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["(To be filled up by the BIR)"]
["    DLN:"]
[]
[]
[]
[]
[]
["  Fill in all applicable spaces. Mark all appropriate boxes with an “X”. "]
["1","For the Year",{"$nulls":7},"2  Amended Return",{"$nulls":7},"3  No. of sheets attached",{"$nulls":6},"4",{"$nulls":3},"Compensation Earner"]
[null,"(YYYY)",{"$nulls":10},"Yes",{"$nulls":3},"No",{"$nulls":11},"Marginal Income Earner"]
[]
["Part I                                                                       ",null,"                B a c k g r o u n d    I n f o r m a t i o n "]
["                                          Taxpayer/Filer",{"$nulls":19},"                            Spouse"]
[5,"TIN",{"$nulls":11},"  6 RDO ",{"$nulls":5},"    7  TIN",{"$nulls":12},"  8 RDO"]
[{"$nulls":13},"     Code",{"$nulls":18},"     Code"]
[9,"Taxpayer's Name  (Last Name, First Name,  Middle Name)",{"$nulls":17},"    10",null,"Spouse's Name  (Last Name, First Name,  Middle Name)"]
[]
[]
["11","Registered Address",{"$nulls":17},"    12",null,"Registered Address"]
[]
[]
["13 Date of Birth (MM/DD/YYYY)",{"$nulls":7},"  14  Zip Code",{"$nulls":3},"15","Telephone Number",{"$nulls":5},"    16 Date of Birth (MM/DD/YYYY)     17 Zip Code       18 Telephone Number "]
[]
["19","Exemption Status",{"$nulls":10},"         19A   Number of Qualified ",{"$nulls":9},"  19B",null,"Is the wife claiming the additional exemption for "]
[null,null,"Single ",null,null," Head of the Family",{"$nulls":5},"   Married",null,null,"   Dependent Children",{"$nulls":9},"qualified dependent children?",{"$nulls":9}," Yes              No"]
["PART II                                                                                     ",{"$nulls":15},"Computation of Tax"]
[{"$nulls":21},"    Taxpayer/Filer",{"$nulls":10},"      Spouse"]
["20","Gross Taxable Compensation Income  (Schedule 1)",{"$nulls":15},"   20A",{"$nulls":10},"  20B"]
[null,"Other Taxable Income (Non-business/Non-profession Income"]
[null,"Including Net  Income of Marginal Income Earners)"]
["21",{"$nulls":16},"   21A",{"$nulls":10},"  21B"]
["22",{"$nulls":16},"   22A",{"$nulls":10},"  22B"]
[]
["23","Gross  Taxable Income (Sum of Items20A,21A,22A/20B,21B,22B)",{"$nulls":15},"   23A",{"$nulls":10},"  23B"]
["24",null,"Less:Total Personal & Additional  Exemptions (Schedule 2)",{"$nulls":14},"   24A",{"$nulls":10},"  24B"]
[null,null,"          Premium paid on health and/or hospitalization insurance"]
[{"$nulls":3},"    not to exceed P2,400 per year. (See Instructions)",{"$nulls":13},"   24C",{"$nulls":10},"  24D"]
[null,"     Total (Sum of Items 24A & 24C/24B & 24D)",{"$nulls":15},"   24E",{"$nulls":10},"  24F"]
["25"," Taxable Income (Item 23A less Item 24E/ Item 23B less Item 24F)",{"$nulls":15},"   25A",{"$nulls":10},"  25B"]
[]
["26","Tax Due",{"$nulls":15},"    26A",{"$nulls":10},"  26B"]
[null,"      [Aggregate Tax Due -  (Sum of Items 26A and 26B)]",{"$nulls":21},"26C"]
["27",null,"Less:Tax Credits/Payments"]
[null,null,"     Tax Withheld Per BIR Form No. 2316",{"$nulls":14},"    27A",{"$nulls":10},"  27B"]
[null,null,"     Foreign Tax Credits",{"$nulls":14},"    27C",{"$nulls":10},"  27D"]
[null,null,"     Tax Paid in Return Previously Filed, if this is an amended"]
[{"$nulls":3},"  return",{"$nulls":13},"    27E",{"$nulls":10},"  27F"]
[null,"      Total Tax Credits/Payments (Sum of Items 27A,27C,27E/27B,",{"$nulls":15},"    27G",{"$nulls":10},"  27H"]
[null,null,"      27D, 27F)"]
["28","Tax Payable (Overpayment)(Item 26A less Item 27G/ Item 26B less Item 27H)",{"$nulls":15},"    28A",{"$nulls":10},"  28B"]
["29",null,"Add: Penalties"]
[{"$nulls":3},"  Surcharge",{"$nulls":13},"    29A",{"$nulls":10},"  29B"]
[{"$nulls":3},"  Interest",{"$nulls":13},"    29C",{"$nulls":10},"  29D"]
[{"$nulls":3},"  Compromise",{"$nulls":13},"    29E",{"$nulls":10},"  29F"]
[null,"      Total Penalties (Sum of Items 29A,29C & 29E/29B,"]
[null,null,"    29D, & 29F)",{"$nulls":14},"    29G",{"$nulls":10},"  29H"]
["30","Total Amount Payable/(Overpayment)(Sum of Items 28A & ",{"$nulls":15},"    30A",{"$nulls":10},"  30B"]
[null,null,"    29G / 28B  & 29H)"]
[null,"Aggregate Amount Payable/(Overpayment)(Sum of Items 30A & 30B)",{"$nulls":21},"30C"]
["31","       Less: Amount Paid in this Return/First Installment",{"$nulls":21}," 31"]
["32","Amount Still Due on or before July 15, if taxpayer is allowed to pay by installment",{"$nulls":21}," 32"]
[]
["     I declare, under the penalties of perjury, that this return has been made in good faith, verified by me, and to the best of my knowledge and belief,"]
["is true and correct, pursuant to the provisions of the National Internal Revenue Code, as amended, and regulations issued under authority thereof."]
