Académique Documents
Professionnel Documents
Culture Documents
DLN:
PSIC:
0618
November 2007 No of Sheets Attached 5 ATC
Fill in all applicable spaces. Mark all appropriate boxes with an "X"
1 2 For the Year Ended
( MM / YYYY )
Calendar
Fiscal
MC 310
I 11 Taxpayer's Name
(Last Name, First Name, Middle Name for Individuals) / (Registered Name for Non-Individuals)
12 14
16
SPF-(Abatement Program)
Part II Computation of Tax
Full Payment
18 19
Basic Tax
18 Stamp of
This is to acknowledge our participation to the Abatement Program. In this regard, I declare, under the Receiving Office/AAB penalties of perjury, that this document has been made in good faith, verified by me, and to the best of myand Date of Receipt 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.
(RO's Signature/ Bank Teller's Initial)
Title/Position of Signatory President/Vice President/Principal Officer/Accredited Tax (Signature Over Printed Name)
TIN of Signatory
gent/Authorized Representative/Taxpayer
Agent Acc. No./Atty's Roll No. (if applicable) D e t Part ails III o f P a y m e n t Particulars 20 Cash/ 20A
Bank Debit Memo
Date of Issuance
Date of Expiry
Number 20C
MM
DD
YYY 20D
Amount
21 Check 21A
21B
17C
21C
21D
22 Others 22A
22B
22C
22D
Machine Validation/Revenue Official Receipt Details (If not filed with the bank)
Code IT IE CG CS ES DN VT PT PM ST SO
Code SL DS DO AP XA XP XM XG XT XF
Description
PERCENTAGE TAX - SPECIAL LAWS DOCUMENTARY STAMP TAX REGULAR DOCUMENTARY STAMP TAX-ONETT ACCRUED PENALTIES EXCISE-ALCOHOL PRODUCTS EXCISE-PETROLEUM PRODUCTS EXCISE-MINERAL PRODUCTS
EXCISE-AUTOMOBILES & NON ESSENTIALS