TAX PAYER ID: N 001-001-000000120

ADDRESS: Cdla. Los Jardines

PHONE: 2978442 IRS AUTHORIZATION N 41457889

DATE 03/12/2015 CITY: Machala

BILL TO : NORY TEXTILE FACTORY ID:

DOCUMENT: Invoice N

FISCAL YEAR CONCEPT TAXABLE % WITHOLDING FISCAL YEAR CONCEPT TAXABLE % WITHOLDING

2015 Income Tax 2800,00 1% 28,00

SUBTOTAL SUBTOTAL 28,00

BALANCE DUE twenty eight ENE CONC

WITHHOLDING:

VAT Income Tax Income Tax

The tax withholding form is used for withholding taxes to a buyer or seller.

070896541200112001

07085987