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II
Psic:
Quarterly Value-Added
Tax Return
2550Q
February 2007 (ENCS)
For the
Year Ended
(MM/YYYY)
'
Calendar
TIN
_____
[183
From
Quarter
Fiscal
Return Period
(MM/DD/YYYY)
e
1st 2nd 3rd 4th
December
04/01/2016
06/30/2016
To,
770j
433
RDO
Code
8 No.of
sheets
attached
074
-------
09
Return?
Return?
Yes No
Line of
Business
11 Telephone Number
14412068
13
Registered Address
Zip Code
No
PART II
Computation of Tax
Sates/Receipts for the Quarter (Exclusive of VAT)
15
Vatable Sales/Receipt
16
Sale to Government
16A
17
17
18
Exempt Sales/Receipts
18
19
19A
20
15A
116,054.34
15B
13,926.52
2,059.448.56
16B
247,133.83
19B
261,060.35
0.00
0.00
2,175,02.90
20A
20A
0.00
20B
Input Tax Deferred on Capital Goods Exceeding P1 Million from Previous Quarter
20B
0.00
200
200
0.00
200
20D
0.00
20E
0.00
20F
0.00
0.00
21 B
0.00
0.00
21 D
0.00
1,241,982.75
21 F
149,037.93
0.00
21H
0.00
0.00
20E
Others
20F
&
20E)
Current Transactions
Purchase of Capital Goods not exceeding P1 Million (See
21 Al B
21 OlD
2
23
1500 1
21
Yes N
Taxpayer's Name (For Individual) Last Name, First Name, Middle Name/ (For Non-individual) Registered Name
12
5 Short
Penod
Return?
2016
000
10
Help
F4549
Republika ng Pilipinas
Kagawaran ny Pananalapi
Kawanihan ng Rentas Intemas
Purchases
21A
21 C
21E/F
21E
210/H
21G
21 IIJ
211
0.00
21J
21 KJL
21K
0.00
21 L
0.00
21 M
21 M
0.00
21N/O
Others
21N
0.00
210
0.00
21 P
21 P
Total Available Input Tax (Sum of Item 20F, 2111, 21D, 21F, 21H, 21 J, 211.
&
1241
'
, 98275
210)
23B
230
230
VAT Refund
23E
Others
23F
/ ICC claimed
&
23E)
22
149,037.93
23A
23B
230
0.00
-
0.00
0.00
23D
0.00
23E
000
23F
0.00
24
149,037.93
25
26
25
112,022.42
26A
45,580.75
26A
(I
Sch.7)
26D
26E
26F
26G
26C
260
Sch. S )
26E
0.00
26F
000
Others
263
26H
0.00
0.00
28 BT
0.00
-
27
Interest
Surcharge
28A
29
60,941.67
26H
27
28
0.00
r
5,500.00
28C1
0.00
0.00
28D
29
5,500.00
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:183-770-433-000
Jame
tDO
074
orm Type
:2550Q
teference No.
:101600016205556
mount Payable
Over Remittance)
550000
ccounting Type
or Tax Period
:06/30/2016
uarter
:2
)ate Filed
. ax Type
:VT
BIR Main
Calendar
07/24/2016
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Successful Message
BIR eFPS has received the payment confirmation for your tax
return from LBP.
TIN
183-770-433-000
Taxpayer's Name
Tax Type
Return Period
Transacting Bank
06/30/20 16
--
1F
LBP (086000)
1
Reference Number
101600016205556
164021405
07/24/2016
5500.00
7B Confirmation Number
[:
----------------
00072420161409266420
Please refer to the Tax Return Inquiry facility to check the status of your payment.