Ou partment of Finance te urea of oral Revenue ee jileeat mg f Era oe oa NOTA LEER rg BACK Ha oh xo ag 7a Naps te dca Bsc ea BGR 17010 O1/18ENCS PI} ACKGROUND INFORMATION ON TAXPAYERIFILER Professional [| Estate (J) Trust b'2 fuses icone Grauled Rates [| 014 heme tor Poeson-Grcuad Rates, [__] 1019 aad cone-Godned Fas [_Joots Business income =O IT Rao 1017 come ram roesson~ 8% IT Roto 016 Mixed come ~89% IT Rate [9 Taxpayer/Fllers Name (ee! None Fst Nane, Mise Noro fr navva)/ ESTATE of rs Na, idl Nano, Lat Nara) TRUST FAO Fist Nene, Me Nao Last Nao) Ve LA 1e8 4,21, 5, WAN i VN E60, a CFS Joel Ea beer [10 Registered Address pnscte carpe oivss Run dst rc oes Fe med Bes tre fae crete Fo ROO ni ered ates by For Ma 105) NMS PN AG EA BAN 1ST) BGA WH UWA AM E20 NC, vty AZIP Code] «1,3 iit To ee Pee ey el Date SF Binh umnoorryvy| 42 Email Address: WN L2 SUA TINA ed mew MAS ara, ee : [is Giizenship [4 Foreign Tax Number (Fapafeebe) [76 Cling Foren Tax reas NCP Ne, ean ei an Lives 1 His Tax TER Method of Deduetion Rate* [4] Graduated Rates perTaxrte-pape2 [¥] Itemized Deduction [—} Optional Standard Deduction (OSD) fenonse ne, (chasse wetnose ecto intr 6x)" [Soe Saas), WRC] [Oo ross Sale ecesRovequsFons Se. 3 cm banesel__] 82% on gross salesireceipts & other non-operating income in leu of Graduated Rates under Sec. 24(A)(2\() & Percentage Tax peteson) uncer Sec. 116 ofthe NIRC, os amended avai reas xesecil and oer no0-oertng income do no etoed Tree lion pasos FSM), PART I= BACKGROUND INFORMATION ON SPOUSE [fapoicsble) fr Spowses TIN |, Bl, el ,, Blo, 0,0,0, ojtenooce |, h9 Faers Spouse Type [-] Single Propietor 7] Frotessiona (icainanaieneaned P2OATC | [irate veonoGasiae Rae] —]ntelxontonoaionGned ae | Wed cine. Gael ITRabs [OTT Compensation Income [Clitistoesseane-2% TR» |] no17 eae fom Presson tna [~]A'6 Mad none 2% Rate [21 Spouse's Name (las Wane Fat Were, Mate Name) Ry eT 22 Gizenship 23 Foreign Tax Number, Fapoicobe a Cian Foreign Tax CeaisT errr | eee ea) Lives Jins 25 Tax 25K Method of Deduction ato" [—] Graduated Rates purTarTato-pooe2 [_] ltomized Deduction [] Optional Standard Deduction (OSD) ences ore, — (GneeseMathod of Cesustonnliom 234) (Son 34/4), NRC) [hoof Gos SueuRecoptsRovonmaroes [Se 24, NRG) ferns om besnesel__] 8% on gross sales/receipts & other non-operating income in lieu of Graduated Rates under Sec. 24(A)(2)(a) & Peroentage Tax pclesson) under Seo. 116 of he NIRG, 2s amended levatabe goss slosh’ and canon. operating name d nol exceed Thre milion sos (3M) PART l= TOTAL TAX PAYABLE (ONT ete it vias rata] Saar Ay TaxpayerfFler B) Spouse 6 Tax Dus (Fem Pat Schwa Hiom 46 OR Sched om 54) a aes |e er |27 Less: Tax Credits/Payments (From Part V, Schedule I!-tem 62) peri sr i} 144545 50) |28 Tax Payable/(Overpayment) (item 26 Less item 27) (From Part V, Item 63) sy pegs Eg | ee 29 Add: Total Penalties (From Part V, Schedule Iv-Item 67) ee a ee es TE }0 Total Amount Payable/(Overpayment) (Sum of items 28 and 29) (From Part V, Item 68) pea ri pie ee 7 yey I Aggregate Amount Payablel(Overpayment) (um ethers 04 ed 308) meta a Tees nde a praia ope ar Re ERE HAO, i Maan A WAR HE Fe a aa Slow a are OT th pobsl bo iarallaonal ners Cote over ee lens wt ot) be! Fue ge ny coal he pce ny ebro nate vy U2 (A N13 rope nips (Acted Ris ta nf a ae 9) JUAN 9. VELA CRUZ _Signalure and Printed Name of Taxpayer Authorized Represertalvel Tax Agent (nda ita Designaton snd TA) PARTIV= DETAILS OF PAYMENT Panieuias ——[Drawee BanWagency Naber Date mount ee tt icherk I eee yg ee Tax Debi Meno ca ar la ‘epee ee ay acne ValatanFe vee Oil Recall Dela (ra fed wh ov Aiorsed Rot Bar) ‘Se TR OBEAATB a aoc Ros (RO SinaturaBank Teri) fa 5 * Tundersiand thal tis choice i revocable for is laxable year. However, the 6m income Tax (1) Rate oplon f Mita IY Sad aT ATCT tare pemianit rans vr guns eabatncat i eels c-cpatsey recrye tuosed The ico pesos FH aE a Lom "Please fead the