0605 573y2p

BIR Form No. Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas

0605

Payment Form

September 2003(ENCS)

1

For the

2

Year Ended (MM/YYYY)

Calendar

3

Fiscal

12 - December

4

Quarter 1st

2nd

3rd

0

13

8

771

Tax Type Type

Backg roun d In fo rm ati on 10

RDO Code

25A

000

11

12

Taxpayer Classification

I

Line of Business/Occupation

OTHER SERVICE ACTIVITIES

N

14

Taxpayer's Name (Last Name, First Name, Middle Name for Individuals) /(ed Name for Non-Individuals)

Telephone Number

GONZALES, VICTORIA II BARTOLOME 15

09435634693 16 Zip Code 3018

ed Address

170 TALISAY ST.,BUNLO,BOCAUE, BULACAN 17

6 ATC ATC FP090

2017

Part I 9 Taxpayer Identification No. 332

5

No. of Sheets Attached

4th

7 Return Period (MM / DD / YYYY)

200

Due Date (MM/DD/YYYY)

18

Manner of Payment

Voluntary Payment

Per Audit/Delinquent

Self-Assessment

Preliminary/Final Assess/Deficiency Tax

Penalties

s Receivable/Delinquent

Tax Deposit/Advance Payment

Type of Payment

Installment No. of Installment

Partial Payment Full Payment

Income Tax Second Installment(Individual) Others(Specify)

ADDITIONAL PENALTY FOR SAWT Part II 19 20

19

Basic Tax/Deposit/Advance Payment Add: Penalties Surcharge

20A 21

Computa tion of Tax

Interest

0.00

20B

Total Amount Payable(Sum of Items 19 & 20D)

Pre-approved by Investigating Office

3,000.00

Compromise

0.00

20C

0.00 20D 21 Not approved by Investigating Office

0.00 3,000.00

BIR Form No. Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas

0605

Payment Form

September 2003(ENCS)

1

For the

2

Year Ended (MM/YYYY)

Calendar

3

Fiscal

12 - December

4

Quarter 1st

2nd

3rd

0

13

8

771

Tax Type Type

Backg roun d In fo rm ati on 10

RDO Code

25A

000

11

12

Taxpayer Classification

I

Line of Business/Occupation

OTHER SERVICE ACTIVITIES

N

14

Taxpayer's Name (Last Name, First Name, Middle Name for Individuals) /(ed Name for Non-Individuals)

Telephone Number

GONZALES, VICTORIA II BARTOLOME 15

09435634693 16 Zip Code 3018

ed Address

170 TALISAY ST.,BUNLO,BOCAUE, BULACAN 17

6 ATC ATC FP090

2017

Part I 9 Taxpayer Identification No. 332

5

No. of Sheets Attached

4th

7 Return Period (MM / DD / YYYY)

200

Due Date (MM/DD/YYYY)

18

Manner of Payment

Voluntary Payment

Per Audit/Delinquent

Self-Assessment

Preliminary/Final Assess/Deficiency Tax

Penalties

s Receivable/Delinquent

Tax Deposit/Advance Payment

Type of Payment

Installment No. of Installment

Partial Payment Full Payment

Income Tax Second Installment(Individual) Others(Specify)

ADDITIONAL PENALTY FOR SAWT Part II 19 20

19

Basic Tax/Deposit/Advance Payment Add: Penalties Surcharge

20A 21

Computa tion of Tax

Interest

0.00

20B

Total Amount Payable(Sum of Items 19 & 20D)

Pre-approved by Investigating Office

3,000.00

Compromise

0.00

20C

0.00 20D 21 Not approved by Investigating Office

0.00 3,000.00