BIR Form No.

2316 – Certificate of Compensation Payment / Tax Withheld from Previous Employer

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Employee Name: __Ariel P. Grajera______ ID No:___ 69060_______________
Start Date :____June 27, 2022______________ TIN No:_771-348-598___________

PLEASE SELECT THE APPROPRIATE BOX:

□ 1. I have no other employer this year, prior to joining Stefanini Philippines, Inc.

□ 2. I resigned from Stefanini Philippines, Inc. this year and was rehired.

□ 3.I have an employer prior to joining Stefanini Philippines, Inc. this year.

□ 4. My previous employer has not issued a copy of my BIR Form 2316. I understand that I will take full responsibility in
i: Consolidating my income and tax for the year.
Ii: Settling my tax payables / deficits directly with BIR.

I, _____________________Ariel P. Grajera________, Filipino, of legal age, and currently an employee of Stefanini

Philippines Inc. with address at 3rd, 5th, 6th floors iMet BPO Building, Metrobank Avenue, Metropolitan Park, Pasay City,
hereby declare and state as follows:

I hereby agree to the following terms and conditions:

1. I understand that it is my obligation to submit my 2022’s BIR Form 2316 from previous employer as part of my
pre-employment requirements.
2. I am aware that my deadline of submission of 2022’s BIR Form 2316 from previous employer is 30 days after my
hiring date in line with the preparation for the year-end tax computation.
3. I acknowledge that my failure to submit BIR Form 2316 to Stefanini Philippines Inc. will not allow Stefanini
Philippines Inc. to properly and correctly annualize the tax computation of my total compensation income for
this year and hence, Stefanini Philippines Inc. will base its tax computation of my compensation for the year
ended 2022 solely on the earning I received from Stefanini Philippines Inc.
4. In view of the foregoing, I hereby assume full responsibility for any tax excess or deficit that may arise from the
computation of my total annual taxable compensation and tax due as a result of or in connection with my failure
to submit the required BIR Form 2316 to Stefanini Philippines Inc. and I hereby waive any claim or responsibility
of Stefanini Philippines Inc. and agree to hold Stefanini Philippines Inc. free and harmless from and for any
responsibility arising from the foregoing circumstances.

Executed this ___31st ____________ day of _____October______________ 2022 at Pasay City,

Philippines.

____Ariel P. Grajera________
Signature over printed name
Signed in the presence of:
N/A N/A
_______________________________ ______________________________