BIR Data Privacy Policy found in the BIR website (www. bir.gov.ph)BIR Form No, a Hy 1701Q Quarterly Income Tax Return Kill sara 2018) For individuals, Estates and Trusts ul 90 2 gO PORT VENT RET ey 432) 344)5)0)7, 8), 0,000 0/9 £, LA, CRY as ‘PART V= COMPUTATION OF TAX DUE _ }37 Less: Cost of Sales/Services _(eppliebe only avaling tized Deductions) op St '38 Gross Income/[Loss) rom Operation (tom 96 Loss tom 7) 1131212, 2,°] 1 | 8 Less: Allowable Deductions: 49 Total Allowable temized Deductions be 217 2) 2] ‘OR 40 Optional Standard Deduction (OSD) (40% of tem 26) Pe | lat Netnealtoes) This Guster (itemized ter 28 Less tom 3% OSD: tomBLessitom 49) |) 118,99, 71 ) y 1) y | 1 ‘Add: 42 Taxable Ineome/(Loss) Previous Quarter/s ee ee Se | 4H dicurtRecoiedSharin onne by aParne tom General Pression Parbertin (GP?) |) yy ° |45 Total Taxable Income/(Loss) To Date (Sum of items 41 to 44) bBo 146 TAX DUE (tem 45x Applicable Tax Rate based on Tax Table below) (To Part Il, Nem 26) a nl td [Schedule i For6% IT Rate 47 SalesiRevenues/Receipts/Fees (nto sales retums, allowances and discounts) eee eee /48 Add: Non-Operating Income (speci). Fm Marri ie 49 Total income for the quarter (Sum of items 47 and 48) Meee Ol eee 150 Add: Total Taxable Income/(Loss) Previous Quarter (item 51 of previous quarter) age ie oe | yd fae 54 Cumulative Taxable Income(Loss) as of This Quarter (Sum at tame 49 and 6 (aes pan) "Alowableredocton fom gross sesheceps and oher non cperating icone of purely sek-onploye inves 52 Less: rposioasas mma 9 ee eee [63 Taxable Income/{Loss) To Date (im 1 Less lem 82) t aoa [64 TAX DUE (item 53% 6% Tox Rat) (To Port tom 26) jie a [Schedule Il- Tax Credits/Payments ae B5 Prior Years Excess Credits (Ue mo | ee [56 Tax Paymentis forthe Previous Quarteris| AMM Niner nc 57 Creditable Tax Withheld for the Previous Quarters nc 68 Crecitable Tax Withheld per BIR Form No. 2307 for this Quarter ace | 69 Tax Paid in Retum Previously Filed, ifthis is an Amended Retum fer ia ee [ ee {60 Foreign Tax Credits, i applicable ae a 12] ae [61 Other Tax Credits/Payments (speci). ap eee 62 Total Tax Crecits/Payments (Sim of toms 65 61) (T Pal, tom 27) nl ol, aa [63 Tax Payable/(Overpayment) (tern 46 or 54, Las te 62) (To Part tom 28) a 0 | [Schedule IV - Penalties e4 Sucerve ee eee Se nteets fe | ES Capron POA iy gc pep 67 Total Penalis (Sumoftoms 64 69 (To Par il, tam 29) iia a | [68 Total Amount Payablel(Overpayment) (Sum of tems 63 and 67) (To Par Il, tem 30) ff 2 | (TEBE Te Tax rates (ertecve tanuary 1, 2018 to Decerber 31,2022) “TABLE 2~ Tax Rates efoctive January 1,2023.and Taxable incomes: Tox Duos: T Taxable Income is fax Due i lover P 250000, 3 Motor P 250000, OR, BrP 0 00 bt nal ver PADD kT encase over 50M] | Deer? 75, 000A ne ove PART 1 ole cess on POTD [OverP<00.00buot over? 000000 [P SOOO 25% ate xcs over P0000] [Over 40,00 bt nat ver P_00,900 > —TESD0T20K oe ssi one ADO 000 over? 60,00 butrot vec 00.0 [P—T30,000+ oie exces over P0000 | [Over 6000 t ot ve P 60,000 P 10250 + 75% of be excess ove PBDO DDD [ower 7,000 00 Bit ot ve F 6,009 00 [P—450,000% Em oe xcs over P,000000| [Over 0,00 ut nat ve P 000,000 402500304 oe ett ove F DOGO ie F8,00.00. P4100 25% oti cscess over in000] [Owe P 8.002000, [P22500 36H othe excess ove P 8000000Republic of the Philippines Department of Finance Buroau of internal Revenuo Quarterly Income Tax Return For Individuals, Estates and Trusts January 2018 ENCS) | Enter equ intrmaton in CAPTAL LETTERS uang BLACK nc Mara acct boxes get “Av, To cope tbe ld wine BI td on Pad byte et Pe Der 17010 O1IBENCS Pi} a ‘Single Proprietor 8 Alphanumeric Tax Code (ATC) Ty Protessonal [Estate] Trust 12 Bios ne Guo a [_] 0b tn Ptr fas [— J) Md aw Gus [ints uioasincame-8% ito [17 heome tom Proton - 8% Tale 1016 Mie ame = 8% Rate 8 Tanpyer/ F107 Marie aa im, Mh nia) /ESTATEGT tone Mia Lia TRST FA Ft aa aa a) EUR ICE MA TWAS ULE Go istered