Certificate of Creditable Tax Withheld at Source Certificate of Creditable Tax Withheld at Source

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BIR Form No.

Republika ng Pilipinas
Certificate of Creditable
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas
Tax Withheld At Source 2307
March 2003 (ENCS)

1 For the Period 07 01 07


11 07 30 11
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 Manila 4A Zip Code

5 Foreign Address 5A Zip Code

Payor Information
6 Taxpayer
000 791 472 000
Identification Number
7 Payor's Name DEPARTMENT OF LABOR AND EMPLOYMENT
(Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals)
8 Registered Address GEN. LUNA STREET MURALLA STREET INTRAMUROS MANILA 8A Zip Code 1002

PART II Details of Monthly Income Payments and Tax Withheld for the Quarter
Income Payments Subject to AMOUNT OF INCOME PAYMENTS
ATC
Expanded Withholding Tax 1st Month of 2nd Month of 3rd Month of Total Tax Withheld
the Quarter the Quarter the Quarter For the Quarter

Total
Money Payments Subject to Withholding
of Business Tax (Government & Private)
INCOME PAYMENTS MADE BY THE
GOVERNMENT TO ITS
LOCAL/RESIDENT SUPPLIERS OF WC-157 18,000.00 18,000.00 360.00
SERVICES

DV No.: 2011-07-3461

Total 18,000.00 - 18,000.00 360.00


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.

RICHELDA L. BALLAD Chief Accountant


Payor/Payor's Authorized Representative Title/Position of Signatory
(Signature Over Printed Name)

Conforme:
Payee/Payee's Authorized Representative Date Signed
Signature Over Printed Name
BIR Form No.
Republika ng Pilipinas
Certificate of Creditable Tax
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas
Withheld At Source 2307
March 2003 (ENCS)

1 For the Period 07 01 1107 07 30 11


From (MM/DD/YY) To (MM/DD/YY)
Part I Payee Information
2 Taxpayer
Identification Number
3 Payee's Name FIVE ACES RESTAURANT AND CATERING INC.
(Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals)
4 Registered Address Manila 4A Zip Code

5 Foreign Address 5A Zip Code

Payor Information
6 Taxpayer
000 791 472 000
Identification Number
7 Payor's Name DEPARTMENT OF LABOR & EMPLOYMENT
AND EMPLOYMENT
(Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals)
8 Registered Address GEN. LUNA STREET MURALLA STREET INTRAMUROS MANILA 8A Zip Code 1002

PART II Details of Monthly Income Payments and Tax Withheld for the Quarter
Income Payments Subject to AMOUNT OF INCOME PAYMENTS
ATC
Expanded Withholding Tax 1st Month of 2nd Month of 3rd Month of Total Tax Withheld
the Quarter the Quarter the Quarter For the Quarter

Total
Money Payments Subject to Withholding
of Business Tax (Government & Private)
Persons exempt from VAT under Sec
109v (creditable) Government Withholding WB080 18,000.00 18,000.00 540.00
Agent

Total 18,000.00 - 18,000.00 540.00


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.

RICHELDA L. BALLAD Chief Accountant


Payor/Payor's Authorized Representative Title/Position of Signatory
(Signature Over Printed Name)

Conforme:
Payee/Payee's Authorized Representative Date Signed
Signature Over Printed Name

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