zip Code 6B Local Home Address Minimum Wage Earner MWE 33 Holiday Pay MWE 34 Overtime Pay MWE 7 Date of Birth MM/DD/YYYY 8 Telephone Number 9 Exemption Status Single 35 Night Shift Differential MWE 36 Hazard Pay MWE 38 De Minimis Benefits 39 SSS GSIS PHIC Pag-ibig Contributions Union Dues 37 13th Month Pay and Other Benefits 6D Foreign Address Married 9A Is the wife claiming the additional exemption for qualified dependent children Yes 10 Name of Qualified Dependent Children No Employee share only 40 Salaries Other Forms of withholding tax and not subject to income tax 16 Employer s Name 41 Total Non-Taxable/Exempt Compensation Income B. TAXABLE COMPENSATION INCOME REGULAR 43 Representation 44 Transportation 45 Cost of Living Allowance 46 Fixed Housing Allowance 47 Others Specify 47A 47B SUPPLEMENTARY 48 Commission 49 Profit Sharing 50 Fees Including Director s Fees 51 Taxable 13th Month Pay 52 Hazard Pay Main Employer Secondary Employer 21 Gross Compensation Income from Summary Present Employer Item 41 plus Item 55 22 Less Total Non-Taxable/ Exempt Item 41 23 Taxable Compensation Income from Present Employer Item 55 24 Add Taxable Compensation Income from Previous Employer 25 Gross Taxable 26 Less Total Exemptions 27 Less Premium Paid on Health and/or Hospital Insurance If applicable 28 Net Taxable 29 Tax Due 30 Amount of Taxes Withheld 30A Present Employer 30A 30B Previous Employer 30B 54A 54B 31 Total Amount of Taxes Withheld As adjusted 55 Total Taxable Compensation Income We declare under the penalties of perjury that this certificate has been made in good faith verified by us and to the best of our 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* Date Signed CONFORME CTC No* of Employee Employee Signature Over Printed Name Place of Issue Amount Paid Date of Issue To be accomplished under substituted filing under BIR Form No* 1604CF which has been filed with the Bureau of Internal Revenue.

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