Adress er i Pt eT Roa ETA ROD ara UNF ETM Ae EAS AN, (510). BRGY) 1M OA 9 UE 2, & FORE 1 23] Date of Bh uno 12 Emad ATTERS 8] 214,979 4 Heh a yz Ba warily yee my i ae 3 Clzanship fa Foreign Tax Number (appease) 75 Ca ae TAROT ee Lee Te TeAMETCT oT DeRaIOT Graduated Rates per Tax Table-page 2 Itemized Deduction (J) Optional standard Deduction (OSD) (Choe towsesenint te) een ne) [Mc Gross Sloe RecapksReveruna ot [Sc 34), NRC) ferncane er uarese[_] 8% on gross saleslecsipts& other non-operating income in leu of Graduated Rates under Sec. 24(A)(2)(a) & Peroentage Tax priessen)_—_under Sec. 116 ofthe NIRC, as amended vali rss salashecaict and cher nor-opraog ine do nto The mon ps 28) PART Il= BACKGROUND INFORMATION ON SPOUSE (Fappienbe) TET, BL PBfo 0, 0,0, of eRb0.coae (9 File? Spouse Type) Single Propitor C1 Professional [| Compensation Eamer ROATC [ior ishets ene Gaia Ras [1014 rene tom rein tan Ras |_]IGT9 Med ore Gad ITRees[_]NOTT Compensation Ineome [itisBosessincone-2%T Rate [ot hcane ton Poko -8%T Rae [016d nore 8% Rte Hf Spouse's Name (Let Nave, Fie Name, Middle Nem) TT eee aa Li rane (Giizenship i 23 Foreign Tax Number, Fa 2 Cling Foren Tax reais ee ee Lo Civ TT 6A Method of Deduction Rate’ [~] Graduated Rates pr Tox ate-nae2[__] ltomized Deduction [] Optionsl Standard Deduction (OSD) chose one — (Checse Mebeof Cecio nom 268) Bae SA) MRC] ramtvstess{_] 8% on gross salsireceipts & other non-operating Income in leu of Graduated Rates under Sec. 24(A)(2Va) & Perdentage Tax Beal unde Sec. 16 of the NRG, a ard alte ges sates nd be orang heme ecne Me een ge og i of Gross SlesRecoptseverunsFoas (Se. 24, MAG] PART Il= TOTAL TAK PAYABLE OT wi Crt ia ev Particulars A) TaxpayeriFiler ‘B)Spouse 6 Tax Due (From Par Sched tom 48 OR Scheco Hom 6). ag ogc | 7 L058 Tax CrediePayments om Po, Schedles 62) ere | 8 Tax Payablel(Overpayment) (im 26 Lessor 27) (From Part V, om &3) prim Mee19} | yy to 1 Add Total Penalties (rom Part SchedleV-tom 67) eae co 10 Total Amount Payable(Overpayment) (Somottens 28end2)(rmmPoniiem®) | |. Tye ©] , 1). yy 10 [54 Aggregate Amount Payablel(Overpayment) (Sum of lems 90A and 308) ilizq coo decree uate para eur and fs atachren RvsDen mado gos, vad bys Fe bao ny Kiowa ed bel Soon ance puna {be bors ol Natal taal Reve Coe, as aor, sf repr sad unr aut ovo! Furr, ey coea oe pecs my oman ss xtc dab "Dairy hol 12 RA No 1073) ial s lw uses, Aster Rapes, ch avr rine 1) URN YQ, gel chur aire and Pcie Name of Taxpayer horned Representative Tax PART IV=DETAILS OF PAYMENT Drawos BantiAgoncy| ‘Number TemDoNy oS achine VatdlionRevervue Oficial RecelplDelals (Frat Wed wan an Auorzed Agent Bark) ‘Slap of Racshing Of cA RAB and Dae ot Recap (RO' Sonata Tosi) | “HOTES: | understand thal his cotas fs revocable forts Taxable year, However, the income Tax (1) Rae Option i iniialy selected shal automaicaly Be changed to graduaied IT rales when gross aales/receips and oer non-operating income exceed Thvee milion pesos (23M) * Piease rea the BIR Data Privacy Poly found inthe BIR website (wa bi gv.ph)BIR Form No, fies Daiae ea edule | a6 SalesiRevenvesTRecell/Fees (tafser lower arco) iF | A 1701Q Quarterly Income Tax Return | at Il Sear aie es) For Individuals, Estates and Trusts it 17010 OI/1BENCS P2| 37 lia Cost af SaleSenvces ‘epplicable only if avaling itemized Deductions) 138 Gross Incomel{Loss) from Operation (tem 36 Less item 37) Tess: Allowable Deductions ‘39 Total Allowable Itemized Deductions OR, 40 Optional Standard Deduction (OSD) (40% of tem 96) at Nal ncorelLoss) This Quarter (Htemized: tem 38 Less tem 39; OSD: em 36 Less ito 40) ‘Add: 42 Taxable Income/(Loss) Previous Quarter/s 43 Non-Operating income (seeci). “44 AeurtRecive’Starein income by a Pate rom General ProessioalParnership (GPP) 145 Total Ta je Incomel(Loss) To Date (Sum of tems 410 44) |46 TAX DUE (tem 45x Applcable Tex Rate based on Tax Table blow) (To Pat tem 26) Schedule il For 6% IT Rate /A7 SalesiRevenues/Receipts!Fees (ret of sales reluns,alowances and discouns) [48 Add: Non-Operating Income (speci) 149 Total Income for the quarter (Sum of tems 47 and 48). 