ANNEX “C1”

Sample layout of VAT and Non-VAT Official Receipt

THIS OFFICIAL RECEIPT SHALL BE VALID

MAG BUSINESS NAME
LO
FOR FIVE (5) YEARS FROM THE DATE OF
ATP.
MARVIN CALAYAN, M.D. GO
NO. 000000500
VAT REG. TIN: 800-000-134-00000 OFFICIAL RECEIPT
DATE: DATE:
20___

610, 6F AGHAM HOSPITAL, QUEZON CITY

CUSTOMER NAME: TIN: ADDRESS:

BUSINESS STYLE TEL. NO. 02 981-8888

BUSINESS STYLE OSCA/PWD NO. SIGNATURE

TOTAL SALES
(VAT INCLUSIVES)

LESS: 12% VAT

IN PAYMENT OF THE FOLLOWING SERVICE/ QTY UNIT PRICE AMOUNT ₱
TRANSACTION/DESCRIPTION NET OF VAT/TOTAL

LESS: SC/PWD DISC.

TOTAL DUE

LESS: WITHHOLDING

TOTAL AMOUNT DUE

VATABLE (V)
VAT EXEMPT (E)
ZERO-RATED (Z)
VAT (12%)
PRINTER’S NAME: TIN: ADDRESS: PRINTER’S ACCREDITATION NO. DATE ISSUED: EXPIRY DATE: TOTAL
[ ] CASH [ ] CHECK [ ] CREDIT
SAM PRINTING SERVICES, INC. 123-456-789-00000 BGY. 123, QUEZON CITY 001MP20180000000003 08-01-17 08-01-22
 PTU NO. BOX/BKLT. NO. SETS: COPIES PER SET: SERIAL NO. BIR ATP NO. DATE ISSUED: VALID UNTIL:
<FOR LOOSELEAF> 2 BKLTS. 100 3x 000000001 - 000000500 3AU000805222 03-31-18 03-30-23 CASHIER/AUTHORIZED PERSON

THIS OFFICIAL RECEIPT SHALL BE VALID

MAG BUSINESS NAME
LO
FOR FIVE (5) YEARS FROM THE DATE OF
ATP.
MARVIN CALAYAN, M.D. GO
NO. 000000500
OFFICIAL RECEIPT
NON-VAT REG. TIN: 800-000-134-00000 DATE: DATE:
20___

610, 6F AGHAM HOSPITAL, QUEZON CITY

CUSTOMER NAME: TIN: ADDRESS:

BUSINESS STYLE TEL. NO. 02 981-8888

BUSINESS STYLE OSCA/PWD NO. SIGNATURE

TOTAL SALES

LESS: SC/PWD DISC.

IN PAYMENT OF THE FOLLOWING SERVICE/ QTY UNIT PRICE AMOUNT ₱
TRANSACTION/DESCRIPTION TOTAL DUE

LESS: WITHHOLDING

TOTAL AMOUNT DUE

SALES SUBJ. TO PT
EXEMPT SALES
[ ] CASH [ ] CHECK [ ] CREDIT

CASHIER/AUTHORIZED PERSON
PRINTER’S NAME: TIN: ADDRESS: PRINTER’S ACCREDITATION NO. DATE ISSUED: EXPIRY DATE:
SAM PRINTING SERVICES, INC. 123-456-789-00000 BGY. 123, QUEZON CITY 001MP20180000000003 08-01-17 08-01-22 “THIS DOCUMENT IS NOT
VALID FOR CLAIM OF
INPUT TAXES”
 PTU NO. BOX/BKLT. NO. SETS: COPIES PER SET: SERIAL NO. BIR ATP NO. DATE ISSUED: VALID UNTIL: ANNEX “C2”
<FOR LOOSELEAF> 2 BKLTS. 100 3x 000000001 - 000000500 3AU000805222 03-31-18 03-30-23
Sample layout of VAT and Non-VAT Sales Invoice

THIS OFFICIAL RECEIPT SHALL BE VALID

TMA BUSINESS NAME
LO
FOR FIVE (5) YEARS FROM THE DATE OF
ATP.
JRC CORPORATION GO
NO. 000000500
VAT REG. TIN: 800-000-134-00000 SALES INVOICE
DATE: DATE:
20___

610, 6F JLHM BLDG. AGHAM RD, QUEZON CITY

SOLD TO: TIN: ADDRESS:

BUSINESS STYLE TEL. NO. 02 981-8888

BUSINESS STYLE OSCA/PWD NO. SIGNATURE

TOTAL SALES
(VAT INCLUSIVES)

LESS: 12% VAT

QTY ARTICLES/DESCRIPTION UNIT PRICE AMOUNT ₱
NET OF VAT/TOTAL

LESS: SC/PWD DISC.

