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7/23/2019 1601-C sample.xls
1/96
(To be filled up by the BIR)
DLN: PSOC: PSIC:
Fill in all applicable spaces. Mark all appropriate boxes with an !.
1 For the Month 2 "#ended Return$
(MM % &&&&)
&es 'o &es
Part I B a c k g r o u n d I n f o r m a t i o n
5 TI' 6 R *ode
ccupation
8 +ithholdin, ",ent-s 'a#e (ast 'a#e/ First 'a#e/ Middle 'a#e for Indi0iduals)%(Re,istered 'a#e for 'on1Indi0iduals) 9 Teleph
23314
10 Re,istered "ddress
12 *ate,ory of +ithholdin, ",ent 1 "re there payees a0ailin, of tax relief under 7pecial aw
or International Tax Treaty$
8ri0ate 9o0ern#ent &es 'o If yes/ speci fy
Part II C o m ! u t a t i o n o f " a #
8articulars "#ount of *o#pensation Tax ue
15 Total "#ount of *o#pensation 15
16 ess: 'on1Taxable *o#pensation
16$
16B
ifferential 8ay/ ;
(Mini#u# +a,e =
16C
1% Taxable *o#pensation 1%
18 Tax Re>uired to be +ithheld 18
19 "dd%ess: "d?ust#ent (fro# Ite# 26 of 7ection ") 19
20 Tax Re>uired to be +ithheld for Re#ittance 20
21 ess: Tax Re#itted in Return 8re0iously Filed/ 21$
if this is an a#ended return
ther 8ay#ents Made (please attach 21B
proof of pay#ent BIR For# 'o. @6@5)
22
22 Total Tax 8ay#ents Made (7u# of Ite# 'os. 2A" 2AB)
'o. of 7heets "ttached & "ny Taxes
% ine of Business%
11 Cip *o
1& " T *
16$ 7tatutory Mini#u# +a,e (M+=s)
16B ;oliday 8ay/0erti#e 8ay/ 'i,ht 7hift
16C ther 'on1Taxable *o#pensation
Republika n, 8ilipinasDa,awaran n, 8ananalapi
Dawanihan n, Rentas Internas
'ont()* +,mittanc, +,turnof Incom, "a#,- .it((,)d
on Com!,n-ation
BIR For# 'o.
COOPERATIVE
2 0 1 6
0 0 0 08 6 23 8 94 1 6 0 2 4
CORE STRATA MULTI-PURPOSE COOPERATIVE (CSMPC)
1
X
B2L2 STRAWBERRY ST. !ATIVI"A" TOW!#OMES PU!TURI! VALE!$UELA
CITY
0 1
1601Euly 2@@ (=
W
7/23/2019 1601-C sample.xls
2/96
2 Tax 7till ue%(0erre#ittance) (Ite# 'o. 2@ less Ite# 'o. 22) 2
2& "dd: 8enalties
7urchar,e Interest *o#pro#ise
2&$ 2&B 2&C 2&D
25
25 Total "#ount 7till ue%(0erre#ittance)
S,ction $ $du-tm,nt of "a#,- .it((,)d on Com!,n-ation or Pr,iou- 'ont(-
8re0ious Month(s) ate 8aid Bank Galidation% Bank *ode
(A) (2) RR 'o. (H)
(MM%&&&&) (MM%%&&&&) ()
S,ction $ 3continuation4
Tax 8aid (=xcludin, 8enalties) 7hould Be Tax ue "d?ust#ent (3)
for the Month for the Month Fro# *urrent &ear Fro# &ear 1 =nd "d?us
(5) (6) (3a) I##ediately 8receedin
26 Total (3a plus 3b) (To Ite# A4)
+e declare/ under the penalties of per?ury/ that this return has been #ade in ,ood faith/ 0erified by us/ and to the best of our knowled,e
is true and correct/ pursuant to the pro0isions of the 'ational Internal Re0enue *ode/ as a#ended/ and the re,ulations issued under authorit
2% ='=R"7/ EG=&' 28
8resident%Gice 8resident%8rincipal fficer%"ccredited Tax ",ent% Treasurer%"ssistant Treasurer
"uthori
7/23/2019 1601-C sample.xls
3/96
7/23/2019 1601-C sample.xls
4/96
7/23/2019 1601-C sample.xls
5/96
'o
ne 'u#ber
546
ithheld$
e
1 7
X
/C*7)
0 1 0
7/23/2019 1601-C sample.xls
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#ent of the
&ear (3b)
nd belief/
y thereof.
p of
ffice%""B
nd
Receipt
i,nature%
ler-s Initial)
7/23/2019 1601-C sample.xls
7/96
7/23/2019 1601-C sample.xls
8/96
7/23/2019 1601-C sample.xls
9/96
(To be filled up by the BIR)
DLN: PSOC: PSIC:
Fill in all applicable spaces. Mark all appropriate boxes with an !.