160 Add: Total Taxable incomel(Loss) Previous Quarter (item 51 of previous quarter) 154 Cumulative Taxable incomel(Loss) as of This Quarter (Sum of toms 49 and 50) 52 Lose HE nt fo ps akin ad ocrovopraig wane rest enpoes avaias LS: sap nt wrt 225010) 153 Taxable Incomel(Loss) To Date (tem 5 Lass item 62) 154 TAX DUE (itom 53 x 8% Tax Rate) (To Part il, item 26) : o 5S Prior Years Excess Credis Se ee | ieee 56 Tax Payments or the Previous Quarters [| 157 Creditable Tax Withheld for the Previous Quarter/s Sp SE eee eae fe [58 Credible Tax Withheld per BIR Form No. 2307 for this Quarter jae 2 ao ae ae ea 59 Tax Paid in Return Previously Filed, ifthis is an Amended Return (eee ee ee [60 Foreign Tax Credits, applicable 1 ao] ea [61 Other Tax Credits/Payments (pect) py Se |62 Total Tax Crecits/Payments (Sum of tems 55 o 61) (To Parti, tem 27) i (mn 111? 163 Tax Payablel(Overpayment) (tem 46 or 6, Lose tom 62) (To Pat, tem 28) Lp 1210 0 ; 7 | Bcheduie Pais = oe Eee RE Lo eee |67 Total Penalties (Sum of tems 64 to 66) (To Part Il item 29) tt 48 ee ea Laan [68 Total Amount Payable/(Overpayment) (Sum ct llems 9 and 67) (To Par il, tom 30) 12711 6)2 ° att 12 CE CS Eee a Tee nt rar P7000 bt rt ove POO 20% ofthe excess oar Zan m00-| | Over Tan 0 ba not ener AOODOD. = over? 40,00 bt not cv P 800000 | SOD 95% ite ease oe Fae Stk ol he encase P_2SOOD at eerie Sr eeuserr ace Sop amuaeshstal aorisnesstee| (er omer ie: marae acer oe is Fanon ston F tot tani ee tas esse eFasoto asimov sk ss eases PaaS [Ove ,00 00 tol over P'.009000- [P12 300-- 205 att wxcst over-cap oor over ,500000 [P402.500--30% afte seest over PZnan aoe [F200 300 5% ofthe cess ever P STS SERIO SS oe exces over 8.000000 |‘of Finance Ropublc of the Philippines == " 17010 cungayncone Taz Ratm |UD For Individuals, Estates he ert aie ater ATA LET ogee Th IOI OWIBENGS 4 er | hind. |3Am Fa "2 T E ALERT W294 0,0,0,0, 0/85 213,71 es C1 Estate. Siete oe Tz Baas nce Gt Ras [__] Oi or Probson-Gon Rat jis mi rn = hots Business Inco «8% Rate 1017 nome kom Profession -8% IT Pate 1016 Med Income ~B% Tal apr ei sn TATE os re L/L A eo DiTUAL 1c. TAD DLE 4,2, 1 Minho 44913) ea 14 rot Birth wamporrrviy| 12 Email Address a wea staat a Aveta e422, 9m 4 tye oy Saas iS Ciizenship ria Foreign Tax Number (Fappeable) 776 Caming Foreign Tax Cede? |= LONE Dr yes [4] No 16 Tax. 6A Method of Deduction Rate’ [iL] Graduated Rates prTorTbo pope? [K] lemized Deduction Optional Standard Deduction (OSD) [ae EI eau en err? OR) erie aia” Co Gian Serco eC) leans Jessen] 8% on gross sales/eceints& oer non-operatng income in leu of Greduated Rates under Sec. 24(A)(2V) & [fase — under See. 16 ofthe NIRC, as amended javalble# gs caesrcet nd ctw ranaperatng income nal exceed Tee Pa PART Il = BACKGROUND INFORMATION ON SPOUSE (applicable) oH h7 Spouse's TN Sl... , Bio 0,0,0, ofsanocede TT _ ko Fie’s Spouse Type _[_) Single Proprietor (Professional [ Gompensation Earner F2OATC | jnipahes rene Goad ane[ tana ton tsa Rae [13M eane- Gti Tabs [_]H011 Compensation Income [its uinesiname- Rate noringae rm Proasen-#4 TT Rae | lio Moedleoe 4a fat Spouse's Name Los Nene, Ft ene, Mae Nove) Percentage Tax vara Reni eae 23 Foreign Tax Number, @appicebe 2 Caming Fotelgn Tax Cres? ae ee Cee 8 tat Ba NaTASTBRALON Rate’ [] Grauatod Rates po Tcrte ny? (_] Woized Decucion _[_] Optional Standard Daducton (OSD) [oc ee eee ames) pon sauna) Cree aerneaputore aoe Ss 3 MAC) fence tet 8% on gross selesireceiots & other non-operaing incor in eu of Graduated Rates under Sec. 24(A)2\.a)& Percentage Tex frcosson — under Sec. 116 ofthe NRC, 2s amended (avelbe ots aesrecits ad re no-pertg com doa exced Tre lon pasos OM) —_ fere Tet ata [22 Ciizenship Re if eS PART I= TOTAL TAX PAYABLE ONT tr ne ewan i Particulars: A) TaxpayeriFiler B)Spouse 6 Tax Due (Fern Pu, Scheie to 48 OR Sched tem 54) (Slope ae ee b7 Less: Tax GredlisyPayments (rm Pa, Saad inten €2) ea terol] ea Jes Tax Payable/(Overpayment) (or 26Less om 27) From Pat V, tom 63) jaca it ONS | TS 8 Aca Total Penalies (um Pav Sched V-tem€7) iia inh [De SS 0 Total Amount PayableOverpayment)(Sumofteons and) FomPaiVioméé) |.) 