REPUBLIC OF THE PHILIPPINES) cry) ss, ‘SWORN DECLARATION AND WAIVER FOR NON-SUBMISSION OF THE. REQUIRED BIR FORM 2316 FOR EMPLOYEES WITH SUCCESSIVE OR. ‘CONCURRENT EMPLOYMENT WITHIN THE CALENDAR YEAR In accordance wit the provisions of Section 2.83.1 of Revenue Regulation No, 2-98 of the Notional Internal Revenue Cod, I — heteby voluntarily depose and sy: L 2 ‘That Ihave suocesive or concurrent employment within the calendar yea, ‘That my previous employee(s ivare vith TN ‘ad with ofies Toeaed'at ‘where [vas eployed fom. 7. ‘That REALPAGE PHILIPPINES Tas required me to secure a copy ofthe sid ‘orm in compliance with te above regultion; ‘That my previous employee(s) mentioned sbove (lle to provide me withthe ‘needed BIR Form No 2316, even afer thirty days (30) after the termination of my employment with them; ‘That even with my persistent request, my previous employers) cannot provide sme with BIR Form No, 2316; ‘That in any case that REALPAGE PHILIPPINES will nt be ale to compute for my correct taxes, L will shoulder the corresponding penalties surcharges and Inerests as may be imposed by the Bureau of Intemal Revenue; ‘That his waiver shal be effective bepaning with my employment with .REALPAGE PHILIPPINES ‘Thereby declare under penalties of perjury thatthe foregoing representations are tue and ‘correct and that this waiver is voluntarily and knawingly made in accordance withthe provisions ofthe National intemal Revenue Code, as amended. Signed this a ‘Signature over Ped Name of EnployeeTaepayer SUBSCRIBED AND SWORN to before me this fant ho is personally known to me exhibiting to me his/her ID" No. Tiued at JT on] Doe. No. __5 Page No.. Book No, Series of 013,