Monthly Percentage

2551M
BIR Form No.
Republika ng Pilipinas

Tax Return
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas
September 2005 (ENCS)
1 For the Calendar Fiscal 3 For the month (MM /YYYY) 4 Amended Return? No. of Sheets
5 Attached
2
Year Ended
12 - December 2015 08 - August 2015 0
(MM/YYYY) Yes
No

Part I Background Information

6 TIN 110 083 108 000 7 RDO 53A Line of Business / Occupation
8
Code GENERAL MERCHANDISE
9 Taxpayer's Name (For Individual) Last Name, First Name, Middle Name/ (For Non-individual) Registered Name 10 Telephone Number
ADIA, PABLO ABANES 9553346
11 Registered Address 12 Zip Code
443 REAL STREET TALON LAS PINAS 1747
13 Are you availing of tax relief under Special Law / International Tax Treaty? Yes No If yes, specify

Part II Computation of Tax ATC

Taxable Transaction / Industry Classification ATC Taxable Amount Tax Rate Tax Due

PERSON EXEMPT FROM VAT UNDER SEC. 109V (SEC. 16) PT010 17,320.00 3.0 519.60

19 Total Tax Due 19 519.60

20 Less: Tax Credits/Payments
20A Creditable Percentage Tax Withheld Per BIR Form No. 2307 (See Schedule 1) 20A 0.00
20B Tax Paid in Return Previously Filed, if this is an amended return 20B 0.00
21 Total Tax Credit/Payments (Sum of Items 20A & 20B) 21 0.00
22 Tax Payable (Overpayment) (Item 19 less Item 21) 22 519.60
23 Add Penalties Surcharge Interest Compromise

23A 0.00 23B 0.00 23C 0.00 23D 0.00

24 Total Amount Payable (Overpayment) (Sum of Items 22 and 23D) 24 519.60

If Overpayment, mark one box only To be Refunded To be issued a Tax Credit Certificate
Schedule 1 Tax Withheld Claimed as Tax Credit
Period Covered Name of Withholding Agent Income Payments Tax Withheld Applied

Total Amount(to item 20A)................. 0.00