2.9y%,28| 1). 14, 2 1 Aggregate Amount Payable/(Overpayment) (Sum of ltams S0A and 308) fanaa aquest eR ea rT HATE i cin mao Na a Fr Gu omy Lua a eta eee erence eae Seeieteay nun cranone coun can sun ¥. DELA ceu2 Sgyae ad Pied Name of Topaye'Tashorwed Represertatvel Tax Agent (ndeateTwabearaton nd =e PARTIV= DETAILS OF PAYMENT iS _— Dezwoe Bangor Nanber Pa Taunt CashBrk Dent Mare eee ae a “ een oe A | a | ax Debi Mer S Sa | ee ee Tai everue Of RecOp Des rath Rad Re a) Sto oT Reig sd ie Tat (RO Seratriank Toler ta) FR STE -- Sa TT onieyarat nessa toeaiee memes oh a "Prease Privacy Policy found in the BIR website (wwew.bir.gov ph) S‘BIR Form No. 1701Q Quarterly Income Tax Return January 2018 (ENCS) For individuals, Estates and Trusts Page 2 DEA “$701Q O4/18ENCS P| le |= For Grad |36 Sales/Revenues/Receipts/Fees (net of sales retums, allowances end dlscounts) TN] [87 Less: Cost of Sales/Services _apoleabe ony if avalng emized Deductions) po '38 Gross incomel(Loss) from Operation (item 26 Less tem 37) Fe FC ese is Tess: Alowable Deductions 39 Total Allowable Kemized Deductions Hp 8 es OR, 40 Oplional Standard Deduction (OSD) (40% ofitem 36) i fa Gc) 44 Net incoel.os) This Quatet (loized Wom 28 Lessiiom 39; HOSD:temsslesstom 4) |) pS My WVPl yy 1 iq ‘Ada: 42 Taxable incomel(Loss) Previous Quarteris Te i 43 Non-Operating Income (ec) pri 1H 1114 ‘A koanlRecriedSiweh hernebjaPatnetom GerealPmessealPabeme()| | 1.) y 1 il 1 1 1 i 1 1 15] [4B Total Taxable Incomel(Loss) To Date (Sum offers 41 4) 5. eel gut gc Op 4B TAX DUE (tem 45. Appiceble Tax Rete based on Tax Table below (To Par Il tem 28) 1 15y6y0,2 8] pp 9g ichedule N—For 8 IT Rate =] a7 SalesiRevenves/Reveipis/Fees (ret of als elums eiowances ond dscuris) Arg nage co | [49 Add: Non-Operating Income (spect) ma eo | am eT [49 Total ncbme forthe quarter (Sum of tans 47 and 4) Me te [50AdE: Total Taxable Incomel(Uoss) Previous Quarter (lem i ofmevouscuate) |) yy 1 1 1 1] yy) 1 us 1? 54 Cumulative Taxable incomel(Loss) as of This Quarter Sum fens 40 and) ne gag a mS Ctr el 0] panne [58 Taxable Incomel(Loss) To Date (tom 51 Less tem 52) yy 0] [54 TAX DUE (tom 53x 8% Tax Rae) (To Parl, tom 2) ee ee [56 Tax Payments forthe Previous Quarters pa] ya [57 Credible Tax Withheld forthe Previous Quarters eee ye [68 Creditable Tax Withheld per BIR Form No, 2307 for this Quarter ees ero an eae [59 Tax Paid in Retum Previously Fd, this an Amended Retum (ee |e [60 Foreign Tax Credits, if applicable ee 1 pee ei Tose |64 Other Tax Credits/Payments (¢peciy). a ees [ezittal excesisyPajmens (simatiane sso siimoeeriMliemzy |) UP OP] [63 Tax Payablel(Overpayment) (tom 46 or 54 Less fem 62) (To Pat, Hom 28) 11 1218141218 fine [Schedule IV -Penaties [64 Surcharge [65 interest [66 Compromise otek le [67 Total Penallies (Sum of tos 64o 66) (To Pai, tom 29), (68 Total Amount Payable/(Overpayment) (Sur of ton 69 ond 6) (To Pal fom 30 4 pampetia Se Sia 28) isi ee SLE T= Tote [sive Jay 201 tw DocombarST AOR] [TABLE = Tox ate (eine Janay 1,279 and omerse]_—_} [Taxable income is: Tox Duel: THTaxablo Income is: Tax Due i oer P5000 oe Nol over 250,000 % er P5000 bt at over P0000 Tite xcs oar 250000 | [Owe P 7.00 ot wwe P_DODHD Tio eco ever 250000, Fo ot bat tenet P BaD 00 PSOE TP oe ess oer P—w0,00-| [Over PaO, 000 BR rot oer 00 ESOT oss oer Pa, 000 (5B, bit rol ve 7000000. vat PW 000 biker 0,00 T0200 25K fh xvas ver P6000 [over 200000 butt ove P000.000, Beziec vet PIO. D0 bart oe 0,000 [P4020 30% of ose oer P0000 ver 00000 [P2500 ofthe