For Retail / Manufacturing Industry

QUICKSILVER DRUG
MERCHANDISE
As of December 31, 2019

LOCATION (Note 1) INVENTORY

VALUATION UNIT PRICE QUANTITY IN STOCKS
PRODUCT / INVENTORY METHOD
ITEM DESCRIPTION
CODE ADDRESS CODE REMARKS
(Note 2) /CASE /PC /CASE
Note 1 a Include all goods whether taxpayer has title thereto or not, provided these goods are actually situated in location/address at the Head Office or Branch or Facilities (with o
the taxpayer). Facilities shall include but not limited to place of production, showroom, warehouse, storage place, leased property, etc. Include also goods out on consign
physically present are nonetheless owned by the taxpayer.

b Use the following codes:

CH Indicate the name of the consignor in the Remarks column
Goods on consignment held by the taxpayer
 Goods on consignment held by the taxpayer
P Indicate the name of related party/owner in the Remarks column
Parked goods or goods owned by related parties
O Goods owned by the taxpayer
CO Indicate the name of the entity in the Remarks column
Goods out on consignment held in the hands of
entity other than taxpayer

Note 2 Indicate Costing Method applied, e.g., Standard Costing, FIFO, Weighted Average, Specific Identification, etc.

We declare, under the penalties of perjury, that this schedule has been made in good faith, verified by us, and to the best of our knowlegde and belief, is true and corre
National Internal Revenue Code, as amended, and the regulations issued under authority thereof.

Name and Signature of Authorized

Representative
TIN : ______________
 ANNEX A
QUICKSILVER DRUG
MERCHANDISE
As of December 31, 2019

UNIT OF
QUANTITY IN STOCKS MEASUREMENT TOTAL
(In weight or volume) WEIGHT / TOTAL COST
e.g., kilos, grams, liters, VOLUME
/PC etc.)
 GRAND TOTAL -

actually situated in location/address at the Head Office or Branch or Facilities (with or without sales activity of
m, warehouse, storage place, leased property, etc. Include also goods out on consignment, though not

e name of the consignor in the Remarks column

e name of related party/owner in the Remarks column

e name of the entity in the Remarks column

ecific Identification, etc.

ood faith, verified by us, and to the best of our knowlegde and belief, is true and correct pursuant to the provisions of the
hereof.