(To be filled up by the BIR) DLN:

PSOC:

PSIC:

Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas

Annual Information Return of Income Taxes Withheld on

Compensation and Final Withholding Taxes

BIR Form No.

1604-CF
July 2008 (ENCS)

Fill in all applicable spaces. Mark all appropriate boxes with an X. 1 For the Year 2 Amended Return? 3 No of Sheets Attached 2010 (YYYY) Yes No Part I Background Information 4 TIN 5 RDO Code 6 Line of Business/ Occupation (Last Name, First Name, Middle Name for Individuals)/(Registered Name for Non-Individuals) 8 Telephone No. 7 Withholding Agent's Name 9 Registered Address 10 Zip Code

11 In case of overwithholding/overremittance after the year-end adjustment on compensation, If yes, specify have you released the refund/s to your employee/s? Yes No the date of refund 12 Total Amount of Overremittance on 13 Month of First Crediting of 14 Category of Withholding Agent Tax Withheld under Compensation Overremittance Private Government Part II S u m m a r y o f R e m i t t a n c e s Schedule 1 R e m i t t a n c e p e r B I R F o r m N o. 1601-C NAME OF BANK/BANK CODE/ DATE OF TOTAL AMOUNT TAXES WITHHELD MONTH REMITTANCE ADJUSTMENT PENALTIES ROR NO., IF ANY REMITTED JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC TOTAL Schedule 2 R e m i t t a n c e p e r B I R F o r m N o. 1601-F NAME OF BANK/BANK CODE/ DATE OF TAXES TOTAL AMOUNT ROR NO., IF ANY WITHHELD REMITTED PENALTIES MONTH REMITTANCE JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC TOTAL Schedule 3 R e m i t t a n c e p e r B I R F o r m N o. 1602 NAME OF BANK/BANK CODE/ DATE OF TAXES TOTAL AMOUNT ROR NO., IF ANY WITHHELD REMITTED MONTH REMITTANCE PENALTIES JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC TOTAL Schedule 4 R e m i t t a n c e p e r B I R F o r m N o. 1603 NAME OF BANK/BANK CODE/ DATE OF TAXES TOTAL AMOUNT ROR NO., IF ANY QUARTER REMITTANCE WITHHELD REMITTED PENALTIES 1ST QTR 2ND QTR 3RD QTR 4TH QTR TOTAL We declare, under the penalties of perjury, that this declaration has been made in good faith, verified by us, and to the best of our Stamp of Receiving Office and knowledge and belief, is true and correct, pursuant to the provisions of the National Internal Revenue Code, as amended, and the Date of Receipt
regulations issued under authority thereof.

15

President/Vice President/Principal Officer/Accredited Tax Agent/ Authorized Representative/Taxpayer (Signature Over Printed Name) Title/Position of Signatory TIN of Signatory Date of Expiry

16

Treasurer/Assistant Treasurer (Signature Over Printed Name)

Title/Position of Signatory TIN of Signatory

Tax Agent Acc. No./Atty's Roll No.(if applicable)Date of Issuance

Part III Schedule 5 SEQ TIN

NO.

BIR Form 1604-CF (ENCS) - PAGE 2 Alphabetical List of Employees/ Payees from whom Taxes were Withheld (format only) ALPHALIST OF PAYEES SUBJECT TO FINAL WITHHOLDING TAX (Reported Under BIR Form No. 2306) NATURE OF INCOME AMOUNT OF NAME OF PAYEES ADDRESS OF * STATUS ATC RATE (As to Residence/ (Last Name, First Name, PAYEES PAYMENT INCOME OF Nationality) (Refer to BIR Form No. 1601-F) Middle Name for Individuals, PAYMENT TAX
complete name for Non - Individuals)

AMOUNT OF TAX WITHHELD (Not Creditable) (10) P

(1)

(2)

(3)

(4)

(5)

(6)

(7) P

(8)

(9)

Total Schedule 6 SEQ NO. (1) TIN NAME OF EMPLOYEES Last Name (3a) First Name (3b) Middle Name (3c) ATC AMOUNT OF FRINGE BENEFIT (5) P P GROSSED - UP MONETARY VALUE (6)

