2316 139520 PDF

DLN:
Certificate of Compensation
Payment/Tax Withheld
Republika ng Pilipinas
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas
For Compensation Payment With or Without Tax Withheld

Fill in all applicable spaces. Mark all appropriate boxes with an "X"
For the Year
2015
( YYYY )
Part I
Employee Information
3 Taxpayer
305
459
499
Identification No.
4 Employee's Name (Last Name, First Name, Middle Name)
1
000
6A Zip Code
207 A F BLUMENTRITT STREET SAN JUAN CITY
1500
32 Basic Salary/
Statutory Minimum Wage
32
Minimum Wage Earner (MWE)
33 Holiday Pay (MWE)
33
34 Overtime Pay (MWE)
34
35 Night Shift Differential (MWE)
35
36 Hazard Pay (MWE)
36
37 13th Month Pay

and Other Benefits
37
38 De Minimis Benefits
38
6C Zip Code
6D Foreign Address
6E Zip Code
7 Date of Birth (MM/DD/YYYY)
8 Telephone Number
3/29/1985
9 Exemption Status
For the Period

01/01
From (MM/DD)
To (MM/DD)
12/31
Details of Compensation Income and Tax Withheld from Present Employer
Part IV-B
Amount
A. NON-TAXABLE/EXEMPT COMPENSATION INCOME
5 RDO Code
0 4 3
6B Local Home Address
2316
July 2008 (ENCS)
TABAGO, JOHN OLIVER CENIR

6 Registered Address
BIR Form No.
Single
18,905.00
Married
9A Is the wife claiming the additional exemption for qualified dependent children?
Yes
10 Name of Qualified Dependent Children
No
11 Date of Birth (MM/DD/YYYY)
39 SSS, GSIS, PHIC & Pag-ibig 39
Contributions, & Union Dues
30,606.36
10,425.60
(Employee share only)
12 Statutory Minimum Wage rate per day
12
13 Statutory Minimum Wage rate per month
13
Minimum Wage Earner whose compensation is exempt from

withholding tax and not subject to income tax
Part II
Employer Information (Present)
15 Taxpayer
211
015
873
000
Identification No.
16 Employer's Name
40 Salaries & Other Forms of

Compensation
40
41 Total Non-Taxable/Exempt
Compensation Income
41
59,936.96
14
TELUS INTERNATIONAL PHILIPPINES, INC

1605
Secondary Employer
x Main Employer
Part III
Employer Information (Previous)
18 Taxpayer
Identification No.
19 Employer's Name
20A Zip Code
Part IV-A
21 Gross Compensation Income from
Summary
21
22
59,936.96
Exempt (Item 41)
23 Taxable Compensation Income
23
199,455.92
from Present Employer (Item 55)
24 Add: Taxable Compensation

Income from Previous Employer
25 Gross Taxable
Compensation Income
26 Less: Total Exemptions
24
27 Less: Premium Paid on Health
27
42
180,434.40
43
44 Transportation
44
45 Cost of Living Allowance
45
46 Fixed Housing Allowance
46
47 Others (Specify)
47A
47A
47B
47B
SUPPLEMENTARY
48 Commission
48
49 Profit Sharing
49
50 Fees Including Director's

Fees
50
51 Taxable 13th Month Pay

and Other Benefits
51
52 Hazard Pay
52
53 Overtime Pay
53
259,392.88
Present Employer (Item 41 plus Item 55)
22 Less: Total Non-Taxable/
42 Basic Salary
43 Representation
17A Zip Code
31ST FLOOR DISCOVERY CENTER, 25 ADB AVE., ORTIGAS

CENTRE, PASIG CITY
B. TAXABLE COMPENSATION INCOME

REGULAR
25
199,455.92
26
50,000.00
and/or Hospital Insurance (If applicable)
28
28 Net Taxable
Compensation Income
29 Tax Due
29
30 Amount of Taxes Withheld

30A Present Employer
30B Previous Employer
149,455.92
24,863.98
30A
54 Others (Specify)
24,863.98
54A Salaries & Other Forms of

Compensation
54B
24,863.98
55 Total Taxable Compensation

Income
54A
19,021.52
54B
30B
31 Total Amount of Taxes Withheld 31

As adjusted
55
199,455.92
We declare, under the penalties of perjury, that this certificate has been made in good faith, verified by us, and to the best of our 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.
56
Date Signed
NONETTE NGAYAN
Present Employer/ Authorized Agent Signature Over Printed Name
CONFORME:
57
CTC No.
of Employee
Date Signed
Employee Signature Over Printed Name

Place of Issue
Date of Issue
Amount Paid
To be accomplished under substituted filing

I declare, under the penalties of perjury, that the information herein stated are reported I declare,under the penalties of perjury that I am qualified under substituted filing of Income Tax
Returns(BIR Form No. 1700), since I received purely compensation income from only one employer
under BIR Form No. 1604CF which has been filed with the Bureau of Internal Revenue.
58
NONETTE NGAYAN
Present Employer/ Authorized Agent Signature Over Printed Name
(Head of Accounting/ Human Resource or Authorized Representative)
in the Phils. for the calendar year; that taxes have been correctly withheld by my employer (tax due
equals tax withheld); that the BIR Form No. 1604CF filed by my employer to the BIR shall constitute
as my income tax return;and that BIR Form No. 2316 shall serve the same purpose as if BIR Form No.
1700 had been filed pursuant to the provisions of RR No. 3-2002, as amended.
59

Employee Signature Over Printed Name

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DLN:

Kawanihan ng Rentas Internas

For Compensation Payment With or Without Tax Withheld

207 A F BLUMENTRITT STREET SAN JUAN CITY

Minimum Wage Earner (MWE)

33 Holiday Pay (MWE)

34 Overtime Pay (MWE)

35 Night Shift Differential (MWE)

36 Hazard Pay (MWE)

37 13th Month Pay

7 Date of Birth (MM/DD/YYYY)

For the Period

6B Local Home Address

TABAGO, JOHN OLIVER CENIR

BIR Form No.

(Employee share only)

12 Statutory Minimum Wage rate per day

13 Statutory Minimum Wage rate per month

Minimum Wage Earner whose compensation is exempt from

40 Salaries & Other Forms of

TELUS INTERNATIONAL PHILIPPINES, INC

20A Zip Code

Exempt (Item 41)

23 Taxable Compensation Income

from Present Employer (Item 55)

24 Add: Taxable Compensation

27 Less: Premium Paid on Health

45 Cost of Living Allowance

46 Fixed Housing Allowance

50 Fees Including Director's

51 Taxable 13th Month Pay

Present Employer (Item 41 plus Item 55)

22 Less: Total Non-Taxable/

17A Zip Code

31ST FLOOR DISCOVERY CENTER, 25 ADB AVE., ORTIGAS

B. TAXABLE COMPENSATION INCOME

and/or Hospital Insurance (If applicable)

30 Amount of Taxes Withheld

54A Salaries & Other Forms of

55 Total Taxable Compensation

31 Total Amount of Taxes Withheld 31

TABAGO, JOHN OLIVER CENIR

Employee Signature Over Printed Name

To be accomplished under substituted filing

TABAGO, JOHN OLIVER CENIR

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