Annex "C"

SWORN DECLARATION

REPUBLIC OF THE PHILIPPINES

PROVINCE OF QUEZON
UNICIPALITY OF TAGKAWAYAN

I, FREDA R. ELEAZAR, Filipino, of legal age designated as Senior Bookkeeper of Tagkawayan

National
High School, with business address located at Brgy. Munting Paran& Tagkawayan, Quezon do
hereby
certify the following g:
That in compliance With the requirements Of Revenue Regulations NO.
submitted
herewith is/are I piece of DVD-Rs containing 50 copies of scanned BIR form 2m/2316
covering the period 12/31/Ä)18.
That the contents Of the DVD-Rs being submitted herewith conform to the
conditions/specification requirements by the Bureau Of Internal Revenue.
That the soft copies ofthe BIR Form contained in the DVD-R/s being submitted
herewith are the complete and exact copies Of the original thereof.
1 HEREBY DECLARE UNDER THE PENALTIES OF PERJURY THAT THE FOREGOING
ATTESTATION ARE TRUE AND CORRECT.
FREDA R. ELEAZAR
Name and Signature of Authorized
Representative
TIN: 93-98H83.a:x)
SUBSCRIBED and sworn to before me, in the City/MunicipaIity of Tagkawayan, this day of
by
issued at
with Residence Certificate
of
No.
Notary P ublic
DOC. NO.
Page NO.
Book No.
Series of