ANNEX “F”

CERTIFICATION
This is to certify that the employees listed below are qualified for substituted filing of their Income Tax
Return pursuant to the provisions of Section 2.83.4 of Revenue Regulations No. 2-98, as amended.

AMOUNT OF TAX DUE WITHHELD

NAME OF EMPLOYEES TIN
COMPENSATION AND REMITTED
ALERIA, JAMES 000-000-000-0000 102,960.00
-
CADAYUNA, POLOGENCIO 000-000-000-0000 91,080.00
-
DE GRACIA, RICHARD 000-000-000-0000 89,760.00
-
JUANES, RANDY 000-000-000-0000 88,320.00
-
PAGAO, STEPHEN 000-000-000-0000 92,160.00
-
SAGAYSAY, RENEBOY 000-000-000-0000 96,000.00
-
SUAREZ, JOEBERT 000-000-000-0000 95,040.00
-
TARE, BEBIANO 000-000-000-0000 89,760.00
-
HAYAGAN, JUNNIA 000-000-000-0000 93,840.00
-
DEGRACIA, REY JAME 000-000-000-0000 95,040.00
-
RADIN, VICENTE 000-000-000-0000 108,000.00
-

I declare under the penalties of perjury, that this declaration has been made in good faith and to the best of
my knowledge and belief to be true and correct.

JENNIFER FAITH L. YU
Signature over Printed Name of Individual Income
Payor/Authorized Officer of Non-Individual Income
Payor

SUBSCRIBED AND SWORN to before me this day of 20 in ,

Applicant Exhibited to me his TIN 917-545-713-000.

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