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.

Name of Employee Taxpayer Amount of Tax Due Withheld

Identification Number Compensation and Remitted
DIZON, ROLAND 463302855 110,000
VILLAFUERTE
ELEGADO, MICHAEL 422927257 110,000
MANUEL
CASTANARES,GEMMA 329491100 99,000
VILLENA
PASCUAL,JOE ANN 417360148 110,000
LAGUERTA
MARCENA,LECEL 262299426 170,500
PRADO
GARCIA,GERMELYN 346623799 104,500
JOY M.
BENITO,BILLY JAN 465949448 99,000
DUZON
TENOSO JR. ,ANTONIO 760453183 99,000
DAZ
SIMON ,JASON 721627840 99,000
CALSES

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.

________________________________________________
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/her ______________________ issued at _________________ on _______________.

NOTARY PUBLIC

Doc. No.: __________

Page No.: __________
Book No.: __________
Series of ___________

Affix ₱30.00

Documentary
Stamp Tax