[{"$nulls":8},"`",{"$nulls":6},33]
[{"$nulls":15},"         Taxpayer/Authorized Agent (Signature over Printed Name)"]
["Community Tax Certificate No.",{"$nulls":9},"     Place of Issue",{"$nulls":7}," Date of Issue (MM/DD/YYYY)",{"$nulls":7},"                Amount"]
["34",{"$nulls":7},"    35",{"$nulls":8},36,{"$nulls":8},"   37",{"$nulls":6},"Stamp of Receiving"]
[]
["Part III",null,null,"D e t a i l s   o f   P a y m e n t",{"$nulls":29},"Office and "]
[{"$nulls":4},"   Drawee Bank/",{"$nulls":11},"        Date"]
["Particulars",{"$nulls":3},"        Agency",{"$nulls":5},"             Number",{"$nulls":4},"     MM",null,"DD        YYYY",{"$nulls":5},"            Amount",{"$nulls":9},"Date of Receipt"]
["38 Cash/Bank ",{"$nulls":20},"  38"]
["        Debit Memo................................................................................………………….."]
["39 Check      39A",{"$nulls":7},"   39B",{"$nulls":5},"  39C",{"$nulls":6},"  39D"]
["40 Tax Debit ",{"$nulls":7},"   40A",{"$nulls":5},"  40B",{"$nulls":6},"  40C"]
["        Memo ............……………….."]
["41 Others     41A",{"$nulls":7},"   41B",{"$nulls":5},"  41C",{"$nulls":6},"  41D"]
[]
["Machine Validation/Revenue Official Receipt Details (If not filed with the bank)"]
[]
[]
[]
[]
[]
[]
["Schedule 1",{"$nulls":3},"                                                                Gross Compensation Income  and Tax Withheld",{"$nulls":26},"BIR Form 1700 (ENCS)-Page 2"]
[{"$nulls":13},"Tax Withheld",{"$nulls":11},"Compensation Income"]
["Name of Employer",{"$nulls":6},"TIN",{"$nulls":5},"Taxpayer/Filer",{"$nulls":6},"Spouse",{"$nulls":5},"Taxpayer/Filer",{"$nulls":5},"Spouse"]
[]
[]
[]
[]
[]
["Schedule 2",{"$nulls":3},"                                                                Qualified Dependent Children"]
["Name",{"$nulls":9},"Birth Date",{"$nulls":3},"(MM/DD/YYYY)",{"$nulls":4},"Name",{"$nulls":9},"Birth Date  (MM/DD/YYYY)"]
[]
[]
[]
["Other Dependents (to be acomplished if taxpayer is Head of the Family)"]
["Name",{"$nulls":14},"Birth Date  (MM/DD/YYYY)",{"$nulls":8},"Relationship to Taxpayer"]
[]
[]
[{"$nulls":16},"              TAX TABLE"]
["If Taxable Income is:",{"$nulls":9},"Tax Due is:",{"$nulls":9},"If Taxable Income is:",{"$nulls":9},"Tax Due is:"]
[null,null,"Not over P  10,000",{"$nulls":9},"          5 %"]
["Over   P   10,000   but not over  P   30,000",{"$nulls":8},"   P  500  + 10 %  of the excess over  P 10,000",{"$nulls":10},"Over   P 140,000   but not over  P 250,000",{"$nulls":8},"   P   22,500  + 25 %  of the excess over  P 140,000"]
["Over   P   30,000   but not over  P   70,000",{"$nulls":8},"   P  2,500  + 15 %  of the  excess over P 30,000",{"$nulls":10},"Over   P 250,000   but not over  P 500,000",{"$nulls":8},"   P   50,000  + 30 %  of the excess over  P 250,000"]
["Over   P   70,000   but not over  P 140,000",{"$nulls":8},"   P   8,500  + 20 %  of the excess over  P 70,000",{"$nulls":10},"Over   P 500,000 ",{"$nulls":8},"   P 125,000  + 34 %  of the excess over  P 500,000"]
["Note : Effective January 1, 1999, the maximum rate will be changed to 33% and 32% on January 1, 2000."]
["BIR Form 1700 - Annual Income  Tax Return"]
["Guidelines and Instructions"]