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Annex D

Inventory List of Unused/Expired Principal and Supplementary Receipts & Invoices


As of < MM / DD / YYYY>

Name of Taxpayer: _________________________________________________________________

Business/Trade Name: _________________________________________________________________

Taxpayer Identification Number (TIN): _________________________ Branch Code: _____________

Business Address: _________________________________________________________________

ATP OCN: ______________________________ Date Issued: ________________________________

DESCRIPTION OF RECEIPTS/INVOICES

No. of Booklets No. of Serial Nos.


Sets No. of
Copies
Per
DESCRIPTION TYPE Loose Bound Booklet Per Set From To

____________________________
(Signature over Printed Name of Taxpayer)

Received by:

_____________________________
(TSS Chief/Registration Section Chief)

Verified correct by:

________________________________
(Officer of the Day – Assessment Section)

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