2/6/2017 | | BIRFormNo.

1601C| |

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ReferenceNo:011700018587201
DateFiled:February04,201706:52PM
BatchNumber:1711241184

PSOC: PSIC: 5522

BIRFormNo.
RepublikangPilipinas MonthlyRemittanceReturn
KagawaranngPananalapi
KawanihanngRentas ofIncomeTaxesWithheld
1601C
July2008(ENCS)
Internas
onCompensation

2AmendedReturn? No.ofSheetsAttached 4 AnyTaxesWithheld?

1 FortheMonth (MM/YYYY) 3

01January 2017 0
Yes No Yes No

PartI BackgroundInformation

5TIN 140 153 588 000 6RDOCode 112 7LineofBusiness/Occupation REFRESHMENTSTANDS,KIOSKSANDCOUNTERS

8WithholdingAgent'sName(LastName,FirstName,MiddleNameforIndividuals)/(RegisteredNameforNonIndividuals)
9TelephoneNumber

GONZALES,JOSEFINOPASANA

10RegisteredAddress 11ZipCode
0778LAPULAPUSTMAGUGPOCENTRALDAVAO 8100

12CategoryofWithholdingAgent 13AreyouavailingoftaxreliefunderSpecialLaw ofInternationalTaxTreaty? 14ATC

Yes No WW010
Private Government
Ifyes,specify

PartII ComputationofTax
Particulars AmountofCompensation TaxDue
15 TotalAmountofCompensation 15 82,000.00

16 Less:NonTaxableCompensation
16A StatutoryMinimumWage(MWEs) 16A 0.00
HolidayPay,OvertimePay,NightShift 16B 0.00
16B DifferentialPay,HazardPay(MinimumWage
Earner)
16C OtherNonTaxableCompensation 16C 0.00
17 TaxableCompensation 17 82,000.00
18 TaxRequiredtobeWithheld 18 3,083.34
19 Add/Less:Adjustment(fromItem25ofSectionA) 19 0.00
20 TaxRequiredtobeWithheldforRemittance 20 3,083.34
21 Less:TaxRemittedInReturnPreviouslyFiled,ifthisisan 21A 0.00
amendedreturn
OtherPaymentsMade(pleaseattachproofofpaymentBIR 21B 0.00
FormNo.0605)
22 TotalTaxPaymentsMade(SumofItemNos.21A&21B) 22 0.00
23 TaxStillDue/(Overremittance)(ItemNo.20lessitemNo.22) 23 3,083.34
24 Add:Penalties
Surcharge Interest Compromise

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2/6/2017 | | BIRFormNo.1601C| |

24A 0.00 24B 0.00 24C 0.00 24D 0.00

25 TaxAmountStillDue/(Overremittance) 25 3,083.34

SectionA
Adjus tm e ntofTaxe s Withhe ldonCom pe ns ationForPre vious M onths
more...
PreviousMonth(s)/Year(1)
Monthly/Yearly (MM/YYYY)
DatePaid(2)(MM/DD/YYYY) BankValidation/RORNo.(3) BankCode(4)

SectionAContinuation
TaxPaid(ExcludingPenalties)forthe ShouldBeTaxDuefortheMonthYear FromYearEndAdjustmentofthe
FromCurrentYear(7a)
Month/Year(5) (6) ImmediatelyPrecedingYear(7b)

0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00

2 6 T otalA mount(total7 aplus 7 b) 0.00

Attachments

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