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Part II Details of Income Payment and Tax Withheld (Attach additional sheet if necessary)
Nature of Income Payment ATC Amount of Payment Tax Withheld
5% WV020 400.00 17.86
FE M. PILAPIL Principal I
Payor/Payor's Authorized Representative/Accredited Tax Agent TIN of Signatory Title/Position of Signatory Date Signed
Signature Over Printed Name
Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry
CONFORME:
Payee/Payee's Authorized Representative/Accredited Tax Agent TIN of Signatory Title/Position of Signatory Date Signed
Signature Over Printed Name
Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry
To be accomplished for Value-Added Tax/Percentage Tax Withholding (substituted filing)
I declare, under the penalties of perjury, that the information I declare under the penalties of perjury that I am qualified under substituted filing of Percentage
herein stated are reported under BIR Form No. 1600 which Tax/Value Added Tax Returns (BIR Form 2551M/2550M/Q), since I have only one payor from
have been filed with the Bureau of Internal Revenue. whom I earn my income; that, in accordance with RR 14-2003, I have availed of the Optional
Registration under the 3% Final Percentage Tax Wthholding/10% Final VAT Withholding in lieu
of the 3% Percentage Tax/10% VAT in order to be entitled to the privileges accorded by the
Substituted Percentage Tax Return/Substituted VAT Return System prescribed in the aforesaid
Payor/Payor's Authorized Representative/Accredited Tax Agent Regulations; that, this Declaration is sufficient authority of the withholding agent to withhold 3%
Signature Over Printed Name Final Percentage Tax/10% Final VAT from my sale of goods and/or services.
TIN of Signatory Title/Position of Signatory Payee/Payee's Authorized Representative/Accredited Tax Agent Title/Position of Signatory
Signature Over Printed Name
Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Tax Agent Accreditation No./Attorney's Roll No. (if applicable) TIN of Signatory
W I 320
0
1098 364
1975
1708
11549
SOUTH COTABATO I ELECTRIC COOPERATIVE, INC.
SOCOTECO II
=
13491.29
382.14
389.5
357.14
17.86
3400.62
ue and
centage
BIR Form No.
Republika ng Pilipinas Certificate of Creditable
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas
Tax Withheld At Source 2307
September 2005 (ENCS)
3 Payee's Name
(Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals)
4 Registered Address 4A Zip Code
105 OSEMEÑA ST., ZONE 1, KORONADAL CITY 9506
5 Foreign Address . 5A Zip Code
Payor Information
6 Taxpayer
000 8 6 3 9 5 8 8 6 5
Identification Number
DepEd, Division of South Cotabato
7 Payor's Name
(Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals)
8 Registered Address KORONADAL CITY 8A Zip Code
9 5 0
6
PART II Details of Monthly Income Payments and Tax Withheld for the Quarter
Income Payments Subject to AMOUNT OF INCOME PAYMENTS
ATC
Expanded Withholding Tax 1st Month of 2nd Month of 3rd Month of Total Tax Withheld
the Quarter the Quarter the Quarter For the Quarter
2% WV640 7,050.00 125.89
Total 125.89
We 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 provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof.
FE M. PILAPIL Principal I
Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry
Conforme:
Payee/Payee's Authorized Representative/Accredited Tax Agent TIN of Signatory Title/Position of Signatory Date Signed
(Signature Over Printed Name)
Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry
CS)
3250
1249.04
4021.36 1249.04
9999 1259.04
. 999
4756.12
.89 5830
1293784
6,294.64
125.89
143.75
.89
1295
1156.25
138.75
.89