tax
DESCRIPTION
TaxTRANSCRIPT
-
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)