ANNEX A of JAO No.

1-2019 (Revision 1)

Name of Cooperative
Branch
Count Region Province
Code
based on CDA registration

A B C D E
1 000 REGION- IX Zamboanga Del Sur PAGADIAN CITY DRY GOODS MULTI PURPOSE COOPERATIVE
1 000 REGION - IX Zamboanga Del Sur PAGADIAN CITY DRY GOODS MULTI PURPOSE COOPERATIVE

Prepared By: Verified/Validated By:

GEAMARY L. MANATAD TIBURCIO POLLESCAS

BOOKKEEPER Manager
 CDA Certificate of Registration (If amended, post the latest date of
amendment based on issued latest COR)

Registered Address
/Branch Registered
Address
Latest Date of
Original Date of Latest Amendment
No.0000-00000000 Amendment
Registration No.
(mm/dd/yy)

F G H I J
Stall #10-13A and 10-14A, Agora9520-09000071
Market Sta. Lucia District 7/3/1995
, Pagadian City, Zamboanga Del Sur 2/19/2019
Stall #10-13A and 10-14A, Agora9520-09000071
Market Sta. Lucia District 7/3/1995
, Pagadian City, Zamboanga Del Sur 2/19/2019

Attested By:

_______________
Chairperson
 Certificate of Tax Exemption

Taxpayer
Identification No.
000-000-000-000 With CTE Start of Effectivity
(Y/N) Date Issued Date of Tax
CTE No. Status of CTE
Just write Y (mm/dd/yy) Exemption (first
or N issued CTE)

K L M N O P
004-320-786-000 Y COOP-00007-20-RR-15-RDO-092
2/14/2020 valid 9/22/2014
004-320-786-000 Y COOP-00007-20-RR-15-RDO-092
2/14/2020 valid 9/22/2014
 Type of Transactions
Business Activities (members only, non -
(Business Activity- members or both)
singular only, so it
Category of
Type of Cooperative will not be lump)
Cooperative
End of Effectivity (breakdown each
Date of Tax business undertaking Members Members &
Exemption per main/branch) Only Non Members
(latest CTE issued)

Q R S T U V
2/14/2025 Multipurpose coop Primary Lending Y
2/14/2025 Multipurpose coop Primary Consumer Y
 Net Sale / Services / Interest Income (Tot
Number of (one line only))
Cooperatives Gross Sales/Receipts (Net Sales = Gross Sales - Sales Returns and
General Reserve Allowances and Sales Discounts)
(Branches) (copy and
Fund
paste per line of
(accumulated)
activity) (in main
(as of
office one line only)
DECEMBER
(no need to input Non- Total Non-
31,2022) Members Members
number in the members (Y+Z=AA) members
branch/es rows)

W X Y Z AA AB AC
1 4,071,385.02 3,003,341.77 444,120.00 3,447,461.77
2 4,071,385.02 1,162,777.10 238,129.00
/ Interest Income (Total
ine only))
ales - Sales Returns and
d Sales Discounts)
Gross Revenue (include Other
Cost of Sales / Services Income) (one liner)
(To apportioned based on the (Net Sales/Services/Interest
percentage of Y and Z) Income - Cost Sales/Services +
Other Income)
Expenses
(To apportioned based on the
percentage of Y and Z)

Total
Total Total
Total Non- (AE+AF=AG) Non- Non-
Members Members (AH+AI= Members (AK+AL=
(AB+AC=AD) members members members
AJ) AM)

AD AE AF AG AH AI AJ AK AL AM

1,400,906.10
 Net surplus for Allocation Allocations for statutory distribution
Allocation
for Interest Allocation for Patronage
on Share Refund (PR)
for for
Capital (ISC)
for General Education Communi for
Non- Total
Members Reserve and ty Optional
members (AN+AO= AP)
Fund Training Developm Fund
Fund ent Fund
Members Members
AN AO AP AQ AR AS AT AU AV
1,762,555.72 176,255.58 176,255.58 52,876.67 123,378.90 616,894.51 616,894.51
 TOTAL
llocation for Patronage
ISCPR Actual Income tax Actual Vat
Refund (PR)
(AU+AV+AW paid Payments
)

Non-Members
AW AX AY AZ
1,233,789.02