Professional Documents
Culture Documents
2 all appropriate
Fill in all applicable spaces. Mark 0 2 2boxes with an "X". 0 1 0 1 1 2 3 1
1 For the Year 2 For the Period
(YYYY) From (MM/DD) To (MM/DD)
7 0 2 Part 3 I3- Employee
4 0 6Information
4 0 0 0 0 0 Part IV-B Details of Compensation Income & Tax Withheld from Present Employer
3 TIN
- - - A.NON-TAXABLE/EXEMPT COMPENSATION INCOME Amount
4BERBANO, JAIMEL
Employee's Name (Last Name,PATRICK GONZALES
First Name, Middle Name) 50 4 Code
RDO 3
29 Basic Salary (including the exempt P250,000 & below) or
the Statutory Minimum Wage of the MWE
6119 CATLEY
Registered A BLDG, MANGGAHAN, PASIG CITY
Address 6A1ZIP
6Code
11 30 Holiday Pay (MWE)
0 6 24 1 9 9 7
7 Date of Birth (MM/DD/YYYY) 8 Contact Number 34 13th Month Pay and Other Benefits 28,252.38
(maximum of P90,000)
35 De Minimis Benefits
0.00
9 Statutory Minimum Wage rate per day
36 SSS, GSIS, PHIC & PAG-IBIG Contributions 15,912.50
and Union Dues (Employee share only)
10 Statutory Minimum Wage rate per month
37 Salaries and Other Forms of Compensation
11 Minimum Wage Earner (MWE) whose compensation is exempt from 44,164.88
withholding tax and not subject to income tax 38 Total Non-Taxable/Exempt Compensation
7 0 2Part II3- Employer
3 4 Information
0 6 4 (Present)
0 0 0 0 0
Income (Sum of Items 29 to 37)
12 TIN
- - - B.TAXABLE COMPENSATION INCOME REGULAR
TNI RESTAURANT 309,028.52
13 Employer's Name
39 Basic Salary
Tapsihan Ng Iniwan, 918 C. Castaneda St., Namayan, Manda 1 5 5 0 0.00
14 Registered Address 14A ZIP Code
X 40 Representation
0.00
41 Transportation
15 Type of Employer 0.00
3 1 5 6Main
8 Employer
6 4 5 0 Secondary Employer
0 0 0 0 0 42 Cost of Living Allowance (COLA)
Part III - Employer Information (Previous) 0.00
16 TIN
STEPHEN JAY D.- ILLUSTRISIMO
- - 43 Fixed Housing Allowance
I/We declare, under the penalties of perjury that this certificate has been made in good faith, verified by me/us, and to the best of my/our knowledge and belief, is true and correct, pursuant to the provisions of
CATHERINE MALOLOT 03 08 2 0 2 3
the National Internal Revenue Code, as amended, and the regulations issued under authority thereof. Further, I/we give my/our consent to the processing of my/our information as contemplated under the *Data
Privacy Act of 2012 (R.A. No. 10173) for legitimate and lawful purposes.
56
Employee Signature over Printed Name