BIR FORM 1601-C

(To be filled up by the BIR)

DLN:

PSOC:

Monthly Remittance Return of Income Taxes Withheld on Compensation

Republika ng Pilipinas Kagawaran ng Pananalapi

Kawanihan ng Rentas Internas

Fill in all applicable spaces. Mark all appropriate boxes with an “X”. 1 For the Month 2  Amended Return? 3 No. of Sheets Attached (MM / YYYY) Yes No No Part I Background Information 5 TIN 6 RDO Code 7 Line of Business/   Occupation

8

PSIC: BIR Form No.

1601-C July 2008 (ENCS) 4 Any Taxes Withheld?

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

10 Registered Address

13  Are there payees availing availing of tax relief under under Special Law or International Tax Treaty? No If yes, specify  Yes

Government

Part II

Telephone Number 

14 A T C WW 0 1 0

Computation of Tax Amount of Compensation

Particulars 15 Total Amount of Compensation

Tax Due

15

Less: Non-Taxable Compensation 16A Statutory Minimum Wage (MWEs)

16

9

No

11 Zip Code

12 Category of Withholding Agent Private

Yes

16A

16B Holiday Pay,Overtime Pay,Overtime Pay, Night Shift Differential Pay, Hazard Pay (Minimum Wage Earner) 16C Other Non-Taxab Non-Taxable le Com ensation ensation

16B

16C

17 Taxable Compensation

17

18 Tax Required to be Withheld

18

Add/Less: Adjustment (from Item 26 of Section Section A)

19

20 Tax Required to be Withheld for Remittance

20

Less: Tax Remitted in Return Return Previously Filed, if this is an amended return Other Payments Made (please attach proof of payment payment BIR Form No. No. 0605)

21A 21B

22 Total Tax Payments Made (Sum of Item Nos. 21A & 21B) Due/(Overremittance) (Item No. 20 less Item No. 22) 23 Tax Still Due/(Overremittance) 24

Add: Penalties Surcharge 24A

23

Interest

Compromise

24B

24C

24D 25

25 Total Amount Still Due/(Overremittance) Section A Previous Month(s) (1) (MM/YYYY)

Adjustment of Taxes W ithheld on Compensation For Previous Months Date Paid Bank Validation/ (2) ROR No. (MM/DD/YYYY) (3)

Section A (continuation) Tax Paid (Excluding Penalties) for the Month (5)

Should Be Tax Due for the Month (6)

From Current Year (7a)

Bank Code (4)

Adjustment (7) From Year - End Adjustment of the Immediately Preceeding Year (7b)

26 Total (7a plus 7b) (To Item 19) We declare, under the penalties of perjury, perjury, that this return has been been made in good good faith, verified by us, and to the best of our knowledge 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. President/Vice President/Vice President/Principal President/Principal Officer/Accredited Tax Agent/  Authorized Representative Representative / Taxpayer Taxpayer (Signature Over Printed Name) Title/Position of Signatory Tax Agent Acc. No./Atty's Roll No.(if applicable)

Part III Drawee Bank/ Particulars Agency 29B 29 Cash/Bank 29A Debit Memo 30B 30 Check 30A 31 Others

31A

31B

Treasurer/Assistant Treasurer/Assistant Treasurer  (Signature Over Over Printed Name) Name)

TIN of Signatory Date of Issuance

Title/Position of Signatory Date of Expiry

TIN of Signatory

Details of Payment Date Number MM DD YYYY

Amount

29C

29D

30C

30D

31C

31D

Machine Validation/Revenue Official Receipt Details (If not filed with the bank)

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