1 For the Month 2 "#ended Return$
(MM % &&&&)
&es 'o &es
Part I B a c k g r o u n d I n f o r m a t i o n
5 TI' 6 R *ode
ccupation
8 +ithholdin, ",ent-s 'a#e (ast 'a#e/ First 'a#e/ Middle 'a#e for Indi0iduals)%(Re,istered 'a#e for 'on1Indi0iduals) 9 Teleph
10 Re,istered "ddress
12 *ate,ory of +ithholdin, ",ent 1 "re there payees a0ailin, of tax relief under 7pecial aw
or International Tax Treaty$
8ri0ate 9o0ern#ent &es 'o If yes/ speci fy
Part II C o m ! u t a t i o n o f " a #
8articulars "#ount of *o#pensation Tax ue
15 Total "#ount of *o#pensation 15
16 ess: 'on1Taxable *o#pensation
16$
16B
ifferential 8ay/ ;
(Mini#u# +a,e =
16C
1% Taxable *o#pensation 1%
18 Tax Re>uired to be +ithheld 18
19 "dd%ess: "d?ust#ent (fro# Ite# 26 of 7ection ") 19
20 Tax Re>uired to be +ithheld for Re#ittance 20
21 ess: Tax Re#itted in Return 8re0iously Filed/ 21$
if this is an a#ended return
ther 8ay#ents Made (please attach 21B
proof of pay#ent BIR For# 'o. @6@5)
22
22 Total Tax 8ay#ents Made (7u# of Ite# 'os. 2A" 2AB)
'o. of 7heets "ttached & "ny Taxes
% ine of Business%
11 Cip *o
1& " T *
16$ 7tatutory Mini#u# +a,e (M+=s)
16B ;oliday 8ay/0erti#e 8ay/ 'i,ht 7hift
16C ther 'on1Taxable *o#pensation
Republika n, 8ilipinas Da,awaran n, 8ananalapi Dawanihan n, Rentas Internas
'ont()* +,mittanc, +,turnof Incom, "a#,- .it((,)d on Com!,n-ation
BIR For# 'o.
3 6 2 -
COOPERATIVE
2 0 1 4
0 0 0 08 6 23 8 94 1 6 0 2 4
CORE STRATA MULTI-PURPOSE COOPERATIVE (CSMPC)
1
X
B2L2 STRAWBERRY ST. !ATIVI"A" TOW!#OMES PU!TURI! VALE!$UELA
CITY
0 6
!O TRA!SACTIO!
1601Euly 2@@ (=
W
7/23/2019 1601-C sample.xls
10/96
2 Tax 7till ue%(0erre#ittance) (Ite# 'o. 2@ less Ite# 'o. 22) 2
2& "dd: 8enalties
7urchar,e Interest *o#pro#ise
2&$ 2&B 2&C 2&D
25
25 Total "#ount 7till ue%(0erre#ittance)
S,ction $ $du-tm,nt of "a#,- .it((,)d on Com!,n-ation or Pr,iou- 'ont(-
8re0ious Month(s) ate 8aid Bank Galidation% Bank *o
(A) (2) RR 'o. (H)
(MM%&&&&) (MM%%&&&&) ()
S,ction $ 3continuation4
Tax 8aid (=xcludin, 8enalties) 7hould Be Tax ue "d?ust#ent (3)
for the Month for the Month Fro# *urrent &ear Fro# &ear 1 =nd "d?
