Certificate of Creditable Tax Withheld at Source: Kawanihan NG Rentas Internas

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BIR Form No.

Republika ng Pilipinas
Certificate of Creditable Tax
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas
Withheld At Source
2307
September 2005 (ENCS)

1 For the Period


From (MM/DD/YY) To (MM/DD/YY)
Part I Payee Information
2 Taxpayer
Identification Number
3 Payee's Name
(Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals)
4 Registered Address 4A Zip Code

5 Foreign Address 5A Zip Code

Payor Information
6 Taxpayer
Identification Number
7 Payor's Name
(Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals)
8 Registered Address 8A Zip Code

PART II Details of Monthly Income Payments and Tax Withheld for the Quarter
Income Payments Subject to AMOUNT OF INCOME PAYMENTS
ATC
Expanded Withholding Tax 1st Month of 2nd Month of 3rd Month of Total Tax Withheld
the Quarter the Quarter the Quarter For the Quarter

Total - -
Money Payments Subject to Withholding
of Business Tax (Government & Private)

Total - -
We declare, under the penalties of perjury, that this certificate has been made in good faith, verified by me, and to the best of my knowledge and belief, is true and correct,
pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof.

Payor/Payor's Authorized Representative/Accredited Tax Agent TIN of Signatory Title/Position of Signatory


(Signature Over Printed Name)

Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry
Conforme:

Payee/Payee's Authorized Representative/Accredited Tax Agent TIN of Signatory Title/Position of Signatory Date Signed
(Signature Over Printed Name)

Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry

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