evens ovr 6.000000Republic of the Philippines BCs! Department of Finance em Buroau of Internal Revenue 1701 Annual Income Tax Return Individuals (including MIXED income Earner), Estates and Trusts January 2018 (ENCS) | Erteral require ivomaton in CAPTTAL LETTERS usig BLACK ik, Mark apolcabl Boxes wih "page 4 ‘an Two copes mus fed wih te BI andor held bythe Tx lo. GTapayer type [74 Single Proprietor [_] Professional [| Estate |_| Trust 7 Aihanurieic Tax Code (ATC) [] 012 Bane nemo Gado Ras | | Wepre FG Rake [_] 119M ara-G Ra 1011 Compensation income [__]}0isBuehetsncme-8% Rae [_] W0TIncormtr Presson 8% IT Rate [_] NE Moed nce 8% T Rate Taxpayers Name (LastName, Ft lomo, Miao Hane /ESTATE OF (Fst Nae, Mil Nur, Los Nesey TRUST FAO, aaa, Me Nana as Nr) ELA CROSMAN OLE GO TB Registered Address nial ample oak Fw opr acess Moet ata sre os os ROO pnt ec ag BR er NT) VMS RAGE ALAS ST BRENT ALN 9 BU E20 MCT Va wee o > 0 Dale or Bin AMBER] 41 Emal Adaress WU adage Uarcm rm Ogre pee | yy py 2 Crteenshi 1 Claing Foren Tak Cres? 14 Foreign Tax Number, appleabe Pee eRe (5 Confact Number (aadintalghone Na). [16 Givi Status paeab wee (] single CiManted CC teeaty Separated _[_] Weower i farted, spouse has income? T Yes (INe [re Fiing Status [|Join Fig | _] Separate Fin { Incone EXEMPT fom Income Tax? [—] Yes [K] No. | 2Dineome subject to SPECIALPREFERENTIALRATE? "Yee [TX] No | fi out ase conalaason of AL ates nt ys outa consolidator of ALL acto par Tax Rain Pat] fat Tex 21A Method of Deduction (chose or) Rate’ [X] Graduated Rates [X] Memizes Deduction, [7 Optional Standard Deduction (080) encase one)" (Crore Mose mason tom 24)! (Son 34a, RC) | kot Gs See RecatsRevons es Se. 240), MRC) [6% inte of Graduated Rates under Sec. 24(A) & Percentage Tax under Sec. 116 of NIRC Inia rss everest nd chr nn ops icone do ones Tr rion pesos 2M) lca = Fel Tak Payee eae aie ees eee eee Pariculars A TaxpayerFiler B, Spouse, 12 Tax Due (From Part Vi tem 5) a 2 AS] bee 3 Less: Tolal Tax Credits/Payments (From Pert Vil lem 10) Bi pai 1g 28h pri a 4 Tax Payable/(Overpayment) (tom 22 Less fem 23) fo MAT [2 Les: orion of Tax PajtleAlowedfor2 stale tobe pad oor below Orr 15 5 (th ors of ton 22) fan ar ee Te 16 Amount of Tax Payablel(Overpayment) (tem 24 Less kam 25) ba ert] a ‘Add: Penalties. 27 Interest peters en en 28 Surcharge fo ee ee 28 Compromise oe ee nw) 30 Total Penalties (Sum of toms 27029) ee ee | eee eee 1 Total Amount Payable/(Overpayment) (Sum of toms 26 and 20) ba 72147] aye 2 Aggregate Amount Payablel{ Overpayment) (Sim of toms 314 ond 316) 1619 14,7 ovenend maior (boron {Ore the che mae, sare rece). Tobe refunded Tobetssveda Tax Crt Cerifcale TC) [_] Toe cried over a ax coi fone earuaror Tiel ur poate foray al isa, an als atcha hae baon me goal vied by ma, aT ta Best of my rowdy od bel eo oe and comet pursue te press fe Netra lal Rovere Cod, amended, an he region sed under ute itwec Further ge my cans oth rcs of my wfomaon e eid uni th "Data Pray Af 202A. Na. 10179) for egitnt nlowl puposs. sey Aho Raper, ate TN a atic eran Bust DV. Yosh CRAL 33 Number of Atachments[ o [> rinied Name and Signature of TaxpayedAuhorized Represertave PART Ill Defalls of Payment — Particulars Drawee Banilagengy Number ‘Date (MMDDIYYYY) “Amrount A rr ae ee eee RI pe fa | a ay ie pmemremreseymeerencmey yy Wachine ValcaonReverue Ofisal Ret Deals iat led whan Aho Agoat Bank) ‘Slap of Recing ORCSAAS and Dela of Rot (RO Seprtr/Bank Toler ri “HOTE: The BIR Data Privacy Poday isn he BIR webale (iw DE GOV PA) aBR Fom Ne. 1704 Annual Income Tax Return enuny2018 eNOS) | Individuals ineluding MIXED Income Earner Estat and Trusts Single Proprietor LJ Professional ‘Compensation Earner TaAlphanamerie Tax Code (ATC) [_]W12 nes eone Grd Ras |_] U0 ane For Peor- Gosia Fas [_] 019M reaew Gad Rat _]tott Compensation income []ratsaisnessincone-tiTRan__[_} 117 reo ronPreson— [te Mod hee - 4 Ret [5 Spouse's