(To be filled up by the BIR)

DLN:
Republika ng Pilipinas Kagawaran ng Pananalapi

PSOC:

Kawanihan ng Rentas Internas Under RAs 1051, 7649 ,8241,8424 and 9337

Monthly Remittance Return of Value-Added Tax and Other Percentage Taxes Withheld
Background Information Amended Return? 3 No. of Sheets Attached Yes No 6 RDO Code 7 Line of Business/ 1 4 2 0 2 5 Occupation

PSIC: BIR Form No.

1600
September 2005
4 Any Taxes Withheld? Yes

Fill in all applicable spaces. Mark all appropriate boxes with an X.

Part I 1 For the Month
(MM / YYYY)

1 1

2 01 1

5 8

TIN

000

8 6 3

9 5 8

Withholding Agent's Name (Last Name, First Name, Middle Name for Individuals)/(Registered Name for Non-Individuals)

9 Telephone No.

Dep. Ed. Bulacan - Division Office

10 Registered Address 11 Zip Code

Capitol Compound, Guinhawa St., Malolos City

12 Category of Withholding Agent Private Government Part II 13 Are there payees availing of tax relief under Special Law or International Tax Treaty? Yes No If yes, specify

3 0 0 0

C o m p u t a t I o n o f T a x (Attach additional sheet if necessary) TAX NATURE OF INCOME PAYMENT ATC TAX BASE RATE

TAX REQUIRED TO BE WITHHELD

Purchase of GOODS

WV-020

21,466.00

5%

1,073.30

14 Total Tax Required to be Withheld and Remitted 15 Less: Tax Remitted in Return Previously Filed, if this is an amended return Add: Penalties Surcharge 17A 17B Interest 17C Compromise 16 Tax Still Due/(Overremittance) 17

14 15 16

1,073.30

1,073.30

17D 18

18 Total Amount Still Due/(Overremittance) (Sum of Items 16 & 17D) For late filers with overremittance, extend amount of penalties (Item 17D to 18)

1,073.30

I declare, under the penalties of perjury, that this return has been made in good faith, verified by me, and to the best of my 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.
19 JOSIE D. LOGRONIO President/Vice President/Principal Officer/Accredited Tax Agent/ Authorized Representative/Taxpayer (Signature Over Printed Name) Principal I 122-725-900 Title/Position of Signatory TIN of Signatory Date of Issuance Date of Expiry 20 Treasurer/Assistant Treasurer (Signature Over Printed Name)

Title/Position of Signatory TIN of Signatory

Tax Agent Acc. No./Atty's Roll No.(if applicable)

Part III Particulars

21 Cash/ Bank 21A

Drawee Bank/ Agency

21B 22B 23B

D e t a i l s of P a y m e n t Date Number MM DD YYYY

21C 22C 23C 21D 22D 23D

Amount

Debit Memo 22 Check 22A 23 Others 23A

Stamp of Receiving Office/AAB and Date of Receipt (RO's Signature/ Bank Teller's Initial)

Machine Validation/Revenue Official Receipt Details (If not filed with an Authorized Agent Bank)

BIR Form No.

1600
2005 (ENCS)
Any Taxes Withheld? No

3 0 0 0

TAX REQUIRED TO BE WITHHELD

1,073.30

1,073.30

1,073.30

1,073.30

Revenue Code, as amended, and the regulations issued under authority thereof.

Stamp of Receiving Office/AAB and Date of Receipt (RO's Signature/ Bank Teller's Initial)

(To be filled up by the BIR)

DLN:
Republika ng Pilipinas Kagawaran ng Pananalapi

PSOC:

Kawanihan ng Rentas Internas Under RAs 1051, 7649 ,8241,8424 and 9337

Monthly Remittance Return of Value-Added Tax and Other Percentage Taxes Withheld
Background Information Amended Return? 3 No. of Sheets Attached Yes No 6 RDO Code 7 Line of Business/ 1 4 2 0 2 5 Occupation

PSIC: BIR Form No.

