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, I hereby declare the following:
Name of taxpayer (owner/operator)
Trade/Business Name
Type of business  Corporation  Partnership  Single Proprietorship  Cooperative SEC Reg. No.
Business address (number/street/building/barangay/district) No.______ Street
Building Name __________________________________________ Barangay ____________________________District No.
AREA (in MAYOR’S/BUSINESS GROSS SALES / RECEIPTS (in pesos)
KIND OF BUSINESS PERMIT NO.
sq. meters) 2018 2019

ORIGINAL DOCUMENTS TO BE PRESENTED IN THE

FOLLOWING ORDER FROM STEP 1 TO STEP __.
Please mark (✓)
2019 Business Permit
2019 Tax Bill and Official Receipt received from the
City Treasurer's Office
2019 Certified breakdown of sales, if there are two or
more lines of businesses/two or more branches
2019 Value Added Tax Returns/ Percentage Tax Returns,
whichever is applicable
I hereby certify, under the penalties of perjury, that 2018 Annual Income Tax Returns with complete set of
the entries herein declared are true and correct to Audited Financial Statement, with proof of payment
the best of my knowledge and belief as reflected in
my 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 PAYER/
AUTHORIZED REPRESENTATIVE
Portion to be filled up by Quezon City Government personnel
TAX YEAR NATURE OF BUSINESS GROSS SALES/RECEIPTS (pesos) REMARKS/FINDINGS

Evaluator’s full name

Signature
Date of evaluation
QCG-CTO(BT)F1-V2