‘REGISTERING OFFICE. "REGISTERED ADDRESS, Scanned with CamScannerFTIEICATE MUST BE EXHIBITED, CO! Scanned with CamScannerANNEX" \COME PAYEE'S SWORN DECLARATION OF GROSS RECEIPTS/SALES (For Sett-Employed and/or Engaged in the Practice of Profession with Lone Income Payor) 1 Renee. Corse famboa PALA Fading tapi MA manny ge SILOM "Ft ie io sr wt “Taxpayer Weeaion Number TP)_DBS ~ BIW = FFL seer having teen uy mom in accordance wih bere depose an ste i \ 1. Martens my teetont__ income ely om Bren eer ne si Taxpayer Leicton None 819 21 te ea TO eas Gore _Sats tr Dn, Fann, Copan iy, eer, ee Oy, Pavone 12 That forthe current year_2824, my gros receipts will nt exceed Tuo Hundred Fifty Thousand Pesos (P250,000.00) and Eat sorgisandasanooVAT uapnjer tha ehuacrrtheamoun oftccne acne twill emply eioroerencne {bcm nce Tat Ren one pci Su dae Feria pup. Topo ma feet ono ne elon Gi Grausted income Tax Rates under Section 24(AX2Xa) ofthe Tax Coe, as amended, based on he table ‘come. Wih this selection acknowledge that Lam sbjet oO income ta, thus not saeco redial ‘withholding tax: subject to peretage a, iapplicable ard wil file he roped personne os oe ne ‘subject to witbolding percenage at, im ese oF BovEMETEN mney payer ign recent (8%) nc tr Seon (AY 2NY) fhe Tas Cae, at nena bse en pro Sc eran eto ts Skis imes ne ie emg mines Se eee ‘ho withholding tx shal be made, . 3. That sd on my cleo sony sos lee andthe on aprig incre excels 250,000 bat tt cn, my sores oa oye Sel nena wie sneha see 4 Incase of Gradoaed Income Tax Rates, acknowledge that aside from income ta, Iam subject to butiness tax (Percentage Tat, if applicable) ad creditable witbolding oficome in excess of P2S0,00000 at basins tx ion. any, aplebl oe eatinsoe paymen OR . Inco Pes) ome. tam ny bjt cee ts, tw the creditable withholding income tax in exces of , 4, That I duly execute this SWORN DECLARATION in compliance withthe requirement prescribe under Section 2 of Revenue Regulations No. 11-2018; 5, Thatl declare, under the penalties of perjury, that this declartion hasbeen made in god faith andto the best of my nowledge and belief to be te andeoreet. IN WITNESS WHEREOF, Ihave ean set mphand his 27 fy of_QEUDWrA, 2023 IL 1LD gine ots tet sans gy et i dd ’ Scanned with CamScanner