Annex D

Inventory List of Unused/Expired Principal and Supplementary Receipts & Invoices

As of __________________

Name of Taxpayer: _____________________________

Business/Trade Name: _____________________________

Taxpayer Identification Number (TIN): _________________ Branch Code: _______

Business Address: __________________________________________________________

ATP OCN: ________________________ Date Issued: ___________________

DESCRIPTION OF RECEIPTS/INVOICES

No. of Booklets No. of Serial Nos.

Sets No.of
Copies
Per
DESCRIPTION TYPE Loose Bound Booklet Per Set From To

__ _________________________
(Signature over Printed Name of Taxpayer)

Received by:

_____________________________
(TSS Chief/Registration Section Chief)

Verified correct by:

________________________________
(Officer of the Day – Assessment Section)