DLN: PSIC: PSOC: Kagawaran ng Pananalapi Kawanihan ng ...

1 (To be filled up the BIR)DLN: PSIC: PSOC: Fill in all applicable spaces. Mark all appropriate boxes with an "X"1 For the Calendar Fiscal3 Quarter 4 Due Date ( MM / DD / YYYY)5No. of Sheets6A T C2 Year Ended Attached ( MM / YYYY ) 1st2nd3rd4th7 Return Period ( MM / DD / YYYY )8 Tax Type Code BCS No. (To be filled up by the BIR)78 Part I B a c k g r o u n d I n f o r m a t i o n 9 Taxpayer Identification Code11 Taxpayer Classification12 Line of Business/Occupation I N13 Taxpayer's 1314 Telephone Number Name (Last Name, First Name, Middle Name for Individuals) / (Registered Name for Non-Individuals) 15 Registered16 Zip Code Address17 Manner of Payment18 Type of PaymentVoluntary PaymentPer Audit/Delinquent AccountInstallmentSelf-AssessmentPenalti esPreliminary/Final Assessment/Deficiency TaxNo.

2 Of InstallmentTax Deposit/Advance PaymentAccounts Receivable/Delinquent AccountPartialIncome Tax Second InstallmentPayment(Individual)FullOthers (Specify)PaymentPart II C o m p u t a t i o n o f T a x19 Basic Tax / Deposit / Advance Payment 1920 Add: PenaltiesSurcharge Interest Compromise 20A20B 20C20D21 Total Amount Payable (Sum of Items 19 & 20D) 21 For Voluntary PaymentFor Payment of Deficiency TaxesStamp of ReceivingFrom Audit/Investigation/Officeand Date of Receipt I declare, under the penalties of perjury, that this document has been APPROVED BY: 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.

3 And the regulations issued under authority 22A Signature over Printed Name of Taxpayer/Authorized RepresentativeTitle/Position of SignatoryPart III D e t a i l s of P a y m e n tParticulars Drawee Bank/AgencyNumber MMDDYYYY Amount23 Cash/Bank 23 Debit Memo 24A 24B 17C 24C 24D24 Check25 Tax Debit 25A25B 25 CMemo 26A 26B 19C 26C 26D26 OthersMachine Validation/Revenue Official Receipt Details (If not filed with the bank)Taxpayer Classification:I - IndividualN - Non-IndividualBIR Form 0605 (ENCS) - PAGE 2 ATCNATURE OF PAYMENTATCNATURE OF PAYMENTATCNATURE OF PAYMENTD eliquent AccountsSignature over Printed Name of Head of Office BIR Form Form0605 republika ng PilipinasKagawaran ng PananalapiKawanihan ng Rentas Internas July 1999 (ENCS) II 011 Pure Compensation IncomeTobacco ProductsXP120 Avturbo Jet FuelII 012 Pure Business IncomeXT010 & XT020 Smoking and Chewing TobaccoXP130 & XP131 KeroseneII 013 Mixed (Compensation and Business)

4 XT030 CigarsXP170 AsphaltsMC 180 Vat/Non-Vat Registration FeeXT040 Cigarettes Packed By HandXP150 & XP160 LPG GasMC 190 Travel TaxXT050-XT130 Cigarettes Packed By MachineXP010, XP020 &Basetocks, Lubes and MC 090 Tin Card FeesTobacco Inspection FeesXP190 GreasesMC010 & MC020 Tax AmnestyXT080 CigarsXP040 Waxes and PetrolatumMC 040 Income from Forfeited PropertiesXT090 CigarettesXP030 Processed GasMC 050 Proceeds from Sale of Rent EstateXT100 & XT110 Leaf Tobacco & Other Manufactured Tobacco Miscellaneous Products/ArticlesMC 060 Energy Tax on Electric Power ConsumptionXT120 Monitoring FeesXG020-XG090 AutomobilesMC 031 Deficiency TaxPetroleum ProductsXG100-XG120 Non Essential GoodsMC 030 Delinquent Accounts/Accounts ReceivableXP070 Premium (Leaded) GasolineMineral ProductsFP 010 - FP 930 Fines and PenaltiesXP060 Premium (Unleaded)

