CERTIFICATION

(BIR Waiver Form)

This is to certify that I, Mr./Ms._____________________________of legal age, civil status____________ with postal
address at,_________________________________________ and presently employed with Ubiquity Global Services
Philippines, Inc., as (___________________), with TIN _______________ certify that I was not able to 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 (don’t leave blank):

� No previous employer for 2023 (prior to employment in Ubiquity Global Services Philippines, Inc.)

� Certificate of Income Tax Withheld on Compensation (2023 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 Ubiquity
Global Services 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 Return (ITR) for the year 2023.

I understand that I am also required to submit a NOTARIZED COPY of this form to HR within seven (7)
days from my hire date.

Upon signing of this certification, I also acknowledge that my tax exemption code, for payroll purposes, shall remain
as Zero (Z) Exemption, unless the following have been complied with as required by the Company pursuant to BIR
Rulings, to change my tax code exemption:

● Sec 2.80 of RR2-98 – Failure to file Application for Registration (BIR Form 1902) or Certificate of Update of
Exemption and of Employer’s and Employee’s Information (BIR Form 2305)

a. Where an employee, in violation of these regulations, either fails or refuses to file the BIR Form 1902
together with the required attachments, the employer shall withhold the taxes prescribed under the
Schedule of Zero Exemption of the 2023 Withholding Tax Table.

b. In case of failure to file the BIR Form 2305 together with the attachments, the employer shall withhold
the taxes based on the reported personal exemptions existing prior to change of status and without
reflecting any change.

● Submission of approved BIR Forms as proof of approved BIR Forms as proof of tax exemption.

Signed this ___th day of________, 2023.

Conforme:

Printed Name and Signature