ANNEX B

(As Amended by Circular No. 742 dated 21 November 2011)

Deadline: Five (5) banking days from the end of reference month when FX sale was made

Submission: International Operations Department, Bangko Sentral ng Pilipinas

_______________________________________________
Name of Bank

Monthly Report on Sale/Remittance of Foreign Exchange (FX )

for Advance Payment of Importations
For the Month of ______________________

Commodity Imported Shipment Value FX Sold/Remitted Name and address of selling entity
Name of Importer Name and Address of Foreign Supplier in Payment if the reporting/remitting bank is
Currency Date Amount USD Equivalent not the selling entity
Description Quantity (MM/DD/YYYY) (in original currency)

I certify that the above information are true and correct:

Signature Over Printed Name of Authorized Officer

Position: ______________________________
Tel. No._______________________________
Date: ________________________________