Annex B

(NAME OF THE ENTITY)

Condensed Statement of Financial Performance
For theYear Ended December 31, ______

Note 2015 2014

Revenue
Tax Revenue 23 xxx xxx
Service and Business Income 24 xxx xxx
Shares, Grants and Donations 25 xxx xxx

Total Revenue xxx xxx

Less: Current Operating Expenses

Personnel Services 26 xxx xxx
Maintenance and Other Operating Expenses 27 xxx xxx
Financial Expenses 28 xxx xxx
Direct Costs 29 xxx xxx
Non-Cash Expenses 30 xxx xxx

Current Operating Expenses xxx xxx

Surplus/(Deficit) from Current Operations xxx xxx

Net Financial Assistance/Subsidy 31 xxx xxx

Sale of Assets 32 xxx xxx
Gains 33 xxx xxx
Losses 34 (xxx) (xxx)

Surplus/(Deficit) for the period xxx xxx

 Appendix 4

Agency
Condensed Statement of Financial Performance
For theYear Ended December ___ , 20X4

Notes 20X4 20X3

Revenue
Tax Revenue 19 xxx xxx
Service and Business Income 20 xxx xxx
Assistance and Subsidy 21 xxx xxx
Shares, Grants and Donations 22 xxx xxx
Gains 23 xxx xxx
Other Non-Operating Income 24 xxx xxx
Total Revenue xxx xxx

Expenses
Personal Services 24 xxx xxx
Maintenance and Other Operating Expenses 25 xxx xxx
Financial Expenses 26 xxx xxx
Direct Costs 27 xxx xxx
Non-Cash Expenses 28 xxx xxx
Total Expenses xxx xxx

Surplus/(Deficit) for the Period xxx xxx

2
* format is based on IPSAS 1 Annex and accounts used is
based on the Revised Chart of Accounts

3
Agency
Condensed Statement of Financial Performance
For theYear Ended December ___ , 20X4

Notes 20X4 20X3

Revenue
Tax Revenue xxx xxx
Service and Business Income xxx xxx
Shares, Grants and Donations xxx xxx
Gains xxx xxx
Sale of Assets xxx xxx
Total Revenue xxx xxx

Less Current Operating Expenses

Personnel Services
Salaries and Wages xxx xxx
Other Compensation xxx xxx
Personnel Benefit Contributions xxx xxx
Other Personnel Benefits xxx xxx
Total Personnel Services xxx xxx

Maintenance and Other Operating Expenses

Traveling Expenses xxx xxx
Training and Scholarship Expenses xxx xxx
Supplies and Materials Expenses xxx xxx
Utility Expenses xxx xxx
Communication Expenses xxx xxx
Awards/Rewards and Prizes xxx xxx
Survey, Research, Exploration and Development Expenses xxx xxx
Demolition/Relocation and Desilting/Dredging Expenses xxx xxx
Generation, Transmission and Distribution Expenses xxx xxx
Confidential, Intelligence and Extraordinary Expenses xxx xxx
Professional Services xxx xxx
General Services xxx xxx
Repairs and Maintenance xxx xxx
Taxes, Insurance Premiums and Other Fees xxx xxx
Labor and Wages xxx xxx
Other Maintenance and Operating Expenses xxx xxx
Depreciation xxx xxx
Amortization xxx xxx
Impairment Loss xxx xxx
Losses xxx xxx
Total Maintenance and Other Operating Expenses xxx xxx

Current Operating Expenses xxx xxx

Agency
Condensed Statement of Financial Performance
For theYear Ended December ___ , 20X4

Notes 20X4 20X3

Profit (Loss) from Current Operations xxx xxx

Financial Assistance/Subsidy from LGUs, GOCCs, NGOs/POs xxx xxx

Less: Financial Assistance/Subsidy to LGUs, GOCCs, NGOs/Pos xxx xxx
Net Financial Assistance/Subsidy xxx xxx

