2307
2307
2307
Republika ng Pilipinas
Kagawaran ng Pananalapi
2307
September 2005 (ENCS)
(MM/DD/YY)
To
(MM/DD/YY)
Payee Information
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
Income Payments Subject to
Expanded Withholding Tax
Details of Monthly Income Payments and Tax Withheld for the Quarter
ATC
2nd Month of
3rd Month of
the Quarter
the Quarter
the Quarter
Total
Tax Withheld
For the Quarter
Total
Money Payments Subject to Withholding
of Business Tax (Government & Private)
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.
Payor/Payor's Authorized Representative/Accredited Tax Agent
(Signature Over Printed Name)
TIN of Signatory
Title/Position of Signatory
Date of Issuance
Date of Expiry
Conforme:
Payee/Payee's Authorized Representative/Accredited Tax Agent
(Signature Over Printed Name)
Tax Agent Accreditation No./Attorney's Roll No. (if applicable)
TIN of Signatory
Date of Issuance
Title/Position of Signatory
Date Signed
Date of Expiry
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Person exempt from VAT under Sec. 109 (v) (Government withholding agent)
Person exempt from VAT under Sec. 109 (v) (Private withholding agent)
Vat Withholding on Purchase of Goods (with waiver of privilege to claim input tax credits)
Vat Withholding on Purchase of Services (with waiver of privilege to claim input tax credits)
3%
3%
10%
10%
ATC
IND
WI 010
WI 011
CORP
WC 010
WC 011
WI 020
WI 021
WI 030
WI 031
WI 040
WI 041
WI 050
W 051
WI 060
WI 061
WI 070
WI 071
WI 080
WI 081
WI 090
WI 091
WI 100
WI 110
WI 120
WI 130
WI 140
WC 100
WC 110
WC 120
WC 140
WI 141
WI 151
WI 150
WI 152
WI 153
WI 156
WI 640
WI 157
WI 158
WI 160
WI 159
WC 156
WC 640
WC 157
WC 158
WC 160
WI 515
WC 515
WI 530
WI 535
WI 540
WI 555
WI 556
WI 557
WI 558
WI 610
WI 620
WI 630
WC 535
WC 540
WC 555
WC 556
WC 557
WC 558
WC 610
WC 620
WC 630
WB 030
WB 040
WB 050
WB 070
WB 090
WB 301
WB 303
WB 103
WB 104
WB 108
WB 109
WB 110
WB 120
WB 121
WB 130
WB 140
WB 150
WB 160
WB 170
WB 180
WB 200
WB 201
WB 202
WB 203
(Individual & Corporate)
WB 080
WB 082
WV 012
WV 022