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Form 480.70(Oe) - Informative Return For Income Tax Exempt Organizations - Puerto Rico Department Of The Treasury Page 4

Income Tax Exempt Organizations - Page 4

Form 480.70(OE) Rev. 05.00

Part VI

Compensation in Excess of $5,000 Paid to Independent Contractors for Professional Services

Social security or employer's

Name and Address

Type of service

Compensation

identification number

OATH

I declare under penalty of perjury that this return (including the schedules and statements attached) has been examined by

me, and according to my better information and belief is true, correct and complete.

CORPORATE

Title

Official's Name

SEAL

Date

For Specialist's Use Only

I declare under penalty of perjury that this return (including the enclosed schedules and statements) has been examined by me,

and to the best of my knowledge and belief, the facts in the same are true, correct and they constitute as a whole, an exact and

complete return. The declaration of the person that prepares this return is with respect to the information received and this

information may be verified.

Note to taxpayer: If you paid to prepare your return, the specialist must sign and write his (her) registration number in the space provided.

Specialist's name (Print letter)

Firm's name

Date

Specialist's social security number

Registration number

Check if self - employed

;

Specialist's signature

Employer's identification number

Address

Zip Code

Form 480.70(Oe) - Informative Return For Income Tax Exempt Organizations - Puerto Rico Department Of The Treasury Page 4