Certificate of Final Tax Withheld at Source: Kawanihan NG Rentas Internas
Certificate of Final Tax Withheld at Source: Kawanihan NG Rentas Internas
Certificate of Final Tax Withheld at Source: Kawanihan NG Rentas Internas
YOLANDA L. VALDIZNO
Payor/Payor's Authorized Representative Date Signed
Signature Over Printed Name
CONFORME:
Date Signed
Payee/Payee's Authorized Representative
Signature Over Printed Name
To be accomplished for Value-Added Tax/Percentage Tax Withholding (substituted filing)
I declare, under the penalties of perjury, that the information I declare under the penalties of perjury that I am qualified under substituted filing of Percentage
herein stated are reported under BIR Form No. 1600 which Tax/Value Added Tax Returns (BIR Form 2551M/2550M/Q), since I have only one payor from
have been filed with the Bureau of Internal Revenue. whom I earn my income; that, in accordance with RR 14-2003, I have availed of the Optional
Registration under the 3% Final Percentage Tax Wthholding/10% Final VAT Withholding in lieu
of the 3% Percentage Tax/10% VAT in order to be entitled to the privileges accorded by the
Substituted Percentage Tax Return/Substituted VAT Return System prescribed in the aforesaid
Regulations; that, this Declaration is sufficient authority of the withholding agent to withhold 3%
Final Percentage Tax/10% Final VAT from my sale of goods and/or services.
13 14
Payor Information
6 Taxpayer
Identification Number
0 0 0 8 6 3 9 5 8 1 4 2
7 Payor's Name Dep Ed Bulacan-Division Office ( Dagat-Dagatan Elementary School) San Rafael, Bulacan
(Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals)
8 Registered Address 8A Zip Code
Malolos City
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)
Conforme:
Payee/Payee's Authorized Representative Date Signed
Signature Over Printed Name
Appendix 32
Fund Cluster :
Republic of the Philippines
Department of Education 101101
DIVISION OF BULACAN
City of Malolos
June / /2021
DISBURSEMENT VOUCHER DV No. : 2021-01-
Responsibility
Particulars MFO/PAP Amount
Center
To payment of repair Expenses for Dagat-Dagatan ES for the
month of June 2021 , amounting to One thousand six hundred
seventy eight pesos and 98/100 only. (1,678.98)
YOLANDA L. VALDIZNO
School Head
B. Accounting Entry:
Account Title UACS Code Debit Credit
Repair Expenses 50213040 1,678.98
Signature Signature
Printed
Printed Name
Name JENELYN V. VELASCO YOLANDA L. VALDIZNO
Date Date