Republic of the Philippines SALES DECLARATION Quezon City AND EVALUATION FORM Pursuant to the provisions of Ordinance No. SP-91, series of 1993 as amended, otherwise known as the Quezon City Revenue Code, pertaining to the payment of business taxes and fees in relation to the renewal of business permits, | hereby declare the followit Name of taxpayer (owner/operator) ‘Trade/Business Name ‘Type of business 0 Corporation [) Partnership (1 Single Proprietorship || Cooperative SEC Reg. No. Business address (number/street/building/barangay/district) No. Street Building Name ___ Barangay istrict No. | AREA (in | mavorsmusivess GROSS SALES / RECEIPTS (in pesos) KIND OF BUSINESS PERMIT NO. 2016 2017 sq. meters) - ‘ORIGINAL DOCUMENTS TO BE PRESENTED IN THE FOLLOWING ORDER ‘SUMMARY OF SALES PER VAT/PERCENTAGETAX | FROM STEP 1 TO STEP 4. Please mark (v7) RETURN/QUARTERLY INCOMETAXRETURN | [2018 Community Tax Certificate issued in Quezon City and other LGUs, if 2017 AMOUNT applicable 1 Quaner 2017 Business Permit Fy =| 2 2017 Tax Bill and Official Receipt received from the City Treasurer's Office 2" Quarter 2017 Tax ill and Official Receipt in other local governments units Quarter (LGUs), if applicable |October 2017 Certified breakdown of sales, if there are two or more lines [November of businesses/two or more branches December. (1 2017 Value Added Tax Returns/ Percentage Tax Returns, whichever Is TroTAL applicable Thereby certify, under the penalties oF C2017 Quarterly Income Tax Returns, with proof of payment 2016 Annval Income Tax Returns with complete set of Audited Financial perjury, that the entries herein declared are true and correct to the best of my Statement, with proof of payment knowledge and belief as reflected in my —_1_BIR Certificate of Registration books of accounts Note: Taxpayer must present ALL applicable documents listed above to proceed to evaluation. No other documents may be required from the taxpayer other than those listed above. NAME AND SIGNATURE OF TAX PAVERT AUTHORIZED REPRESENTATIVE Portion to be filled up by Quezon City Government personnel TAX YEAR| NATURE OF BUSINESS ‘GROSS SALESRECEIPTS (p03) REMARKS/FINDINGS Evaluator’s full name Signature Date of evaluation QCG-CTO(BT)FI-V2