P
ALPHALIST OF EMPLOYEES OTHER THAN RANK AND FILE WHO WERE GIVEN FRINGE BENEFITS DURING THE YEAR (Reported Under BIR Form No. 2306)

(2)

(4)

AMOUNT OF TAX WITHHELD (NOT CREDITABLE) (7) P

Total * A - Citizens of the Philippines

B - Resident Alien Individuals C - Non-Resident Alien Engaged in Business D - Non-Resident Alien not Engaged in Business E - Domestic Corporation F - Resident Foreign Corp. G - Non-Resident Foreign Corp. H - Alien employees of oil exploration service contractors and subcontractors, offshore banking units and regional or area headquarters of multinational corporations

CF

Government

r y o f R e m i t t a n c e s p e r B I R F o r m N o. 1601-C TOTAL AMOUNT REMITTED

p e r

B I R

F o r m

N o. 1601-F TOTAL AMOUNT REMITTED

p e r

B I R

F o r m

N o. 1602 TOTAL AMOUNT REMITTED

p e r

B I R

F o r m

N o. 1603 TOTAL AMOUNT REMITTED

Stamp of Receiving Office and Date of Receipt

ees from whom Taxes were Withheld (format only) AMOUNT OF TAX WITHHELD (Not Creditable) (10)

WERE GIVEN FRINGE BENEFITS DURING THE YEAR (Reported Under BIR Form No. 2306)

AMOUNT OF TAX WITHHELD (NOT CREDITABLE) (7)

D - Non-Resident Alien not Engaged in Business

ALPHABETICAL LIST OF EMPLOYEES/PAYEES FROM WHOM TAXES WERE WITHHELD (FORMAT ONLY)
(Use Schedule 7.5 for Minimum Wage Earner) Schedule 7.1 ALPHALIST OF EMPLOYEES TERMINATED BEFORE DECEMBER 31 (Reported Under BIR Form No. 2316)

(Use the same format as in Schedule 7.3 but prepare a separate column (before Gross Compensation) for inclusive date of employment. The annualized method should have been applied in computing the tax due from the employee upon termination of the employment contract.)
Schedule 7.2 SEQ TIN NO (1) (2) NAME OF EMPLOYEES Last First Middle Name Name Name (3a) (3b) (3c) ALPHALIST OF EMPLOYEES WHOSE COMPENSATION INCOME ARE EXEMPT FROM WITHHOLDING TAX BUT SUBJECT TO INCOME TAX (Reported Under BIR Form No. 2316) (Applicable from January 1 to July 5, 2008) (4) GROSS COMPENSATION INCOME Gross NON - TAXABLE Total Non-Taxable/Exempt TAXABLE EXEMPTION Premium Paid Compensation SSS,GSIS,PHIC, & Pag - ibig Salaries & Other Forms Compensation Code Amount 13th Month Pay De Minimis Basic Salaries & Other Forms on Health and/or Income Contributions, and Union Dues of Compensation Income Hospital & Other Benefits Benefits Salary of Compensation 4(a) 4(d) 4(e) 4(f) ( 5a) ( 5b) Insurance (6) 4(b) 4(c) 4(g) 4(h) Net Taxable Compensation Income (7)

TOTALS Schedule 7.3 SEQ TIN NO (1) (2) NAME OF EMPLOYEES Last First Middle Name Name Name (3a) (3b) (3c)

Gross Compensation Income 4(a)

13th Month Pay & Other Benefits 4(b)

ALPHALIST OF EMPLOYEES AS OF DECEMBER 31 WITH NO PREVIOUS EMPLOYER WITHIN THE YEAR (Reported Under BIR Form No.2316) (4) GROSS COMPENSATION INCOME NON - TAXABLE SSS,GSIS,PHIC, & Pag - ibig Salaries & Other Forms Total Non-Taxable/Exempt 13th Month Pay De Minimis Basic Contributions, and Union Dues of Compensation Compensation Income & Other Benefits Benefits Salary 4(d) 4(e) 4(f) 4(h) 4(c) 4(g)