1600
September 2005 (ENCS)
4 Any Taxes Withheld? Yes No

Fill in all applicable spaces. Mark all appropriate boxes with an X.

Part I 1 For the Month
(MM / YYYY)

1 2

2009

5 8

TIN

000

8 6 3

9 5 8

Withholding Agent's Name (Last Name, First Name, Middle Name for Individuals)/(Registered Name for Non-Individuals)

9 Telephone No.

Dep. Ed. Bulacan - Division Office

10 Registered Address 11 Zip Code

Capitol Compound, Guinhawa St., Malolos City

12 Category of Withholding Agent Private Government Part II 13 Are there payees availing of tax relief under Special Law or International Tax Treaty? Yes No If yes, specify

3 0 0 0

C o m p u t a t I o n o f T a x (Attach additional sheet if necessary) TAX NATURE OF INCOME PAYMENT ATC TAX BASE RATE

TAX REQUIRED TO BE WITHHELD

Purchase of GOODS

WV-020

54,000.00

5%

2,700.00

14 Total Tax Required to be Withheld and Remitted 15 Less: Tax Remitted in Return Previously Filed, if this is an amended return Add: Penalties Surcharge 17A 17B Interest 17C Compromise 16 Tax Still Due/(Overremittance) 17

14 15 16

2,700.00

2,700.00

17D 18

18 Total Amount Still Due/(Overremittance) (Sum of Items 16 & 17D) For late filers with overremittance, extend amount of penalties (Item 17D to 18)

2,700.00

I declare, under the penalties of perjury, that this return has been made in good faith, verified by me, and to the best of my 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.
19 MARIA M. SALCEDO President/Vice President/Principal Officer/Accredited Tax Agent/ Authorized Representative/Taxpayer 20 Treasurer/Assistant Treasurer (Signature Over Printed Name)

(Signature Over Printed Name) Accountant II Title/Position of Signatory TIN of Signatory Tax Agent Acc. No./Atty's Roll No.(if applicable) Date of Issuance Date of Expiry

Title/Position of Signatory TIN of Signatory

Part III Particulars

21 Cash/ Bank 21A

Drawee Bank/ Agency

21B 22B 23B

D e t a i l s of P a y m e n t Date Number MM DD YYYY

21C 22C 23C 21D 22D 23D

Amount

Debit Memo 22 Check 22A 23 Others 23A

Stamp of Receiving Office/AAB and Date of Receipt (RO's Signature/ Bank Teller's Initial)

Machine Validation/Revenue Official Receipt Details (If not filed with an Authorized Agent Bank)

Repub lika ng Pil ipinas Kagawaran ng Pa nanala pi

Kawanihan ng Rentas Internas

Remi of Value-Ad Percentag

Under RAs 1051, 7649 ,8241 and 8424

g Pil ipinas ng Pa nanala pi

n ng Rentas Internas

Remittance Return of Value-Added Tax and Other Percentage Taxes Withheld

BIR Form No.

1600
July, 1999 (ENCS)

7649 ,8241 and 8424

Schedule I
NATURE OF PAYMENT

ALPHANUMERIC TAX CODES

Tax Rate ATC WV 010 WV 020 WV 030 WB 030 WB 040 WB 050 WB 070 WB 090 WB 120 WB 121 WB 130 WB 140 WB 150 WB 160 WB 170 WB 180 WB 200 NATURE OF PAYMENT - Maturity period is more than five years B. On dividends and equity shares and net income of subsidiaries C. On royalties, rentals of property, real or personal, profits from exchange and all other items treated as gross income under the Code D. On net trading gains within the taxable year on foreign currency, debt securities, derivatives and other similar financial instruments Tax on Other Non-Banks Financial Intermediaries Not Performing Quasi-Banking Functions A. On interest, commissions and discounts from lending activities as well as income from financial leasing, on the basis of the remaining maturities of instrument from which such receipts are derived - Maturity period is five years or less - Maturity period is more than five years B. On all other items treated as gross income under the code APPLICABLE TO BOTH GOVERNMENT AND PRIVATE WITHHOLDING AGENTS: VAT Withholding from non-residents (Government Withholding Agent) VAT Withholding from non-residents (Private Withholding Agent) VAT Withholding on Purchases of Goods (with waiver of privilege to claim input tax credit) (creditable) VAT Withholding on Purchases of Goods (with waiver of privilege to claim input tax credit) (final) VAT Withholding on Purchases of Services (with waiver of privilege to claim input tax credit) (creditable) VAT Withholding on Purchases of Services (with waiver of privilege to claim input tax credit) (final) Persons Exempt from VAT under Sec. 109v (creditable)-Government Withholding Agent Persons Exempt from VAT under Sec. 109v (creditable)-Private Withholding Agent Persons Exempt from VAT under Sec. 109v (final) WB 301