(5) (6) (3a) I##ediately 8receed
26 Total (3a plus 3b) (To Ite# A4) +e declare/ under the penalties of per?ury/ that this return has been #ade in ,ood faith/ 0erified by us/ and to the best of our knowled,
is true and correct/ pursuant to the pro0isions of the 'ational Internal Re0enue *ode/ as a#ended/ and the re,ulations issued under autho
2% E&&' ='=R"7 28 E=''I=&''=1R7= *. J&
8resident%Gice 8resident%8rincipal fficer%"ccredited Tax ",ent% Treasurer%"ssistant Treasurer
"uthori
7/23/2019 1601-C sample.xls
11/96
7/23/2019 1601-C sample.xls
12/96
7/23/2019 1601-C sample.xls
13/96
'o
ne 'u#ber
ithheld$
e
2 3 3 0
1 7
X
/C*7)
0 1 0
7/23/2019 1601-C sample.xls
14/96
#ent of the
&ear (3b)
nd belief/y thereof.
p of
ffice%""B
nd
Receipt
i,nature%
ler-s Initial)
7/23/2019 1601-C sample.xls
15/96
7/23/2019 1601-C sample.xls
16/96
7/23/2019 1601-C sample.xls
17/96
(To be filled up by the BIR)
DLN: PSOC: PSIC:
Fill in all applicable spaces. Mark all appropriate boxes with an !.
1 For the Month 2 "#ended Return$
(MM % &&&&)
&es 'o &es
Part I B a c k g r o u n d I n f o r m a t i o n
5 TI' 6 R *ode
ccupation
8 +ithholdin, ",ent-s 'a#e (ast 'a#e/ First 'a#e/ Middle 'a#e for Indi0iduals)%(Re,istered 'a#e for 'on1Indi0iduals) 9 Teleph
10 Re,istered "ddress
12 *ate,ory of +ithholdin, ",ent 1 "re there payees a0ailin, of tax relief under 7pecial aw
or International Tax Treaty$
8ri0ate 9o0ern#ent &es 'o If yes/ speci fy
Part II C o m ! u t a t i o n o f " a #
8articulars "#ount of *o#pensation Tax ue
15 Total "#ount of *o#pensation 15
16 ess: 'on1Taxable *o#pensation
16$
16B
ifferential 8ay/ ;
(Mini#u# +a,e =
16C
1% Taxable *o#pensation 1%
18 Tax Re>uired to be +ithheld 18
19 "dd%ess: "d?ust#ent (fro# Ite# 26 of 7ection ") 19
20 Tax Re>uired to be +ithheld for Re#ittance 20
21 ess: Tax Re#itted in Return 8re0iously Filed/ 21$
if this is an a#ended return
ther 8ay#ents Made (please attach 21B
proof of pay#ent BIR For# 'o. @6@5)
22
22 Total Tax 8ay#ents Made (7u# of Ite# 'os. 2A" 2AB)
'o. of 7heets "ttached & "ny Taxes
% ine of Business%
11 Cip *o
1& " T *
16$ 7tatutory Mini#u# +a,e (M+=s)
16B ;oliday 8ay/0erti#e 8ay/ 'i,ht 7hift
16C ther 'on1Taxable *o#pensation
Republika n, 8ilipinas Da,awaran n, 8ananalapi Dawanihan n, Rentas Internas
'ont()* +,mittanc, +,turnof Incom, "a#,- .it((,)d on Com!,n-ation
BIR For# 'o.
3 6 2 -
COOPERATIVE
2 0 1 4
0 0 0 08 6 23 8 94 1 6 0 2 4
CORE STRATA MULTI-PURPOSE COOPERATIVE (CSMPC)
1
X
B2L2 STRAWBERRY ST. !ATIVI"A" TOW!#OMES PU!TURI! VALE!$UELA
CITY
0 6
!O TRA!SACTIO!
1601Euly 2@@ (=
W
7/23/2019 1601-C sample.xls
18/96
2 Tax 7till ue%(0erre#ittance) (Ite# 'o. 2@ less Ite# 'o. 22) 2
2& "dd: 8enalties
7urchar,e Interest *o#pro#ise
2&$ 2&B 2&C 2&D
25
25 Total "#ount 7till ue%(0erre#ittance)
S,ction $ $du-tm,nt of "a#,- .it((,)d on Com!,n-ation or Pr,iou- 'ont(-
8re0ious Month(s) ate 8aid Bank Galidation% Bank *o
(A) (2) RR 'o. (H)
(MM%&&&&) (MM%%&&&&) ()
S,ction $ 3continuation4
Tax 8aid (=xcludin, 8enalties) 7hould Be Tax ue "d?ust#ent (3)
for the Month for the Month Fro# *urrent &ear Fro# &ear 1 =nd "d?