TOTAL DUE

LESS: WITHHOLDING

TOTAL AMOUNT DUE

VATABLE (V)
VAT EXEMPT (E)
ZERO-RATED (Z)
VAT (12%)
PRINTER’S NAME: TIN: ADDRESS: PRINTER’S ACCREDITATION NO. DATE ISSUED: EXPIRY DATE: [TOTAL
] CASH [ ] CHECK [ ] CREDIT
SAM PRINTING SERVICES, INC. 123-456-789-00000 BGY. 123, QUEZON CITY 001MP20180000000003 08-01-17 08-01-22
 PTU NO. BOX/BKLT. NO. SETS: COPIES PER SET: SERIAL NO. BIR ATP NO. DATE ISSUED: VALID UNTIL:
<FOR LOOSELEAF> 2 BKLTS. 100 3x 000000001 - 000000500 3AU000805222 03-31-18 03-30-23 CASHIER/AUTHORIZED PERSON

THIS OFFICIAL RECEIPT SHALL BE VALID

TMA BUSINESS NAME FOR FIVE (5) YEARS FROM THE DATE OF
ATP. LO
JRC CORPORATION GO
NO. 000000500
SALES INVOICE
NON-VAT REG. TIN: 800-000-134-00000 DATE: DATE:
20___

610, 6F JLHM BLDG. AGHAM RD, QUEZON CITY

SOLD TO: TIN: ADDRESS:

BUSINESS STYLE TEL. NO. 02 981-8888

BUSINESS STYLE OSCA/PWD NO. SIGNATURE

TOTAL SALES

LESS: SC/PWD DISC.

QTY ARTICLE/DESCRIPTION UNIT PRICE AMOUNT ₱
TOTAL DUE

LESS: WITHHOLDING

TOTAL AMOUNT DUE

SALES SUBJ. TO PT
EXEMPT SALES
[ ] CASH [ ] CHECK [ ] CREDIT

CASHIER/AUTHORIZED PERSON
PRINTER’S NAME: TIN: ADDRESS: PRINTER’S ACCREDITATION NO. DATE ISSUED: EXPIRY DATE:
SAM PRINTING SERVICES, INC. 123-456-789-00000 BGY. 123, QUEZON CITY 001MP20180000000003 08-01-17 08-01-22 “THIS DOCUMENT IS NOT
VALID FOR CLAIM OF
INPUT TAXES”
 PTU NO. BOX/BKLT. NO. SETS: COPIES PER SET: SERIAL NO. BIR ATP NO. DATE ISSUED: VALID UNTIL:
ANNEX “C3”
<FOR LOOSELEAF> 2 BKLTS. 100 3x 000000001 - 000000500 3AU000805222 03-31-18 03-30-23 Sample layout of Exempt Official Receipt/Sales Invoice

THIS OFFICIAL RECEIPT SHALL BE VALID

DEBBIE S. GIBSON FOR FIVE (5) YEARS FROM THE DATE OF
ATP. LO
NON-VAT REG. TIN: 800-000-134-00000 GO
NO. 000000500

610, 6F LCCV BLDG., AGHAM, QUEZON CITY DATE:

DATE: 20___

BUSINESS STYLE TEL. NO. 02 981-8888

CUSTOMER NAME: TIN: ADDRESS:

BUSINESS STYLE OSCA/PWD NO. SIGNATURE

TOTAL SALES

LESS: DISC.
IN PAYMENT OF THE FOLLOWING SERVICE/ QTY UNIT PRICE AMOUNT ₱
TRANSACTION/DESCRIPTION TOTAL AMOUNT DUE

[ ] CASH [ ] CHECK [ ] CREDIT

CASHIER/AUTHORIZED PERSON
PRINTER’S NAME: TIN: ADDRESS: PRINTER’S ACCREDITATION NO. DATE ISSUED: EXPIRY DATE:
SAM PRINTING SERVICES, INC. 123-456-789-00000 BGY. 123, QUEZON CITY 001MP20180000000003 08-01-17 08-01-22 “THIS DOCUMENT IS NOT
VALID FOR CLAIM OF
INPUT TAXES”
 PTU NO. BOX/BKLT. NO. SETS: COPIES PER SET: SERIAL NO. BIR ATP NO. DATE ISSUED: VALID UNTIL:
<FOR LOOSELEAF> 2 BKLTS. 100 3x 000000001 - 000000500 3AU000805222 03-31-18 03-30-23

THIS OFFICIAL RECEIPT SHALL BE VALID

JMLH BUSINESS NAME FOR FIVE (5) YEARS FROM THE DATE OF
ATP. LO
ELENITA R. MEDINA, SOLE PROPRIETOR GO
NO. 000000500

NON-VAT REG. TIN: 800-000-134-00000 DATE: DATE:

20___

610, 6F MAC BLDG. AGHAM RD, QUEZON CITY

SOLD TO: TIN: ADDRESS:

BUSINESS STYLE TEL. NO. 02 981-8888

BUSINESS STYLE OSCA/PWD NO. SIGNATURE

TOTAL SALES

LESS: DISCOUNT
QTY ARTICLE/DESCRIPTION UNIT PRICE AMOUNT ₱
TOTAL AMOUNT DUE

[ ] CASH [ ] CHECK [ ] CREDIT

CASHIER/AUTHORIZED PERSON
PRINTER’S NAME: TIN: ADDRESS: PRINTER’S ACCREDITATION NO. DATE ISSUED: EXPIRY DATE:
SAM PRINTING SERVICES, INC. 123-456-789-00000 BGY. 123, QUEZON CITY 001MP20180000000003 08-01-17 08-01-22 “THIS DOCUMENT IS NOT
VALID FOR CLAIM OF
INPUT TAXES”
PTU NO. BOX/BKLT. NO. SETS: COPIES PER SET: SERIAL NO. BIR ATP NO. DATE ISSUED: VALID UNTIL:
<FOR LOOSELEAF> 2 BKLTS. 100 3x 000000001 - 000000500 3AU000805222 03-31-18 03-30-23