Gains xxx xxx

Losses xxx xxx
Surplus (Deficit) for the period xxx xxx
 Annex B1

ENTITY NAME
DETAILED STATEMENT OF FINANCIAL PERFORMANCE
(ALL FUNDS OR NAME OF FUND)
FOR THE YEAR ENDED DECEMBER 31, 2014

2014

Revenue
Tax Revenue
Tax Revenue - Individual and Corporation
Income Tax xxx
Professional Tax xxx
Travel Tax xxx
Immigration Tax xxx
Tax Revenue - Property
Estate Tax xxx
Donors Tax xxx
Capital Gains Tax xxx
Tax Revenue - Goods and Services
Import Duties xxx
Excise Tax xxx
Business Tax xxx
Tax on Sand, Gravel and Other Quarry Products xxx
Tax on Delivery Vans and Trucks xxx
Tax Revenue - Others
Documentary Stamp Tax xxx
Motor Vehicles Users' Charge xxx
Other Taxes xxx
Tax Revenue - Fines and Penalties
Taxes on Individual and Corporation xxx
Property Taxes xxx
Taxes on Goods and Services xxx
Other Taxes xxx
xxx

Service and Business Income

Service Income
Permit Fees xxx
Registration Fees xxx
Registration Plates, Tags and Stickers Fees xxx
Clearance and Certification Fees xxx
Franchising Fees xxx
Licensing Fees xxx
Supervision and Regulation Enforcement Fees xxx
Spectrum Usage Fees xxx
Legal Fees xxx
Inspection Fees xxx
Verification and Authentication Fees xxx
Passport and Visa Fees xxx
Processing Fees xxx

30
 Annex B1

2014
Fines and Penalties - Service Income xxx

31
 Annex B1

2014
Other Service Income xxx
xxx
Business Income
School Fees xxx
Affiliation Fees xxx
Examination Fees xxx
Seminar/Training Fees xxx
Rent/Lease Income xxx
Communication Network Fees xxx
Transportation System Fees xxx
Road Network Fees xxx
Waterworks System Fees xxx
Power Supply System Fees xxx
Seaport System Fees xxx
Landing and Parking Fees xxx
Income from Hostels/Dormitories and Other Like Facilities xxx
Slaughterhouse Operation xxx
Income from Printing and Publication xxx
Sales Revenue xxx
Less: Sales Discounts xxx
Net Sales xxx

Hospital Fees xxx

Guarantee Income xxx
Fidelity Insurance Income xxx
Dividend Income xxx
Interest Income xxx
Share in the Profit of Joint Venture xxx
Fines and Penalties - Business Income xxx
Service Concession Revenue xxx
Other Business Income xxx
xxx

Shares, Grants and Donations

Share from National Wealth xxx
Share from PAGCOR/PCSO xxx
Share from Earnings of GOCCs xxx
Income from Grants and Donations in Cash xxx
Income from Grants and Donations in Kind xxx
xxx
Gains
Gain on Initial Recognition of Biological Assets xxx
Gain on Sale of Biological Assets xxx
Gain from Changes in Fair Value Less Cost to Sell of Biological
Assets Due to Physical Change xxx
Gain from Changes in Fair Value Less Cost to Sell of Biological
Assets Due to Price Change xxx
Gain on Sale of Agricultural Produce xxx
xxx

