Bir Form No. 0605 - Payment Form

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(To be filled up the BIR)
DLN:
PSIC:
PSOC:
BIR Form No.
Republika ng Pilipinas
0605
Payment Form
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas
July 1999 (ENCS)
Fill in all applicable spaces. Mark all appropriate boxes with an "X"
For the
Calendar
Fiscal 3
Quarter
4
Due Date ( MM / DD / YYYY) 5
6
A T C
No. of Sheets
1
2
Year Ended
Attached
( MM / YYYY )
1st
2nd
3rd
4th
7
Return Period ( MM / DD / YYYY )
BCS No./Item No. (To be filled up by the BIR)
8
Tax Type Code
7
8
Part I
B a c k g r o u n d
I n f o r m a t i o n
9
Taxpayer Identification No.
10 RDO Code
11 Taxpayer Classification
12 Line of Business/Occupation
I
N
Taxpayer's
13
14 Telephone Number
13
Name
(Last Name, First Name, Middle Name for Individuals) / (Registered Name for Non-Individuals)
15 Registered
16 Zip Code
Address
17 Manner of Payment
18 Type of Payment
Voluntary Payment
Per Audit/Delinquent Account
Installment
Self-Assessment
Preliminary/Final Assessment/Deficiency Tax
No. of Installment
Penalties
Tax Deposit/Advance Payment
Accounts Receivable/Delinquent Account
Partial
Income Tax Second Installment
Payment
(Individual)
Full
Payment
Others (Specify)
Part II
C o m p u t a t i o n o f T a x
19
19
Basic Tax / Deposit / Advance Payment
20
Add: Penalties
Surcharge
Interest
Compromise
20A
20B
20C
20D
21
Total Amount Payable (Sum of Items 19 & 20D)
21
For Voluntary Payment
For Payment of Deficiency Taxes
Stamp of Receiving
From Audit/Investigation/
Office
Deliquent Accounts
and Date of Receipt
I declare, under the penalties of perjury, that this document has been
APPROVED BY:
made in good faith, verified by me, and to the best of my knowledge and
belief, is true and correct, pursuant to the provisions of the National
Internal Revenue Code, as amended, and the regulations issued under
authority thereof.
22B
22A
Signature over Printed Name of
Signature over Printed Name of Taxpayer/Authorized Representative
Title/Position of Signatory
Head of Office
Part III
D e t a i l s of P a y m e n t
Particulars
Drawee Bank/Agency
Number
MM
DD
YYYY
Amount
23 Cash/Bank
23
Debit Memo
24A
24B
17C
24C
24D
24 Check
25A
25B
25C
25 Tax Debit
Memo
26A
26B
19C
26C
26D
26 Others
Machine Validation/Revenue Official Receipt Details (If not filed with the bank)
Taxpayer Classification:
I - Individual
N - Non-Individual
BIR Form 0605 (ENCS) - PAGE 2
ATC
NATURE OF PAYMENT
ATC
NATURE OF PAYMENT
ATC
NATURE OF PAYMENT

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