Fill in all applicable spaces. Mark all appropriate boxes with an X. 1 For the Year 2 Amended Return? 3 No. of sheets attached ( YYYY ) Yes No Part I B a c k g r o u n d I n f o r m a t i o n Taxpayer/Filer Spouse 4 Taxpayer Identification Number (T I N) 5 RDO Code 6 Taxpayer Identification Number (T I N) 7 RDO Code 8 Taxpayer's Name (Last Name, First Name, Middle Name) 9 Spouse's Name (Last Name, First Name, Middle Name) (if applicable) 10 Philippine Home Address 11 Philippine Home Address 12 Foreign Address 13 Foreign Address 14 Date of Birth 15 Zip Code 16 Line of Business/ 17 Date of Birth 18 Zip Code 19 Line of Business/ (MM/DD/YYYY) Occupation (MM/DD/YYYY) Occupation 20 Telephone Number 21 Status of Filer 21A Number of Qualified Dependent Children Single Head of the Family Married Part II Declaration of Income Amount of Gross Income Conversion Amount in US Dollars Nature of Income Country in the Currency of Rate to Source - Country US Dollar 22 Compensation (Name and Address of Employer) 23 Exercise of Profession 24 Business 25 Other Income 26 Total Gross Income in US $ 27 Less: Foreign National Income Taxes Paid in US $ 28 Net Income in US $ 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. 29 Taxpayer/Authorized Agent Signature over Printed Name BIR Form No. Annual Income Information Return 1703 July, 1999 ( ENCS ) For Non-Resident Citizens/OCWs and Seamen (For Foreign - Sourced Income) Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas Taxpayer/Filer Spouse Guidelines and Instructions BIR Form No. 1703 - Annual Income Information Return Who Shall File This information return shall be filed in triplicate by Non-resident Citizens and Overseas Contract Workers (OCWs), including qualified Filipino seamen, on income derived from sources abroad. The term "Non-resident Citizen" means: 1. A citizen of the Philippines who establishes to the satisfaction of the Commissioner the fact of his physical presence abroad with a definite intention to reside therein. 2. A citizen of the Philippines who leaves the Philippines during the taxable year to reside abroad, either as an immigrant or for employment on a permanent basis. 3. A citizen of the Philippines who works and derives income from abroad and whose employment thereat requires him to be physically present abroad most of the time during the taxable year. 4. A citizen who has been previously considered as non-resident citizen and who arrives in the Philippines at any time during the taxable year to reside permanently in the Philippines shall likewise be treated as a non-resident citizen for the taxable year in which he arrives in the Philippines with respect to his income derived from sources abroad until the date of his arrival in the Philippines. An individual citizen of the Philippines who is working and deriving income from abroad as an overseas contract worker is taxable only on income from sources within the Philippines; Provided, that a seaman who is a citizen of the Philippines and who receives compensation for services rendered abroad as a member of the complement of a vessel engaged exclusively in international trade shall be treated as an overseas contract worker. When and Where to File The income information return must be filed not later than April 15 of the year following the taxable year in which the income was earned to the Foreign Post or the Revenue District Office which has jurisdiction over the place of residence of the taxpayer. Non-resident citizens with foreign addresses or those who have no legal addresses in the Philippines may opt to file or mail from abroad the information returns directly to Revenue District Office No. 51, Pasay City. Penalties There shall be imposed and collected a penalty for failure to file the information return on time, a fine of not more than One Thousand Pesos (P1,000) or suffer imprisonment of not more than six (6) months, or both, upon conviction for each act or omission. In lieu of criminal prosecution, a compromise penalty following the BIR's prescribed Schedule of Compromise Penalties maybe imposed subject to acceptance by the taxpayer. Attachments Required 1. Employer's Declaration of Income Earned 2. Financial Statements, if applicable 3. Proof to show the intention of leaving the Philippines to reside permanently abroad or to return to and reside in the Philippines, ex. Employment Contract, Passport, etc. Note: All background information must be properly filled up. Box No. 1 refers to transaction period and not the date of filing this return. The last 3 digits of the 12-digit TIN refers to the branch code. ENCS