TAXABLE Salaries & Other Forms of Compensation 4(i)

Total Taxable Compensation Income 4(j)

TOTALS Schedule 7.3 (continuation) Premium Paid on EXEMPTION Health and/or Hospital Insurance Code Amount (6) (5a) (5b)

P Net Taxable Compensation Income (7)

P TAX DUE (JAN. -DEC.) (8)

P AMOUNT OF TAX WITHHELD AS ADJUSTED ( to be reflected in BIR Form No. 2316) (11)=(9+10a) or (9-10b)

P Substituted Filing? Yes/No (12)

ALPHALIST OF EMPLOYEES AS OF DECEMBER 31 WITH NO PREVIOUS EMPLOYER WITHIN THE YEAR TAX WITHHELD YEAR - END ADJUSTMENT (10a or 10b) (JAN. - NOV.) AMOUNT WITHHELD OVER WITHHELD TAX AND PAID FOR REFUNDED TO IN DECEMBER EMPLOYEE (9) (10a) = (8) - (9) (10b)=(9) - (8)

P Schedule 7.4 SEQ TIN NO

P NAME OF EMPLOYEES Last Name First Name (3b) Middle Name (3c)

Gross Compensation Income (4a)

(1)

(2)

(3a)

13th Month Pay & Other Benefits (4b)

ALPHALIST OF EMPLOYEES AS OF DECEMBER 31 WITH PREVIOUS EMPLOYER/S WITHIN THE YEAR (Reported Under BIR Form No. 2316) GROSS COMPENSATION INCOME PRESENT EMPLOYER PREVIOUS EMPLOYER NON - TAXABLE NON - TAXABLE TAXABLE Total Taxable SSS,GSIS,PHIC & SSS,GSIS,PHIC & Salaries 13th Month Pay Total Non-Taxable 13th Month De De Minimis Basic Salaries & Salaries & (Previous Employer) Pay & Other Minimis Pag - ibig Contributions, Pag - ibig Contributions, Other Forms & Other Compensation Income Benefits Salary Other Forms Other Forms and Union Dues and Union Dues Of Compensation Benefits (Previous) Benefits Benefits of Compensation of Compensation (4m) (4d) (4e) (4h) (4j= 4g+4h+4i) (4k) (4l) (4n) (4c) (4f) (4g) (4i)

TOTALS

P
Total Compensation Present

P Total Taxable (Previous & Present

Employers )

P Premium Paid on Health and/or Hospital Insurance (6) Net Taxable

Compen-

P TAX DUE (JAN. DEC.) (8)

P TAX WITHHELD (JAN. - NOV.) PREVIOUS EMPLOYER (9a)

P AMOUNT OF TAX WITHHELD AS ADJUSTED (To be reflected in BIR Form No. 2316 issued by the present employer ) (11)=(9b+10a) or (9b-10b)

Schedule 7.4 (continuation)

PRESENT EMPLOYER

ALPHALIST OF EMPLOYEES AS OF DECEMBER 31 WITH PREVIOUS EMPLOYER/S WITHIN THE YEAR EXEMPTION
Code

Basic Salary (4p)

TAXABLE 13th Month Pay Salaries & & Other Other Forms Benefits of Compensation (4q) (4r)

(4s = 4p+4q+4r)

(4t = 4j+ 4s)

(5a)

Amount (5b)

sation Income (7)

PRESENT EMPLOYER (9b)

YEAR - END ADJUSTMENT (10a or 10b) AMOUNT W/HELD OVER WITHHELD TAX & PAID FOR REFUNDED TO IN DECEMBER EMPLOYEE (10a)=(8)-(9a+9b) (10b)=(9a+9b)-(8)

P NAME OF EMPLOYEES Last Name First Name (3b) Middle Name (3c)

Schedule 7.5 SEQ TIN NO

ALPHALIST OF MINIMUM WAGE EARNERS Region No. Where Assigned (4) TOTALS P

Gross Compensation
Income Previous

Basic/ SMW (5b) P

Holiday Overtime Pay Pay (5c) P P (5d)

(1)

(2)

