ANNEX D

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

As of

Name of Taxpayer:
Business/Trade Name:
Taxpayer Identification Number (TIN): RDO Code: 084
Business Address:
ATP OCN: Date Issued:

Description of Receipts/ Invoices

No. of No. of sets No. of Serial Numbers

Booklets
per copies
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)