(5) (6) (3a) I##ediately 8receed
26 Total (3a plus 3b) (To Ite# A4) +e declare/ under the penalties of per?ury/ that this return has been #ade in ,ood faith/ 0erified by us/ and to the best of our knowled,
is true and correct/ pursuant to the pro0isions of the 'ational Internal Re0enue *ode/ as a#ended/ and the re,ulations issued under autho
2% E&&' ='=R"7 28 E=''I=&''=1R7= *. J&
8resident%Gice 8resident%8rincipal fficer%"ccredited Tax ",ent% Treasurer%"ssistant Treasurer
"uthori
7/23/2019 1601-C sample.xls
19/96
7/23/2019 1601-C sample.xls
20/96
7/23/2019 1601-C sample.xls
21/96
'o
ne 'u#ber
ithheld$
e
2 3 3 0
1 7
X
/C*7)
0 1 0
7/23/2019 1601-C sample.xls
22/96
#ent of the
&ear (3b)
nd belief/y thereof.
p of
ffice%""B
nd
Receipt
i,nature%
ler-s Initial)
7/23/2019 1601-C sample.xls
23/96
7/23/2019 1601-C sample.xls
24/96
7/23/2019 1601-C sample.xls
25/96
(To be filled up by the BIR)
DLN: PSOC: PSIC:
Fill in all applicable spaces. Mark all appropriate boxes with an !.
1 For the Month 2 "#ended Return$
(MM % &&&&)
&es 'o &es
Part I B a c k g r o u n d I n f o r m a t i o n
5 TI' 6 R *ode
ccupation
8 +ithholdin, ",ent-s 'a#e (ast 'a#e/ First 'a#e/ Middle 'a#e for Indi0iduals)%(Re,istered 'a#e for 'on1Indi0iduals) 9 Teleph
10 Re,istered "ddress
12 *ate,ory of +ithholdin, ",ent 1 "re there payees a0ailin, of tax relief under 7pecial aw
or International Tax Treaty$
8ri0ate 9o0ern#ent &es 'o If yes/ speci fy
Part II C o m ! u t a t i o n o f " a #
8articulars "#ount of *o#pensation Tax ue
15 Total "#ount of *o#pensation 15
16 ess: 'on1Taxable *o#pensation
16$
16B
ifferential 8ay/ ;
(Mini#u# +a,e =
16C
1% Taxable *o#pensation 1%
18 Tax Re>uired to be +ithheld 18
19 "dd%ess: "d?ust#ent (fro# Ite# 26 of 7ection ") 19
20 Tax Re>uired to be +ithheld for Re#ittance 20
21 ess: Tax Re#itted in Return 8re0iously Filed/ 21$
if this is an a#ended return
ther 8ay#ents Made (please attach 21B
proof of pay#ent BIR For# 'o. @6@5)
22
22 Total Tax 8ay#ents Made (7u# of Ite# 'os. 2A" 2AB)
'o. of 7heets "ttached & "ny Taxes
% ine of Business%
11 Cip *o
1& " T *
16$ 7tatutory Mini#u# +a,e (M+=s)
16B ;oliday 8ay/0erti#e 8ay/ 'i,ht 7hift
16C ther 'on1Taxable *o#pensation
Republika n, 8ilipinas Da,awaran n, 8ananalapi Dawanihan n, Rentas Internas
'ont()* +,mittanc, +,turnof Incom, "a#,- .it((,)d on Com!,n-ation
BIR For# 'o.
3 6 2 -
COOPERATIVE
2 0 1 4
0 0 0 08 6 23 8 94 1 6 0 2 4
CORE STRATA MULTI-PURPOSE COOPERATIVE (CSMPC)
1
X
B2L2 STRAWBERRY ST. !ATIVI"A" TOW!#OMES PU!TURI! VALE!$UELA
CITY
0 6
!O TRA!SACTIO!
