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0605 Page 1 of 1
BIR Form No.
Republika ng Pilipinas
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas
Payment Form 0605
September 2003(ENCS)
i Calendar m
1 For the n
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m n Fiscal
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l 3 Quarter 4 Due Date (MM/DD/YYYY) 5 No. of Sheets Attached 6 ATC
2 Year Ended (MM/YYYY) j 1st
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n j 2nd
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n j 3rd
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n j 4th
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n 01 31 2021 0 MC180
12 - December 2021
Tax
7 Return Period (MM / DD / YYYY) 12 31 2021 8 Type
RF
Part I B a c k g r o u n d I n f o r m a t i o n
9 Taxpayer Identification No. 10 RDO Code 11 Taxpayer Classification 12 Line of Business/Occupation
n Others(Specify)
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ANNUAL REGISTRATION FEE
Part II C o m p u t a t i o n o f T a x
19 Basic Tax/Deposit/Advance Payment 19 500.00
20 Add: Penalties
Surcharge Interest Compromise
20A 0.00 20B 0.00 20C 0.00 20D 0.00
n Pre-approved by Investigating Office
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m n Not approved by Investigating Office
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For Payment of Deficiency Taxes
For Voluntary Payment Stamp of Receiving
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Office
From Audit/Investigation/
and Date of Receipt
Deliquent Account
I declare, under the penalties of perjury, that this document 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 National
APPROVED BY:
Internal Revenue Code, as amended, and the regulations issued under
authority thereof.
22B____________________
22A__________________________________________ ________________ Signature Over Printed Name of
Signature over Printed Name of Taxpayer/Authorized Representative Title/Position of Signatory Head of Office
Machine Validation/Revenue Official Receipt Details (If not filed with the bank)
Taxpayer Classification: I - Individual N - Non-Individual
file://C:\Users\Glorie\AppData\Local\Temp\{0C5F8753-EEDC-4B09-A276-412C1BE322... 1/10/2021