BIR 2316 Waiver Form

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To: EXLService Philippines Inc.

, Human Resources

CERTIFICATION

This is to certify that I, Mr/Ms ______________________________, of legal age, ____ (civil status), with
postal address at __________________________________________and presently employed with
EXLService Philippines Inc., as ________________ (position), with TIN Number ________________
certify that I was not submit my Certificate of Income Tax on Compensation (BIR Form No. 2316) from
my previous employer due to the following reason/s:

Please check reason/s:

___No previous employer for 2021 (prior to employment in EXLService Philippines Inc.)

___Certificate of Income Tax Withheld on Compensation (BIR Form No. 2316) was not available from my
previous employer.

I further certify that whatever taxes due from me as a result of my failure to submit the above documents
to EXLService Philippines Inc. will be borne by me and I will pay directly to the Bureau of Internal
Revenue (BIR) upon filing of my Income Tax for the year 2021.

Signed this _____day of _________, 2021

Conforme:

__________________________________

Printed Name and Signature

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