1601Euly 2@@ (=
W
7/23/2019 1601-C sample.xls
26/96
2 Tax 7till ue%(0erre#ittance) (Ite# 'o. 2@ less Ite# 'o. 22) 2
2& "dd: 8enalties
7urchar,e Interest *o#pro#ise
2&$ 2&B 2&C 2&D
25
25 Total "#ount 7till ue%(0erre#ittance)
S,ction $ $du-tm,nt of "a#,- .it((,)d on Com!,n-ation or Pr,iou- 'ont(-
8re0ious Month(s) ate 8aid Bank Galidation% Bank *o
(A) (2) RR 'o. (H)
(MM%&&&&) (MM%%&&&&) ()
S,ction $ 3continuation4
Tax 8aid (=xcludin, 8enalties) 7hould Be Tax ue "d?ust#ent (3)
for the Month for the Month Fro# *urrent &ear Fro# &ear 1 =nd "d?
(5) (6) (3a) I##ediately 8receed
26 Total (3a plus 3b) (To Ite# A4) +e declare/ under the penalties of per?ury/ that this return has been #ade in ,ood faith/ 0erified by us/ and to the best of our knowled,
is true and correct/ pursuant to the pro0isions of the 'ational Internal Re0enue *ode/ as a#ended/ and the re,ulations issued under autho
2% E&&' ='=R"7 28 E=''I=&''=1R7= *. J&
8resident%Gice 8resident%8rincipal fficer%"ccredited Tax ",ent% Treasurer%"ssistant Treasurer
"uthori
7/23/2019 1601-C sample.xls
27/96
7/23/2019 1601-C sample.xls
28/96
7/23/2019 1601-C sample.xls
29/96
'o
ne 'u#ber
ithheld$
e
2 3 3 0
1 7
X
/C*7)
0 1 0
7/23/2019 1601-C sample.xls
30/96
#ent of the
&ear (3b)
nd belief/y thereof.
p of
ffice%""B
nd
Receipt
i,nature%
ler-s Initial)
7/23/2019 1601-C sample.xls
31/96
7/23/2019 1601-C sample.xls
32/96
7/23/2019 1601-C sample.xls
33/96
(To be filled up by the BIR)
DLN: PSOC: PSIC:
Fill in all applicable spaces. Mark all appropriate boxes with an !.
1 For the Month 2 "#ended Return$
(MM % &&&&)
&es 'o &es
Part I B a c k g r o u n d I n f o r m a t i o n
5 TI' 6 R *ode
ccupation
8 +ithholdin, ",ent-s 'a#e (ast 'a#e/ First 'a#e/ Middle 'a#e for Indi0iduals)%(Re,istered 'a#e for 'on1Indi0iduals) 9 Teleph
10 Re,istered "ddress
12 *ate,ory of +ithholdin, ",ent 1 "re there payees a0ailin, of tax relief under 7pecial aw
or International Tax Treaty$
8ri0ate 9o0ern#ent &es 'o If yes/ speci fy
Part II C o m ! u t a t i o n o f " a #
8articulars "#ount of *o#pensation Tax ue
15 Total "#ount of *o#pensation 15
16 ess: 'on1Taxable *o#pensation
16$
16B
ifferential 8ay/ ;
(Mini#u# +a,e =
16C
1% Taxable *o#pensation 1%
18 Tax Re>uired to be +ithheld 18
19 "dd%ess: "d?ust#ent (fro# Ite# 26 of 7ection ") 19
20 Tax Re>uired to be +ithheld for Re#ittance 20
21 ess: Tax Re#itted in Return 8re0iously Filed/ 21$
if this is an a#ended return
ther 8ay#ents Made (please attach 21B
proof of pay#ent BIR For# 'o. @6@5)
22
22 Total Tax 8ay#ents Made (7u# of Ite# 'os. 2A" 2AB)
'o. of 7heets "ttached & "ny Taxes
% ine of Business%
11 Cip *o
1& " T *
16$ 7tatutory Mini#u# +a,e (M+=s)
16B ;oliday 8ay/0erti#e 8ay/ 'i,ht 7hift
16C ther 'on1Taxable *o#pensation
Republika n, 8ilipinas Da,awaran n, 8ananalapi Dawanihan n, Rentas Internas
'ont()* +,mittanc, +,turnof Incom, "a#,- .it((,)d on Com!,n-ation
BIR For# 'o.