APPLICABLE TO GOVERNMENT WITHHOLDING AGENTS ONLY: VAT Withholding on Purchase of Goods 5% VAT Withholding on Purchase of Services 5% VAT Withholding on Government Public Work Contracts 5% Tax on carriers and keepers of garages 3% Franchise Tax on Gas and Water Utilities 2% Franchise Tax on radio & TV broadcasting companies whose annual 3% gross receipts do not exceed P10 M & who are not VAT-registered taxpayers Tax on life insurance premiums 5% Tax on Overseas Dispatch, Message or Conversation 10% from the Philippines Business Tax on Agents of foreign insurance co.- insurance agents 10% Business Tax on Agents of foreign insurance co.- owner of 5% the property Tax on International Carriers 3% Tax on Cockpits 18% Tax on Cabaret, night and day clubs 18% Tax on Boxing exhibitions 10% Tax on Professional basketball games 15% Tax on jai - alai and race tracks 30% Tax on sale, barter or exchange of stocks listed & traded through 1/2 of 1% Local Stock Exchange Tax on shares of stock sold or exchanged through initial and secondary public offering: - Not over 25% 4% - Over 25% but not Exceeding 33 1/3 % 2% - Over 33 1/3% 1% Tax on Banks and Non-Bank Financial Intermediaries Performing Quasi-Banking Functions A. On interest, commissions and discounts from lending activities as well as income from financial leasing, on the basis of the remaining maturities of instrument from which such receipts are derived - Maturity period is five years or less 5%

WB 201 WB 202 WB 203

BIR FORM NO. 1600 - MONTHLY REMITTANCE RETURN OF VALUE-ADDED TAX AND OTHER PERCENTAGE TAXES WITHHELD GUIDELINES AND INSTRUCTIONS

Tax Rate 1% 0% 7% 7%

ATC WB 303 WB 102 WB 103 WB 104

e derived

5% WB 108 1% WB 109 5% WB 110 OLDING AGENTS: 10% WV 040 10% WV 050 10% WV 012 10% 10% 10% 3% 3% 3% WV 014 WV 022 WV 024 WB 080 WB 082 WB 084

ELD

ALPHABETICAL LIST OF PAYEES

Page ___ of ___ FOR THE MONTH OF :
( MM/YYYY)

WITHHOLDING AGENT TIN :

WITHHOLDING AGENT NAME : _______________________________

Schedule II SEQ NO. (1)

TIN (2)

ALPHABETICAL LIST OF PAYEES FROM WHOM TAXES WERE WITHHELD (Attach additional sheet/s, if necessary) PAYEE DETAILS INCOME PAYMENT / TAX WITHHELD DETAILS INDIVIDUAL / CORPORATION NATURE OF PAYMENT AMOUNT ATC (3) (4) (5) (6) (LAST NAME, FIRST NAME, MIDDLE NAME FOR INDIVIDUALS OR REGISTERED NAME FOR NON-INDIVIDUALS)

TAX RATE (7)

TAX REQUIRED TO BE WITHHELD (8)

Total

Page ___ of ___

_____________

TAX REQUIRED TO BE WITHHELD (8)