(3a)

(5a)

Night Hazard Shift Pay Differential (5e) (5f) P P P

(Reported Under BIR Form No. 2316) GROSS COMPENSATION INCOME PREVIOUS EMPLOYER NON - TAXABLE 13th Month Pay SSS,GSIS,PHIC & Salaries & Other De Minimis & Other Pag - ibig Contributions, Forms of Benefits Benefits and Union Dues Compensation (5g) (5i) (5j) (5h) P P P P

Total NonTaxable/Exempt Compensation Income (5k)

13th Month Pay & Other Benefits (5l) P P

TAXABLE Salaries & Other Forms of Compensation (5m)

Schedule 7.5 (continuation)

Inclusive Date of Employment From To (5o) (5p) P

Gross Compensation Income (5q) P

Basic SMW Per Day (5r) P

Basic SMW Per Month (5s) P

Basic SMW Per Year (5t)

ALPHALIST OF MINIMUM WAGE EARNERS (Reported Under BIR Form No. 2316) GROSS COMPENSATION INCOME PRESENT EMPLOYER NON-TAXABLE 13th Month Pay SSS,GSIS,PHIC & Factor Used Holiday Overtime Night Shift Hazard De Minimis & Other Pag - ibig Contributions, (No. of Pay Pay Differential Pay Benefits Benefits and Union Dues Days/Year) (5z) (5ab) (5u) (5v) (5w) (5x) (5y) (5aa) P P P P P P P P

Salaries & Other Forms of Compensation (5ac)

TAXABLE 13th Month Pay SALARIES & & Other OTHER FORMS Benefits OF COMP. (5ad) (5ae) P P P

Total Compensation Present (5af) P

Total Compensation Income (Previous & Present Employers ) (5ag)

Schedule 7.5 (continuation) EXEMPTION Premium Paid on Health and/or Hospital Net Taxable Compensation Income TAX DUE (JAN. - DEC.)

ALPHALIST OF MINIMUM WAGE EARNERS TAX WITHHELD (JAN. - NOV.) PREVIOUS

(Reported Under BIR Form No. 2316) YEAR - END ADJUSTMENT (11a or 11b) AMOUNT W/HELD OVER WITHHELD TAX & PAID FOR REFUNDED TO AMOUNT OF TAX WITHHELD AS ADJUSTED

PRESENT

Insurance Code (6a) Amount (6b) (7) (8) (9)

EMPLOYER (10a)

EMPLOYER (10b) P SMW - Statutory Minimum Wage P

IN DECEMBER (11a) = (9) - (10a+10b)

EMPLOYEE (11b) = (10a+10b) - (9) P P

(To be reflected in BIR Form No. 2316 issued by the present employer )

(12) = (10b+11a) or (10b -11b)

P P P P P Note: For schedule numbers 5, 6 and 7.1, 7.2, 7.3, 7.4 prepare separate schedules for foreign nationals/payees

LOYEES/PAYEES FROM WHOM TAXES WERE WITHHELD (FORMAT ONLY)

7.3 but prepare a separate column (before Gross Compensation) for inclusive date of employment. en applied in computing the tax due from the employee upon termination of the employment contract.)
Tax Due (8)

P (4) GROSS COMPENSATION INCOME TAXABLE Total Taxable Compensation Income 4(j)

Substituted Filing? Yes/No (12)

GROSS COMPENSATION INCOME

PRESENT EMPLOYER NON - TAXABLE Total Non-Taxable Compensation Income (Present) (4o)

P AMOUNT OF TAX WITHHELD AS ADJUSTED (To be reflected in BIR Form No. 2316 issued by the present employer ) (11)=(9b+10a) or (9b-10b)

GROSS COMPENSATION INCOME PREVIOUS EMPLOYER TAXABLE Total Taxable

(Previous Employer)

(5n = 5l + 5m) P

Total Compensation Income (Previous & Present Employers ) (5ag)

AMOUNT OF TAX WITHHELD AS ADJUSTED

(To be reflected in BIR Form No. 2316 issued by the present employer )

(12) = (10b+11a) or (10b -11b)