3 6 2 -
COOPERATIVE
2 0 1 4
0 0 0 08 6 23 8 94 1 6 0 2 4
CORE STRATA MULTI-PURPOSE COOPERATIVE (CSMPC)
1
X
B2L2 STRAWBERRY ST. !ATIVI"A" TOW!#OMES PU!TURI! VALE!$UELA
CITY
0 6
!O TRA!SACTIO!
1601Euly 2@@ (=
W
7/23/2019 1601-C sample.xls
34/96
2 Tax 7till ue%(0erre#ittance) (Ite# 'o. 2@ less Ite# 'o. 22) 2
2& "dd: 8enalties
7urchar,e Interest *o#pro#ise
2&$ 2&B 2&C 2&D
25
25 Total "#ount 7till ue%(0erre#ittance)
S,ction $ $du-tm,nt of "a#,- .it((,)d on Com!,n-ation or Pr,iou- 'ont(-
8re0ious Month(s) ate 8aid Bank Galidation% Bank *o
(A) (2) RR 'o. (H)
(MM%&&&&) (MM%%&&&&) ()
S,ction $ 3continuation4
Tax 8aid (=xcludin, 8enalties) 7hould Be Tax ue "d?ust#ent (3)
for the Month for the Month Fro# *urrent &ear Fro# &ear 1 =nd "d?
(5) (6) (3a) I##ediately 8receed
26 Total (3a plus 3b) (To Ite# A4) +e declare/ under the penalties of per?ury/ that this return has been #ade in ,ood faith/ 0erified by us/ and to the best of our knowled,
is true and correct/ pursuant to the pro0isions of the 'ational Internal Re0enue *ode/ as a#ended/ and the re,ulations issued under autho
2% E&&' ='=R"7 28 E=''I=&''=1R7= *. J&
8resident%Gice 8resident%8rincipal fficer%"ccredited Tax ",ent% Treasurer%"ssistant Treasurer
"uthori
7/23/2019 1601-C sample.xls
35/96
7/23/2019 1601-C sample.xls
36/96
7/23/2019 1601-C sample.xls
37/96
'o
ne 'u#ber
ithheld$
e
2 3 3 0
1 7
X
/C*7)
0 1 0
7/23/2019 1601-C sample.xls
38/96
#ent of the
&ear (3b)
nd belief/y thereof.
p of
ffice%""B
nd
Receipt
i,nature%
ler-s Initial)
7/23/2019 1601-C sample.xls
39/96
7/23/2019 1601-C sample.xls
40/96
7/23/2019 1601-C sample.xls
41/96
(To be filled up by the BIR)
DLN: PSOC: PSIC:
Fill in all applicable spaces. Mark all appropriate boxes with an !.
1 For the Month 2 "#ended Return$
(MM % &&&&)
&es 'o &es
Part I B a c k g r o u n d I n f o r m a t i o n
5 TI' 6 R *ode
ccupation
8 +ithholdin, ",ent-s 'a#e (ast 'a#e/ First 'a#e/ Middle 'a#e for Indi0iduals)%(Re,istered 'a#e for 'on1Indi0iduals) 9 Teleph
10 Re,istered "ddress
12 *ate,ory of +ithholdin, ",ent 1 "re there payees a0ailin, of tax relief under 7pecial aw
or International Tax Treaty$
8ri0ate 9o0ern#ent &es 'o If yes/ speci fy
Part II C o m ! u t a t i o n o f " a #
8articulars "#ount of *o#pensation Tax ue
15 Total "#ount of *o#pensation 15
16 ess: 'on1Taxable *o#pensation
16$
16B
ifferential 8ay/ ;
(Mini#u# +a,e =
16C
1% Taxable *o#pensation 1%
18 Tax Re>uired to be +ithheld 18
19 "dd%ess: "d?ust#ent (fro# Ite# 26 of 7ection ") 19
20 Tax Re>uired to be +ithheld for Re#ittance 20
21 ess: Tax Re#itted in Return 8re0iously Filed/ 21$
if this is an a#ended return
ther 8ay#ents Made (please attach 21B
proof of pay#ent BIR For# 'o. @6@5)
22
22 Total Tax 8ay#ents Made (7u# of Ite# 'os. 2A" 2AB)
'o. of 7heets "ttached & "ny Taxes
% ine of Business%
11 Cip *o
1& " T *
16$ 7tatutory Mini#u# +a,e (M+=s)
16B ;oliday 8ay/0erti#e 8ay/ 'i,ht 7hift
16C ther 'on1Taxable *o#pensation
Republika n, 8ilipinas Da,awaran n, 8ananalapi Dawanihan n, Rentas Internas
'ont()* +,mittanc, +,turnof Incom, "a#,- .it((,)d on Com!,n-ation
BIR For# 'o.