5 GasolineXM010 Coal & CokeMC 200 OthersXP080 Regular GasolineXM020 Non Metallic & Quarry ResourcesExcise Tax on GoodsXP090 & XP100 Naptha & Other Similar ProductsXM030 Gold and ChromiteAlcohol ProductsXP110 Aviation GasolineXM040 Copper & Other Metallic MineralsXA010-XA040 Distilled SpiritsXP140 Diesel GasXM050 Indigenous PetroleumXA061-XA090 WinesXP180 Bunker Fuel OilXM051 OthersXA051-XA053 Fermented LiquorT A X T Y P ECode DescriptionCode DescriptionCode DescriptionRFREGISTRATION FEECSCAPITAL GAINS TAX - StocksWCWITHHOLDING TAX-COMPENSATIONTRTRAVEL TAX-PTAESESTATE TAXWEWITHHOLDING TAX-EXPANDEDETENERGY TAXDNDONOR'S TAXWFWITHHOLDING TAX-FINALQPQUALIFYING FEES-PAGCORVTVALUE-ADDED TAXWGWITHHOLDING TAX - VAT AND OTHERMCMISCELLANEOUS TAXPTPERCENTAGE TAXPERCENTAGE TAXESXVEXCISE-AD VALOREMSTPERCENTAGE TAX - STOCKS WOWITHHOLDING TAX-OTHERS (ONE-TIME TRAN-XSEXCISE-SPECIFICSOPERCENTAGE TAX - STOCKS (IPO)SACTION NOT SUBJECT TO CAPITAL XFTOBACCO INSPECTION AND SLPERCENTAGE TAX - SPECIAL LAWSGAINS TAX)MONITORING FEESDSDOCUMENTARY STAMP TAXWRWITHHOLDING TAX - FRINGE BENEFITSITINCOME TAXWBWITHHOLDING TAX-BANKS AND OTHERWWWITHHOLDING TAX - PERCENTAGE TAXCGCAPITAL GAINS TAX - Real PropertyFINANCIAL INSTITUTIONSON WINNING AND PRIZESBIR Form No.

6 0605 - Payment FormGuidelines and InstructionsWho Shall UseEvery taxpayer shall use this form, in triplicate, topay taxes and fees which do not require the use of a taxreturn such as second installment payment for incometax, deficiency tax, delinquency tax, registration fees,penalties, advance payments, deposits, installmentpayments, and Where to File and PayThis form shall be accomplished:1. Everytime a tax payment or penalty is dueor an advance payment is to be made; receipt of ademand letter/assessment notice and/orcollection letter from the BIR; and3. Upon payment of annual registration fee fornew business and for renewals on or beforeJanuary 31 of every form shall be filed and the tax shall be paidwith any Authorized Agent Bank (AAB) under thejurisdiction of the Revenue District Office where thetaxpayer is required to register/conductingbusiness/producing articles subject to excise tax/havingtaxable transactions.

7 In places where there are noAABs, this form shall be filed and the tax shall be paiddirectly with the Revenue Collection Officer or dulyAuthorized City Or Municipal Treasurer of theRevenue District Office where the taxpayer is requiredto register/conducting business/producing articlessubject to excise tax/having taxable transactions, whoshall issue Revenue Official Receipt (BIR Form ) the return is filed with an AAB, thelower portion of the return must be properlymachine-validated and stamped by the AuthorizedAgent Bank to serve as the receipt of payment. Themachine validation shall reflect the date of payment,amount paid and transaction code, and the stampmark shall show the name of the bank, branch code,teller s name and teller s initial.

8 The AAB shall alsoissue an official receipt or bank debit advice or creditdocument, whichever is applicable, as additionalproof of set of form shall be filled-up for each kindof tax and for each taxable Duly approved Tax Debit Memo, if applicable;2. Copy of letter or notice from the BIR for whichthis payment form is accomplished and the taxis paid whichever is applicable:a. Pre-Assessment / Final AssessmentNotice/Letter of Demandb. Post Reporting Noticec. Collection Letter of Delinquent/Accounts Receivabled. Xerox copy of the return(ITR)/Reminder Letter in case ofpayment of second installment onincome : All background information must beproperly filled up.

9 The last 3 digits of the 12-digit TIN refers to thebranch code. ENCS