32
 Annex B1

2014
Total Revenue xxx

33
 Annex B1

2014

Less Current Operating Expenses

Personnel Services
Salaries and Wages
Salaries and Wages - Regular xxx
Salaries and Wages - Casual/Contractual xxx
xxx
Other Compensation
Personal Economic Relief Allowance (PERA) xxx
Representation Allowance (RA) xxx
Transportation Allowance (TA) xxx
Clothing/Uniform Allowance xxx
Subsistence Allowance xxx
Laundry Allowance xxx
Quarters Allowance xxx
Productivity Incentive Allowance xxx
Overseas Allowance xxx
Honoraria xxx
Hazard Pay xxx
Longevity Pay xxx
Overtime and Night Pay xxx
Year End Bonus xxx
Cash Gift xxx
Other Bonuses and Allowances xxx
xxx
Personnel Benefit Contributions
Retirement and Life Insurance Premiums xxx
PhilHealth Contributions xxx
Employees Compensation Insurance Premiums xxx
Provident/Welfare Fund Contributions xxx
xxx
Other Personnel Benefits
Pension Benefits xxx
Retirement Gratuity xxx
Terminal Leave Benefits xxx
Other Personnel Benefits xxx
xxx
Total Personnel Services xxx

Maintenance and Other Operating Expenses

Traveling Expenses
Traveling Expenses - Local xxx
Traveling Expenses - Foreign xxx
xxx
Training and Scholarship Expenses
Training Expenses xxx
Scholarship Grants/Expenses xxx
xxx

34
 Annex B1

2014
Supplies and Materials Expenses
Office Supplies Expenses xxx
Accountable Forms Expenses xxx
Non-Accountable Forms Expenses xxx
Animal/Zoological Supplies Expenses xxx
Food Supplies Expenses xxx
Welfare Goods Expenses xxx
Drugs and Medicines Expenses xxx
Medical, Dental and Laboratory Supplies Expenses xxx
Fuel, Oil and Lubricants Expenses xxx
Agricultural and Marine Supplies Expenses xxx
Textbooks and Instructional Materials Expenses xxx
Military, Police and Traffic Supplies Expenses xxx
Chemical and Filtering Supplies Expenses xxx
Other Supplies and Materials Expenses xxx
xxx
Utility Expenses
Water Expenses xxx
Electricity Expenses xxx
xxx
Communication Expenses
Postage and Courier Services xxx
Telephone Expenses xxx
Internet Subscription Expenses xxx
Cable, Satellite, Telegraph and Radio Expenses xxx
xxx
Awards/Rewards and Prizes
Awards/Rewards Expenses xxx
Prizes xxx
xxx
Survey, Research, Exploration and Development Expenses
Survey Expenses xxx
Research, Exploration and Development Expenses xxx
xxx
Demolition/Relocation and Desilting/Dredging Expenses
Demolition and Relocation Expenses xxx
Desilting and Dredging Expenses xxx
xxx
Generation, Transmission and Distribution Expenses
Generation, Transmission and Distribution Expenses xxx

Confidential, Intelligence and Extraordinary Expenses

Confidential Expenses xxx
Intelligence Expenses xxx
Extraordinary and Miscellaneous Expenses xxx
xxx
Professional Services
Legal Services xxx
Auditing Services xxx
Consultancy Services xxx

35
 Annex B1

2014
Other Professional Services xxx
xxx
General Services
Environment/Sanitary Services xxx
Janitorial Services xxx
Security Services xxx
Other General Services xxx
xxx
Repairs and Maintenance
Repairs and Maintenance - Investment Property xxx
Repairs and Maintenance - Land Improvements xxx
Repairs and Maintenance - Infrastructure Assets xxx
Repairs and Maintenance - Buildings and Other Structures xxx
Repairs and Maintenance - Machinery and Equipment xxx
Repairs and Maintenance - Transportation Equipment xxx
Repairs and Maintenance - Furniture and Fixtures xxx
Repairs and Maintenance - Leased Assets xxx
Repairs and Maintenance - Leased Assets Improvements xxx
Restoration and Maintenance - Heritage Assets xxx
Repairs and Maintenance - Other Property, Plant and Equipment xxx
xxx
Taxes, Insurance Premiums and Other Fees
Taxes, Duties and Licenses xxx
Fidelity Bond Premiums xxx
Insurance Expenses xxx
xxx
Labor and Wages
Labor and Wages xxx

