(To be filled up by the BIR

)

Annual Information Return
of Income Taxes Withheld on

Republika ng Pilipinas
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas

Compensation and Final Withholding Taxes

BIR Form No.

1604-CF
July 2008 (ENCS)

Fill in all applicable spaces. Mark all appropriate boxes with an “X”.
1 For the Year
2 Amended Return?
3 No of Sheets Attached
2013
(YYYY)
Yes
No
Part I
Background Information
4 TIN
5 RDO Code
6 Line of Business/
007
565
424
000
TRADING
039
Occupation
(Last Name, First Name, Middle Name for Individuals)/(Registered Name for Non-Individuals)
8 Telephone No.
7 Withholding Agent's Name

GLOBAL ECO-DRAGONS TRADING INC
9

411-5237

Registered Address

10 Zip Code

Unit 9 2nd floor DC Square Bldg # 54 Timog Avenue , Quezon city
If yes, specify
11 In case of overwithholding/overremittance after the year-end adjustment on compensation,
have you released the refund/s to your employee/s?
Yes
No
the date of refund
12 Total Amount of Overremittance on
13 Month of First Crediting of
14 Category of Withholding Agent
Tax Withheld under Compensation
Overremittance
Private
Government
Part II
S u m m a r y o f R e m i t t a n c e s
Schedule 1
R e m i t t a n c e p e r B I R F o r m
N o. 1601-C
NAME OF BANK/BANK CODE/
DATE OF
TOTAL AMOUNT
TAXES
WITHHELD
MONTH REMITTANCE
ADJUSTMENT
PENALTIES
ROR NO., IF ANY
REMITTED
JAN
02/11/13
EWBC
2,397.55
2,397.55
FEB
03/11/13
EWBC
2,371.00
2,371.00
MAR
04/10/13
EWBC
2,297.00
2,297.00
APR
05/10/13
EWBC
2,415.40
2,415.40
MAY
06/10/13
EWBC
2,209.14
2,209.14
JUN
07/09/13
EWBC
2,178.80
2,178.80
JUL
08/08/13
EWBC
2,227.23
2,227.23
AUG
09/10/13
EWBC
2,133.38
2,133.38
SEP
10/10/13
EWBC
1,631.27
1,631.27
OCT
11/11/13
EWBC
151.60
151.60
NOV
12/10/13
EWBC
159.94
159.94
DEC
01/09/14
EWBC
273.13
273.13
TOTAL
20,445.44
20,445.44
Schedule 2
MONTH

R e m i t t a n c e
NAME OF BANK/BANK CODE/

TAXES

REMITTANCE

ROR NO., IF ANY

WITHHELD

JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
TOTAL
Schedule 3
DATE OF
REMITTANCE

NAME OF BANK/BANK CODE/

DATE OF
QUARTER REMITTANCE
1ST QTR
2ND QTR
3RD QTR
4TH QTR
TOTAL

NAME OF BANK/BANK CODE/

MONTH
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
TOTAL
Schedule 4

p e r

DATE OF

ROR NO., IF ANY

ROR NO., IF ANY

B I R

F o r m

N o. 1601-F

PENALTIES

R e m i t t a n c e p e r
TAXES
WITHHELD

B I R

R e m i t t a n c e p e r
TAXES
WITHHELD

B I R

F o r m

PENALTIES

JUBAL L. AYO
President/Vice President/Principal Officer/Accredited Tax Agent/
Authorized Representative/Taxpayer
(Signature Over Printed Name)
ADMIN
Title/Position of Signatory
TIN of Signatory

Tax Agent Acc. No./Atty's Roll No.(if applicable)Date of Issuance

16

Date of Expiry

Treasurer/Assistant Treasurer
(Signature Over Printed Name)

Title/Position of Signatory
TIN of Signatory

TOTAL AMOUNT
REMITTED

N o. 1603

We declare, under the penalties of perjury, that this declaration 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.

15

REMITTED

N o. 1602

PENALTIES

F o r m

TOTAL AMOUNT

TOTAL AMOUNT
REMITTED

Stamp of Receiving Office and
Date of Receipt