Name (Las! Name, Fist Name, Wgde Heme) scone Number yy Tcheership ror ee aa en Lene ly Fro income EXEMPT from Income Tax? TT ¥e 1] No] tT income aubjecto SPECIAUPREFERENTIAL RATE? pate] {ious conser of ALL Acs, warty __|_ tyes, tou seo consolidation of AL ectvies per Tax Regine PartX)__| Ha tex “72 Mettiod of Delucon (choose oe) Rate [__] Graduated Rates [] Hemized Deduction [[] Optional standard Deduction (OSD) ate ane) > (Cheese Mae ef Deducton or 124) [Sat 94), NRG) [Ht of Grote SaoRecalsRvervesFees (Se. 34) MRC] [Tek intew ot Graduated Rates under Sec. 24(A) & Percentage Tax under Seo. 116 of NIRC g Ivete i goss ssc der nor cpraig come oP exceed Thee aon 825 PARTV = Computation of Tax Schedule T= Gross Compensation Income and Tax Wild (tach Aadonal ress, feces “Orie tant? ever equrediormaton fr each our enelye7s ard mao wheter he nfamaton je Taxpayer arte Spose, Oo Re 8 eee Tal (Gress Campers and Tot Tox West Taxpayer andon er 8 fy the Spouse (BONOT en Cans Cras Lass op down SDocnon nurd a Nave of EMpIVE Giles a WO oO bid Be NS st ae pire vt ea ea aT ee eee Beret [Centon Tee AB Feel Toca z a) are ean =i Garpoaio ome wa TOT NT =] ae Sen jose jon neo a raRVAPIT Tor j ‘SA _TAVPAVERITo Pat V Seb 2 on 4a Pr en ee en jane "yp Gives Compensation Income and Total Tax Wied Tor A 3 SPOUSE (oa Sh on ad Pa 8 1 eT jUicifn jana a [Schodile = Taxable Compensation Income [DONT eros Cts oes ip own 0 6 UH Parieulare 7A TaxpayetFlor B, Spouse “4 Gross Compensation Income (From Par V Sched {lim 2486) ee ae B Less, Non-Taxable / Exempt Compensation Oa | eS @ Taxable Compensation Ineame diem 4 Lees tor 5) eS Tax Due-Compensation income fa 6x appeal noe Tat ° ol rates Fin ems 60 24; fat cone x rae, ems 25%6 30) “TA For Graduated income Tax Rates 8 SalsiReveruesiReceipisiFees 1 Ny 1219 1218 oe eee @ Lessi Seles Retire, Alowances and Discounts eee erage [10 Net SalesiRevenvesRecepte/Feos (vom @ Loss tem) joe, xO ee | aga, A ea [1 Less: Cost of Sales/Services.(opleale ony Having tensed Duco) i gee Fi Gross incomel{Loss) fom Operation (fem 70 Less tem 11) p(Q0 28 Skene 2) C2 aah ma me Tess Daduetons Alonable under Exsing Laws H Ordinary Allowable Nemized Deductions (rom PanVScredsestomi@ |, ya 216,7)°.°] 1 1 4 ig aa Fa'Special Aloweble terized Deduclions (mmPatVschebleblendendtrmoms) |) y ) yy) vel; 1 yy 14 1 10 115 Aoneesfa Nd Operaglos Cary On NOLO) ermPetVsondiwbiondaniibnt|| , yyy) iol 11a 1 11 ye 6 Total Allowable Hemized Deductions (Sum oftems 134015) mC ormnoMo eaten 2) OR liz Optional Standard Deduction (OSD) 40% often 10) seer TET ol 8 Net incorel(Los) lai on 1a wo 18 LOSE 0s ten mgr] 2 mr Nan Operating eames (spec Below) ee SS ee Sean (SS ea Ps | (are eee |e ees W134 10,0 o J e 44 31240 ¢ 82151312 21701 Annual Income Tax Return Individuals (including MIXED income Earner), Estates and Trusts ‘January 2018 (ENCS) 93 M2 he ET 0,000,010, c1,4 pet 808 (rel of sales res, alowances end discounts) ° | Theome (speehy below) ; er 1 el rel eR aes 3 aS ogame} tt 1 eae Nba econ fa rx ete and ofr on cera rea enpcyes nud dpsed ne owt P2SDOO (oLopesetwincanperxinicane) |_| || Pet ees [30 Taxable income(Loss) (tem 2 Less tar 29) Lt 1 10] 4 Tax DuBose Income fe 99% at cone Tact) fe ye ee fs Teta Tex oe-Canpusion& Goes cone rata amelie ile 4 Ordinary Alowab'e fomiznd Deductions (atach datonal sheets, rrocessay) “’Amortizations , 1 1 yO) Ee Jee Dalal, ine fh ee |3 Charitable and Other Contributions Lu Ooze (ees Lo fa Depletion. ae eC) i ea 5 Depreciation bid 6) eee 16 Entertainment, Amusement and Recreation on oe ee 77 Fringe Benatis cane ln bm aioe cl B interest Lit COC tess eee S Losses big 1112 gi ae Ho Pension Trusts ae aa A agente 14 Ln ene) -i2 Research and Development pat eee |= 43 Salaries, Wages and Allowances a aa ee eee 114 SSS, GSIS, Phiheatth, HOM and Other Contributions i | oy wpe 18 Taxes and Licenses 1 pel ee [16 Transportation and Travel A el 717 ‘Others(Daduatons