Other Maintenance and Operating Expenses

Advertising Expenses xxx
Printing and Publication Expenses xxx
Representation Expenses xxx
Transportation and Delivery Expenses xxx
Rent/Lease Expenses xxx
Membership Dues and Contributions to Organizations xxx
Subscription Expenses xxx
Donations xxx
Litigation/Acquired Assets Expenses xxx
Other Maintenance and Operating Expenses xxx

Total Maintenance and Other Operating Expenses xxx

Financial Expenses
Financial Expenses
Management Supervision/Trusteeship Fees xxx
Interest Expenses xxx
Guarantee Fees xxx
Bank Charges xxx
Commitment Fees xxx
Other Financial Charges xxx

36
 Annex B1

2014

Total Financial Expenses xxx

37
 Annex B1

2014
Non-Cash Expenses
Depreciation
Depreciation - Investment Property xxx
Depreciation - Land Improvements xxx
Depreciation - Infrastructure Assets xxx
Depreciation - Buildings and Other Structures xxx
Depreciation - Machinery and Equipment xxx
Depreciation - Transportation Equipment xxx
Depreciation - Furniture, Fixtures and Books xxx
Depreciation - Leased Assets xxx
Depreciation - Leased Assets Improvements xxx
Depreciation - Heritage Assets xxx
Depreciation - Service Concession Assets xxx
Depreciation - Other Property, Plant and Equipment xxx
xxx
Amortization
Amortization - Intangible Assets xxx

Impairment Loss
Impairment Loss - Financial Assets Held to Maturity xxx
Impairment Loss - Loans and Receivables xxx
Impairment Loss - Lease Receivables xxx
Impairment Loss - Investments in GOCCs xxx
Impairment Loss - Investments in Joint Venture xxx
Impairment Loss - Other Receivables xxx
Impairment Loss - Inventories xxx
Impairment Loss - Investment Property xxx
Impairment Loss - Property, Plant and Equipment xxx
Impairment Loss - Biological Assets xxx
Impairment Loss - Intangible Assets xxx
Impairment Loss - Investments in Associates xxx
Impairment Loss - Other Assets xxx
xxx
Losses
Loss on Sale of Biological Assets xxx
Loss on Sale of Agricultural Produce xxx
Loss on Initial Recognition of Biological Assets xxx
xxx

Total Non-Cash Expenses xxx

Current Operating Expenses xxx

Surplus (Deficit) from Current Operations xxx

Financial Assistance/Subsidy from LGUs, GOCCs

Subsidy from National Government xxx
Subsidy from other NGAs xxx
Assistance from Local Government Units xxx

38
 Annex B1

2014
Assistance from Government-Owned and/or Controlled Corporations xxx
xxx
Less: Financial Assistance/Subsidy to LGUs, GOCCs, NGOs/POs
Financial Assistance to NGAs xxx
Subsidy to NGAs (for BTr only) xxx
Financial Assistance to Local Government Units xxx
Budgetary Support to GOCCs xxx
Financial Assistance to NGOs/POs xxx
Subsidies - Others xxx
xxx
Net Financial Assistance/Subsidy xxx

Other Non-Operating Income

Sale of Assets
Sale of Garnished/Confiscated/Abandoned/Seized Goods and Properties xxx
Gains
Gain on Foreign Exchange (FOREX) xxx
Gain on Sale of Investments xxx
Gain on Sale of Investment Property xxx
Gain on Sale of Property, Plant and Equipment xxx
Gain on Sale of Intangible Assets xxx
Other Gains xxx
xxx
Losses
Loss on Foreign Exchange (FOREX) xxx
Loss on Sale of Investments xxx
Loss on Sale of Investment Property xxx
Loss on Sale of Property, Plant and Equipment xxx
Loss on Sale of Intangible Assets xxx
Loss on Sale of Assets xxx
Loss of Assets xxx
Loss on Guaranty xxx
Other Losses xxx
xxx

Surplus (Deficit) for the period xxx

39