02/02/2016 TRA Confirmation Page

REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF FINANCE
BUREAU OF INTERNAL REVENUE

TAX REMITTANCE ADVICE

Serial No. : 0100682016415743

TIN : 270­012­491­000
Reference Number : 171600014103780

AGENCY DEPT. FUND

NAME OF AGENCY: PRIETO DIAZ NATIONAL HIGH SCHOOL RDO NO.: DATE:
CODE: CODE: CODE:
ADDRESS: MANINGCAY DE ORO SORSOGON DESS DECS 068 101 02/02/2016
The Commissioner of Internal Revenue:
This is to remit the amount of Four Hundred Seventy­Seven Pesos and 41/100 only (PhP 477.41 ) to cover withholding tax liabilities
for the month of : January/2016
Type of Tax:

1601C 1601E 1601F 1600 1603

It is understood that the amount herein remitted shall be in accordance with the provisions of the National Internal Revenue Code
of 1997, as amended, and its implementing rules and regulations, and consistent with the prescribed budgeting, accounting and
auditing rules and regulations pursuant to the DOF­DBM­COA Joint Circular No. 1­2000, as amended by DOF­DBM­COA Joint
Circular 1­2000A.

APPROVED BY: CERTIFIED BY:

___________________________________________________ ______________________
Head of Agency or Duly Authorized Representative Chief Accountant

BIR­RDO DATE: BTr­RO DATE: BIR­RO DATE:

(MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY)

Stamp of __________ Stamp of __________ Stamp of __________

Receiving Receiving Receiving
Office __________ Office __________ Office __________
Initial Initial Initial

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