BIR Form No. 17014. * Page 1 of 1 a Pe — Bopanna mow st ? eued na Revie SIR Fom No. Annual Income Tax Return ecitaerngteere ny ee ATOTA | comtnarenebrn Wee tsa AN ste | nur segues nmrtonin APTAL LETTERS vg BLAGIC TM a appeal boes STOTA OIE PI [Cemwwaarey [i] FES t meemctent Own Ow /3 ernccian! Ow Ow TART = BREKGROUND FORMATION ON TARPRYERIFCER a 7 © teem p22 - fos - fsa. foo 1110 Osinge Proprietor © Professiona! ar) O wabacnrewdeaasTha © mttansma team Oeaen Tan O os Bans one 57 Rate [8 Tscyers Nae lat ane Fat Nae, Mee Nae) fBrero, june oo [AGAN GRANDVILLE, GiTY HEIGHTS, general santos ay — 10 mast Bim paucorr 14 Enea penans77 bBlene rocrguezt@@yahoocom 12 caeono 13 Cuming Forgn Toxins?” 14 Forigr Tas Numb race ino Ovee @re 18 Contac Nate msc 16 wists Ose vanes Opa Sapte Oise One 18 ring sas Oorerarg © seowate Ferg (© crananaa tates wn 080 at mates © na of Gace Re une Sc 24,8 Perc Tax nde 85.118 fw RC, eeaxton Tarte ve senior ern cowry hee do pet ceed Tee io Fas 0) PARTI - TOTAL TAX PAYABLE (own ris Soran inpaan Sammars Particulars 'A) TaxpayerFilor B) Spou 120 taxove ral 12028700 2B SSC 24 oes: To Tax cect aa [14767900 218 | oOo 22. TaxPayaier Overpayment. 2 za [1833200 228 [0.00 23 smgtge arama acmnretn neem Oa 880m 9g (905 298 [ 3 26 Ancureot Tax Reasresta te Pat por FngKOvepayrent iawn) 24a [1838200 248 [000 ‘et Porates 25 suche 28a | 000 ase [SCO 26 ieest za[ ~~ 268 feed 27 Cerwonse 2a | 006 278 | 28 Tom Peas teen 27 aif eae] a 29 Toa! Amoun Peat Overpyment under ta zaa [—___-18,38200_ 298 [0.00 30 Aopeaste Amur PaybinOverpymon) on stn) sof 1898200 ovapaymer kee} bax ny (One he asic mae, ta sari nerds) © Taverekedes Tobe ainda Tax Cast Cotte 00) © Tovecaried oer att ct na vera Feo Sean pray Pa int So a RSTO DS FISH GTR ae oe Fa Dat oy MS TSS essa coven prtctn he powscne ol tsk tata Rosin Cae oe nant eb epation moos om Po Fees Fame pee SS cing oy rng covet PD Pony A 072 RA No.1) reg ws pp samen ee at uuwe 6. eemo 4, 31 neers PART Il- DETAILS OF PAYMENT = = ‘Date MDOT — 2 2 34 Taxon ere 36_ones weBIR Form No. 17014. ° Page | of | Annual income Tax Return /BIARLaIY {move unsere rodutee ome ox ath O80 te mode Sebuctons ‘Ok nose wna opal baa eat cae at PART IV - COMPUTATION OF INCOME TAX i Opsonl Sandor Dodocions (65D) fh Rams 6104; 18, fn Hane A058 N.A - For Graduated Income Tax Ratos ‘A) Taxpayorfiler 8) Spouse wal OB 000 sal 0 swe[_______ 0. aa[ 000 asa [000 39a [000 398 [0.00 x80 408 [05 «Bf 428 | 0.00 3B [006 “et Oar tt as [006 el Tete ae ene em) 4B [SS~S0 TAXOUE tenon ea tc a 45 [——00 aera ‘Total Taxable Income Stun tens 4 an 52) ‘538 [a \sremseammernatememerteezemmanememiant gyn | 255,00000 ‘Taxaple IncomeLoss) oar 53 te 54) seal _—*1,616,085.00 }56 TAX DUE (ner 88x04 neove Tax Ra) seal ——*120,287.00 IW Tax Cr Paynes SET 167 Prcr Years Excess Credits ‘57a | B4315.00 58 Tax Payments forthe Fst Three (3) Quarters saa [ 000 59 Crostable Tax With forthe Fist Thewe (3) Quarters seal ~«RBOOO }60 Crestable Tax Wath per IR Fox No. 2307 for the th Quarter eon —~—=«AT, 944.00 |61. Tex Pentin Retun Previcusly Filed, # Wiss an Amended Ret 6A ey [62 Foren ax cast tsorcane O Wrz esses heame cama TR O woretsone tom Profesor Grate Rats O Ws Busnes same Rat O sor income tor resco 6 Rate 72 Cesare One TA Frege Teche ramos [ "© cramasnams win OSD es manos O 8% nav ot Gace Rats unde Sec. 2A) &Perceinge Tox rr Se. "16 be MAC Fetaten Inlet poe sleheorts 2 cer non cpererg here do rot one Tae rion pans PM)ax Return Receipt Confirmation From: ebirforms-noreply@bir.gov.ph (ebirforms-noreply@bir.gov.ph) To: _ailene rodriguez16@yahoo.com Date: Monday, April 15, 2024 at 08:53 PM GMT+8 This confirms receipt of your submission with the following details subject to validation by BIR: File name: 00947475000-1702RTV2018C-122023.xm Date received by BIR: 15 April 2024 Time received by BIR: 08:31 PM Penalties may be imposed for any violation of the provisions of the NIRC and issuances thereof. FOR RETURNS WITH TAX PAYABLE: Please pay through any of the following ePayment Chann Land Bank of the Philippines Link.BizPortal + LBP ATM Cards + Bancnet ATM/Debit Cards + PCHC PayGate or PESONeT (RCEC, Robinsons Bank, UnionBank, PSBank, BPI, Asia United Bank) DBP PayTax Online + Credit Cards (MasterCard/Visa) + Bancnet ATM/Debit Cards Unionbank of the Philippines + Unionbank Oniine (for Unionbank Individual and Corporate Account Holders) + UPAY via InstaPay (For individual Non-Unionbank Account Holders) Taxpayer Agent! Tax Software Provider-TSP + (Gcash/PayMaya/MyEG) This is a system-generated email. Please do not reply. Bureau of Internal Revenue