Subject fo Wihhoding Tax and Other Expenses) Seay beow Aad adavona hole), Tnecosen) 2 | Janitorial and Messengeral Services ii ate) ene b | Professional Fees SEL joe aay es c | Security Services Lut ei £ be. | Business Tryevse pe? yO yp 48 ToslOcimyAontialiniedDeamioe Gondiens titra (rorvenamaamnt| |) 42 67°] | | yy oO] Schedule 6 = Special Allowable Kemized Deductions (attach additions! sheeU’s, ‘itnecessary) ‘A= TaxpayerFler Description Teale rou a eee) eee dal net 1 1 1 et 1 Tee feet vei 1 La 1 js See Peg ees (Sui of tos 4 and 2) (T0 Pan V Sohedule 2A hem 148) ely si = Spouse, Pe lee 1 1 fy ee rl lalerelenel 14 esa L ps ees otal Special Allowable Nemized Deductions-Spouse (Sum of tems 4 and 6) (To Part V Schedule 3. em 148) 19 of Net Operating Loss Carry Over (NOLCO) Somputation of NOLCO Description }4.Gross Income. Hie jee (eg pak 1 0} 2 Less: Ordinary Allowable Itemized Deductions Lt 14 pol 2 Ging LOGS OeaflestenTOSGeAmOATionTAerSowaivsA@mrA] | | yy yy i] yi yy) yj i? es bea Congas ESE ROED eas eunoecones C ‘D.NOLCO Applied et a ee ies | cnolcoemina | NOLO AER ‘oerBR Fa Ne 7 1701 Annual Income Tax Return ll teehee | sania 2o18NCS) | Indviuae (including MIKED Income Earner Estats and Trusts lh i NE 4,2, 3, 4,5 6,7,6,9,0,0,0,0,0] p64, \¢ a = Tab Ha lis] TetaNOLCO= af ri TaD) [To Pa Seno 8A Te) PART Vi= Summary of income Tax Due H Regular Rate-Income Tax Due (From Pat V, Ener item 26 or tem 32) to he ee 2 Special Rate-Income Tax Due (Frm Partx tem 178/17F) tt gf eg [3 Less: Share of OtherGovernmentAgency, HreritedaheciviothoAgerey |. y ) 141.0] yy ys yu 1 4 Net Special Rato-Ircoe Tax DuolShar of Natonal Govt. fem 2 Less to 3) Di oe) [5 Total income Tax Due (Sum of tems 1&4) (To Partito 22) V2, 3,325 S reer rrercerarore eg Pree. [Prior Years Excess Gredts (er As 2 Tax Payments forthe First Three @) Quaners 6 F jens 3 Creditable Tax Withheld for the First Three (3) Quarters a TiO an 4 Grectable Tax Withheld per BIR Form No. 2907 forthe 4" Quarter a ard Perino. 5 Credtble Tax Wied per BR Form No Z316 (Fam Par V Schedule 1 tan Sade) A mo [ee a 6 Tax Paid in Retum Previously Fed, ithis is an Amended Retum io o|a,_ Sante 7 Foreign Tax Credits, apotcabie a | [8 Special Tax Credits, fapoicable (To Pat Viltem 6) ae ii 6 | [9 Other Tax Credits/Payments (apes. i ce | TS 0 Total Tax Credis/Payments (Sum of tems 109) (To Part tem 23) “gg gO ice | Dari a al OR PART Vil= Tax Relist Avaiment Viva Special Fate FreprearnNRenmieainer) ol 1 Taxa Spec Aowse leraedDanicon HAO 4 2) ee 3 Sub-Total = Tax Relief Sum of ems tend 2) Lt oy ao | a 4 Less: Income Tax Due (Fram Pert tem 178 andr lem 175) fry aes nan i Tax Relief Avainent Before Special Tax Credit (em 9 Less Nem 4) nk | ag [® Add: Special Tax Credit, any (From Pert Vil tem 8) le) | o| 7 Total Tax Relief Availment- SPECIAL (Sum of tems Send 6) me cd Vins= Exempt DRequarintieTHCOeweeOuearXinTehentexapeatengivmomemiee) |» y ) ) y 1 1. 1 yy 1a 1 0 TaxrsbtonSpeca Alot lerizedDedicions Ctenarieeminmg | J it i 1 v1 il | iy ypu ye 40 Total Tax Relief Avaliment- EXEMPT (Sum of ems 8 end) a yea lo |, a [PART IX Reconciliation of Net Income per Books Agalrat Tenable Wicomo (tuch afona soa Hnaresay) Parteulars “A TaxpayorFlor 5 Spouse ‘4 Net Income/{Loss) per Books £173,300) yy 7 12 7 Non-Dedhetbe Expenses/Tarabie OMe Income 2 eee ec aan pie s nae Sk 11 ial 4 oe ee eer fot aS, {6 Total (Simotitoms 1104) seats Vee ce | A) Non: Taxabie none and coe Subjecied 16 Final Tax s ar rar oS Pea a oa ae yy : 5 | bora 70 are one [re ro Tater Teo rar Baca arto FatimecanowerP FORO | [Over P Posto el or Pav Tale namo HR Fee ee et aeieyF—saearacnsscaaa® acon] [MP —otoobant oer? wom [P2e~as ce wes omP_ OD] ear eee oarPZoataD |p Tato sOe dbs ecaso somo [One PtoLObd elect 200000 > ior sm +e tbe ee oiP DOE notes Bao 8800 [taboos rst ast oar aisseoeaat oa’ Feo [> 2007s de astsemese casoassnerracaion] [OwPs 000 frzssdson soe ee es