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Reference No:292200045630613
Date Filed:January 16 2022 11:12 AM
Batch Number:0

PSOC: PSIC: 9309

BIR Form No.

Republika ng Pilipinas
Kagawaran ng Pananalapi
0605
Kawanihan ng Rentas Internas Payment Form September 2003(ENCS)

1 For the 3 Quarter Clear Quarter 4 Due Date 5 No. of Sheets Attached 6ATC
Calendar Fiscal (MM/DD/YYYY)

2 Year
Ended 12 - December 2022 1st 2nd 3rd 4th 01 31 2022 0 MC180
(MM/YYYY)

7 Return Period (MM/DD/YYYY) 01 31 2022 8Tax Type Code RF

Part I Background Information
9 Taxpayer Identification No. 10 RDO Code 11 Taxpayer Classification 12 Line of Business/Occupation

233 081 932 000 059 I N OTHER SERVICE ACTIVITIES, N.E.C

13 Taxpayer's Name(Last Name, First Name, Middle Name for Individuals)/(Registered Name for Non-Individuals) 14 Telephone Number
GONZALES, RONIE UMALI

15 Registered Address 16 Zip Code

GEN LUNA POBLACION BATANGAS 4226

17 Manner of Payment 18 Type of Payment

Voluntary Payment Per Audit/Delinquent Account

Self-Assessment Installment

Penalties Preliminary/Final Assess/Deficiency No. of Installment

Tax Deposit/Advance Payment Tax
Income Tax Second Installment(Individual) Accounts Receivable/Delinquent Partial Payment

Others(Specify) Account Full Payment

ANNUAL REGISTRATION FEE

Part
Computation of Tax
II
19 Basic Tax/Deposit/Advance Payment 19 500.00

20 Add Penalties Surcharge Interest Compromise

20A 0.00 20B 0.00 20C 0.00 20D 0.00

21 500.00
21 Total Amount Payable(Sum of Items 19 & 20D)
Payment of Deficiency Taxes
For Voluntary Payment From Audit/Investigation
Delinquent Accounts
I declare, Under the penalties of perjury, that this document has been
made in good faith, verified by me, and to the best of my knowledge
Pre-approved by Investigating Office
and belief, is true and correct, pursuant to the provisions of the
National Internal Revenue Code, as amended, and the regulations Not approved by Investigating Office
issued under authority thereof.

Print Payment Details Proceed to Payment

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