Professional Documents
Culture Documents
1600
Republika ng Pilipinas
Kagawaran ng Pananalapi Value-Added Tax and Other
Kawanihan ng Rentas Internas
Percentage Taxes Withheld
Under RAs 1051, 7649 ,8241,8424 and 9337 September 2005 (ENCS)
Fill in all applicable spaces. Mark all appropriate boxes with an “X”.
Part I Background Information
1 For the Month 11 2016 2 Amended Return?
x No
3 No. of Sheets Attached 4 Any Taxes Withheld?
(MM / YYYY) Yes x Yes No
5 TIN 000 553 180 087 6 RDO Code 103 7 Line of Business/ National Gov't. Agency
Occupation
8 Withholding Agent's Name (Last Name, First Name, Middle Name for Individuals)/(Registered Name for Non-Individuals) 9 Telephone No.
DILG - AGUSAN DEL NORTE 341-3732
10 Registered Address 11 Zip Code
CAPITOL COMPOUND, BUTUAN CITY 8600
12 Category of Withholding Agent 13 Are there payees availing of tax relief under Special Law or
Private Government International Tax Treaty? Yes No If yes, specify
Part II C o m p u t a t I o n o f T a x (Attach additional sheet if necessary)
TAX TAX REQUIRED
NATURE OF INCOME PAYMENT ATC TAX BASE
RATE TO BE WITHHELD
Person excempt from VAT under Sec. 109 (v) WB 084 51,500.00 3% 1,545.00
Tax Agent Acc. No./Atty's Roll No.(if applicable) Date of Issuance Date of Expiry TIN of Signatory
Part III D e t a i l s of P a y m e n t Stamp of
Drawee Bank/ Date Receiving Office/AAB
Particulars Agency Number MM DD YYYY Amount and Date of Receipt
21 Cash/ Bank 21A 21B 21C 21D (RO's Signature/
Debit Memo Bank Teller's Initial)
22 Check 22A 22B 22C 22D
Machine Validation/Revenue Official Receipt Details (If not filed with an Authorized Agent Bank)
ENCS)
BIR FORM NO. 1600 - MONTHLY REMITTANCE RETURN OF VALUE-ADDED TAX AND OTHER PERCENTAGE TAXES WITHHELD
GUIDELINES AND INSTRUCTIONS
ALPHABETICAL LIST OF PAYEES
Page ___ of ___
FOR THE MONTH OF : WITHHOLDING AGENT TIN : WITHHOLDING AGENT NAME : _______________________________
( MM/YYYY)
Schedule II ALPHABETICAL LIST OF PAYEES FROM WHOM TAXES WERE WITHHELD (Attach additional sheet/s, if necessary)
SEQ PAYEE DETAILS INCOME PAYMENT / TAX WITHHELD DETAILS TAX TAX REQUIRED
NO. TIN INDIVIDUAL / CORPORATION *
ATC NATURE OF PAYMENT AMOUNT RATE TO BE WITHHELD
(1) (2) (3) (4) (5) (6) (7) (8)
(LAST NAME, FIRST NAME,
MIDDLE NAME FOR INDIVIDUALS
OR REGISTERED NAME
FOR NON-INDIVIDUALS)
Total P