0605 Version 1999

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Transcript of 0605 Version 1999

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    (To be filled up the BIR)

    DLN: PSIC: PSOC:

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

    1 For the alendar Fiscal 3 !uarter 4 ue ate ( MM # # $$$$) 5 %o. of &heets 6 ' T

    2 $ear nded 'ttached

    ( MM # $$$$ ) st *nd +rd ,th

    7 Return -eriod ( MM # # $$$$ ) 8 Tax Tpe ode B& %o.#Ite/ %o. (To be filled up b the BIR)

    Part I B a c k g r o u n d I n f o r m a t o n

    ! Taxpaer Identification %o. 1" R0 ode 11 Taxpaer lassification 12 1ine of Business#0ccupation

    I %

    13

    %a/e

    (1ast %a/e2 First %a/e2 Middle %a/e for Indi3iduals) # (Re4istered %a/e for %on5Indi3iduals)

    15 Re4istered

    'ddress

    6oluntar -a/ent -er 'udit#elin7uent 'ccount Install/ent

    &elf5'ssess/ent -enalties -reli/inar#Final 'ssess/ent#eficienc Tax %o. of Install/ent

    Tax eposit#'d3ance -a/ent 'ccounts Recei3able#elin7uent 'ccount -artial

    Inco/e Tax &econd Install/ent -a/ent

    (Indi3idual) Full

    0thers (&pecif) -a/ent

    Part II C o m # u t a t o n o f $ a %

    1! Basic Tax # eposit # 'd3ance -a/ent1!

    8 ena es urc ar4e n eres o/pro/ se

    2"& 2"B 2"C 2"D

    21 Total '/ount -aable (&u/ of Ite/s 9 : *;)

    21

    'or (o)untar* Pa*m+nt 'or Pa*m+nt of D+fc+nc* $a%+, Stam# of -+c+.ng

    'rom &udt/In.+,tgaton/ Offc+

    I declare2 under the penalties of peread of 0ffice

    Part III D + t a ) , of P a * m + n t

    -articulars rawee Bank#'4enc %u/ber MM $$$$ '/ount

    23

    ebit Me/o

    24& 24B 24C 24D

    25& 25B 25CMe/o

    26& 26B 26C 26D

    Machine 6alidation#Re3enue 0fficial Receipt etails (If not filed with the bank)

    Taxpaer lassification8 I 5 Indi3idual % 5 %on5Indi3idual

    Taxpaer?s 14Telephone %u/ber

    16 @ip ode

    17 Manner of -a/ent 18 Tpe of -a/ent

    23 ash#Bank

    24 heck

    25 Tax ebit

    26 0thers

    BIR For/ %o.

    Pa*m+nt 'orm "6"5Republika n4 -ilipinasAa4awaran n4 -ananalapi

    Aawanihan n4 Rentas Internas

    ul 999 (%&)

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    BIR For/ ;C;D (%&) 5 -'E *

    &$C N&$- O' P&N$ &$C N&$- O' P&N$ &$C N&$- O' P&N$

    II ; -ure o/pensation Inco/e Tobacco -roducts X-*; '3turbo et Fuel

    II ;* -ure Business Inco/e XT;; : XT;*; &/okin4 and hewin4 Tobacco X-+; : X-+ Aerosene

    II ;+ Mixed (o/pensation and Business) XT;+; i4ars X-; 'sphalts

    M G; 6at#%on56at Re4istration Fee XT;,; i4arettes -acked B >and X-D; : X-C; 1-E Eas

    M 9; Tra3el Tax XT;D;5XT+; i4arettes -acked B Machine X-;;2 X-;*; : Basetocks2 1ubes and

    M ;9; Tin ard Fees Tobacco Inspection Fees X-9; reases

    M;; : M;*; Tax '/nest XT;G; i4ars X-;,; Haxes and -etrolatu/

    M ;,; Inco/e fro/ Forfeited -roperties XT;9; i4arettes X-;+; -rocessed Eas

    M ;D; -roceeds fro/ &ale of Rent state XT;; : XT; 1eaf Tobacco : 0ther Manufactured Tobacco Miscellaneous -roducts#'rticles

    M ;C; ner4 Tax on lectric -ower onsu/ption XT*; Monitorin4 Fees XE;*;5XE;9; 'uto/obiles

    M ;+ eficienc Tax -etroleu/ -roducts XE;;5XE*; %on ssential Eoods

    M ;+; elin7uent 'ccounts#'ccounts Recei3able X-;; -re/iu/ (1eaded) Easoline Mineral -roducts

    F- ;; 5 F- 9+; Fines and -enalties X-;C; -re/iu/ (nleaded) Easoline XM;; oal : oke

    M *;; 0thers X-;G; Re4ular Easoline XM;*; %on Metallic : !uarr Resources

    xcise Tax on Eoods X-;9; : X-;; %aptha : 0ther &i/ilar -roducts XM;+; Eold and hro/ite

    'lcohol -roducts X-; '3iation Easoline XM;,; opper : 0ther Metallic Minerals

    X';;5X';,; istilled &pirits X-,; iesel Eas XM;D; Indi4enous -etroleu/

    X';C5X';9; Hines X-G; Bunker Fuel 0il XM;D 0thers

    X';D5X';D+ Fer/ented 1i7uor

    $ & $ P

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    BI- 'orm No "6"5 Pa*m+nt 'orm

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