REPORT ON AVAILMENT OF ABATEMENT UNDER REVENUE REGULATIONS NO.

9- 2010
Revenue Region__________/Large Taxpayers Service ________
RDO _________/LTS Division ______/LTDO _______
For the Month of _____________, 2010

NAME OF TAXPAYER

TIN

PERIOD
COVERED

BIR FORM
KIND OF TAX

(Tax
Return)

DATE OF SUBMISSION
OF DECLARATION

ORIGINAL RETURN FILED

UNDER THESE REGULATIONS

AMENDED RETURN FILED UNDER THESE

REGULATIONS
ORIGINAL

BASIC

INTEREST

BASIC

AMOUNT APPLIED FOR ABAT

AMENDED
BASIC

INTEREST

TOTAL

SURCHARGE

ANNEX B

MENT UNDER REVENUE REGULATIONS NO. 9- 2010

_____/Large Taxpayers Service ________

LTS Division ______/LTDO _______
the Month of _____________, 2010

AMOUNT APPLIED FOR ABATEMENT

COMPROMISE
PENALTY

AMOUNT PAID

BASIC

DATE ENDORSED
TO OCIR

INTEREST

Submitted by:

(Signature Over Printed Name)

Revenue District Officer/
Chief (LTDO/LT Division)