Company Name :

Business Address :
Date of Registration :
Sector : Please check one
Please check one

Agriculture and fishery

Economic and low cost housing
Energy (coal, diesel)
Energy (refining, storage, marketing and distribution of petroleum products
Enery (renewables)
Manufacturing (industrial goods, machines, electronics, electrical and semi-con products)
Manufacturing (others)
Mining and quarrying
PPP projects
Services (call center, BPO)
Services (other)
Tourism
Others (please specify): ________________________________________________
Summary of Benefits - 2017

Company Name:

Paticulars Amount (PHP) Reference

Importation
Duties TIMTA Annex A.2
VAT TIMTA Annex A.2

VAT Zero rated local purchases TIMTA Annex A.2

VAT on local purchases -

Net Sales/Revenues/Receipts/Fees TIMTA Annex A.1

Gross Income TIMTA Annex A.1
Net Taxable Income TIMTA Annex A.1

Note:
Kindly fill in only those portions highlighted in YELLOW
 Guide

column labeled as "M" - Duties

column labeled as "N" - VAT (Php)

column labeled as "BB" - Value of VAT Zero Rated Purchases (In Php)

column labeled as "G" - Net Sales

column labeled as "I" - Gross Income
column labeled as "J" - Net Taxable Income
 Remarks

to be used to estimate Local Business Tax

Company Name :

Employment information
Particulars Number
2017 Manpower Count
2017 Average Number of Dependents per employee

Particulars Amount
2017 Gross Annual Compensation
2017 Total Statutory Contributions - Employer's Share -
a. SSS
b. PHIC
c. HDMF
2017 Total Statutory Contributions - Employees' Share -
a. SSS
b. PHIC
c. HDMF

Average Gross Annual Compensation 0

Average Annual Statutory Contribution - ER Share 0
Average Annual Statutory Contribution - EE Share 0

Note:
Kindly fill in only those portions highlighted in YELLOW
 Remarks
as of December 31, 2017

Remarks
total amount paid by the company to its employees

Note: please do not edit

Company Name :
Purchases : Please check those applicable

A.

B.
Please check those applicable

Purchase of services
Advertising and promotions
Communications
Freight/courier
Janitorial and messengerial
Professional/Management/Consultancy
Rental
Repairs and maintenance (labor)
Security
Trainings and seminars
Transportation and travels
Others: (please specify)

Purchase of goods
Fuel and oil
Light and water
Raw materials
Repairs and maintenance (materials and supplies)
Raw materials
Others: (please specify)
Company Name :

Real Properties Information

Properties

Building and improvements

Machinery and equipment
TOTAL

Note:
Kindly fill in only those portions highlighted in YELLOW
 2017

Acquisition Cost Appraised Value (if applicable)

- -
Net Book Value