tax

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1 For the Period From (MM/DD/YY) To (MM/DD/YY) Part I Payee Information 2 Taxpayer Identification Number 3 Payee's Name (Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals) 4 Registered Address 4A Zip Code 5 Foreign Address 5A Zip Code Payor Information 6 Taxpayer Identification Number 7 Payor's Name (Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals) 8 Registered Address 8A Zip Code PART II Details of Monthly Income Payments and Tax Withheld for the Quarter Income Payments Subject to ATC AMOUNT OF INCOME PAYMENTS Expanded Withholding Tax 1st Month of 2nd Month of 3rd Month of Total Tax Withheld the Quarter the Quarter the Quarter For the Quarter PROFESSIONAL FEE 5,000 9,000 11,000 20,000 2,000 Total Money Payments Subject to Withholding Total We declare, under the penalties of perjury, that this certificate has been made in good faith, verified by me, and to the best of my knowledge and belief, is true and correct, pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof. MS. VIVIAN A. RANTE ACCOUNTANT Payor/Payor's Authorized Representative/Accredited Tax Agent TIN of Signatory Title/Position of Signatory (Signature Over Printed Name) Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry Payee/Payee's Authorized Representative/Accredited Tax Agent TIN of Signatory Title/Position of Signatory Date Signed (Signature Over Printed Name) Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry f Business Tax (Government & Private Conforme: 13 0 00 1 18 8 23 22 5 01 BIR Form No. Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas 13 03 UNIT J 3RD FLOOR RED MAPLE BLDG. 411 NS AMORANTO SENIOR AVE MAHARLIKA, QC 000 359 221 206 PADUA INTERNATIONAL CORPORATION MARCOS HI-WAY SITIO KAYBAGSIK BGY. SAN LUIS ANTIPOLO CITY 1 8 70 NIMFA S. PINEDA 31 01 Certificate of Creditable Tax Withheld At Source 2307 September 2005 (ENCS)

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  • 1 For the Period

    From (MM/DD/YY) To (MM/DD/YY)

    Part I Payee Information

    2 Taxpayer

    Identification Number

    3 Payee's Name

    (Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals)

    4 Registered Address 4A Zip Code

    5 Foreign Address 5A Zip Code

    Payor Information

    6 Taxpayer

    Identification Number

    7 Payor's Name

    (Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals)

    8 Registered Address 8A Zip Code

    PART II Details of Monthly Income Payments and Tax Withheld for the Quarter

    Income Payments Subject to ATC

    AMOUNT OF INCOME PAYMENTS

    Expanded Withholding Tax 1st Month of 2nd Month of 3rd Month of Total Tax Withheld

    the Quarter the Quarter the Quarter For the Quarter

    PROFESSIONAL FEE 5,000 9,000 11,000 20,000 2,000

    Total

    Money Payments Subject to Withholding

    Total

    We declare, under the penalties of perjury, that this certificate has been made in good faith, verified by me, and to the best of my knowledge and belief, is true and correct,

    pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof.

    MS. VIVIAN A. RANTE ACCOUNTANTPayor/Payor's Authorized Representative/Accredited Tax Agent TIN of Signatory Title/Position of Signatory

    (Signature Over Printed Name)

    Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry

    Payee/Payee's Authorized Representative/Accredited Tax Agent TIN of Signatory Title/Position of Signatory Date Signed

    (Signature Over Printed Name)

    Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry

    of Business Tax (Government & Private)

    Conforme:

    13

    0 00 1 18 8 23 22 5

    01

    BIR Form No.Republika ng PilipinasKagawaran ng PananalapiKawanihan ng Rentas Internas

    1303

    UNIT J 3RD FLOOR RED MAPLE BLDG. 411 NS AMORANTO SENIOR AVE MAHARLIKA, QC

    000 359 221 206 PADUA INTERNATIONAL CORPORATION

    MARCOS HI-WAY SITIO KAYBAGSIK BGY. SAN LUIS ANTIPOLO CITY 1 8 7 0

    NIMFA S. PINEDA

    31 01

    Certificate of Creditable Tax Withheld At Source 2307

    September 2005 (ENCS)