3 6 2 -
COOPERATIVE
2 0 1 4
0 0 0 08 6 23 8 94 1 6 0 2 4
CORE STRATA MULTI-PURPOSE COOPERATIVE (CSMPC)
1
X
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22
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1 For the Month 2 "#ended Return$
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20 Tax Re>uired to be +ithheld for Re#ittance 20
21 ess: Tax Re#itted in Return 8re0iously Filed/ 21$
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proof of pay#ent BIR For# 'o. @6@5)
22
22 Total Tax 8ay#ents Made (7u# of Ite# 'os. 2A" 2AB)
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1
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1 For the Month 2 "#ended Return$
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&es 'o &es
Part I B a c k g r o u n d I n f o r m a t i o n
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18 Tax Re>uired to be +ithheld 18
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20 Tax Re>uired to be +ithheld for Re#ittance 20
21 ess: Tax Re#itted in Return 8re0iously Filed/ 21$
if this is an a#ended return
ther 8ay#ents Made (please attach 21B
proof of pay#ent BIR For# 'o. @6@5)
22
22 Total Tax 8ay#ents Made (7u# of Ite# 'os. 2A" 2AB)
'o. of 7heets "ttached & "ny Taxes
% ine of Business%
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16$ 7tatutory Mini#u# +a,e (M+=s)
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2 0 1 4
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CORE STRATA MULTI-PURPOSE COOPERATIVE (CSMPC)
1
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B2L2 STRAWBERRY ST. !ATIVI"A" TOW!#OMES PU!TURI! VALE!$UELA
CITY
0 6
!O TRA!SACTIO!
1601Euly 2@@ (=
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26 Total (3a plus 3b) (To Ite# A4) +e declare/ under the penalties of per?ury/ that this return has been #ade in ,ood faith/ 0erified by us/ and to the best of our knowled,
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1 For the Month 2 "#ended Return$
(MM % &&&&)
&es 'o &es
Part I B a c k g r o u n d I n f o r m a t i o n
5 TI' 6 R *ode
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18 Tax Re>uired to be +ithheld 18
19 "dd%ess: "d?ust#ent (fro# Ite# 26 of 7ection ") 19
20 Tax Re>uired to be +ithheld for Re#ittance 20
21 ess: Tax Re#itted in Return 8re0iously Filed/ 21$
if this is an a#ended return
ther 8ay#ents Made (please attach 21B
proof of pay#ent BIR For# 'o. @6@5)
22
22 Total Tax 8ay#ents Made (7u# of Ite# 'os. 2A" 2AB)
'o. of 7heets "ttached & "ny Taxes
% ine of Business%
11 Cip *o
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16$ 7tatutory Mini#u# +a,e (M+=s)
16B ;oliday 8ay/0erti#e 8ay/ 'i,ht 7hift
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'ont()* +,mittanc, +,turnof Incom, "a#,- .it((,)d on Com!,n-ation
BIR For# 'o.
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COOPERATIVE
2 0 1 4
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CORE STRATA MULTI-PURPOSE COOPERATIVE (CSMPC)
1
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B2L2 STRAWBERRY ST. !ATIVI"A" TOW!#OMES PU!TURI! VALE!$UELA
CITY
0 6
!O TRA!SACTIO!
1601Euly 2@@ (=
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26 Total (3a plus 3b) (To Ite# A4) +e declare/ under the penalties of per?ury/ that this return has been #ade in ,ood faith/ 0erified by us/ and to the best of our knowled,
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DLN: PSOC: PSIC:
Fill in all applicable spaces. Mark all appropriate boxes with an !.
1 For the Month 2 "#ended Return$
(MM % &&&&)
&es 'o &es
Part I B a c k g r o u n d I n f o r m a t i o n
5 TI' 6 R *ode
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18 Tax Re>uired to be +ithheld 18
19 "dd%ess: "d?ust#ent (fro# Ite# 26 of 7ection ") 19
20 Tax Re>uired to be +ithheld for Re#ittance 20
21 ess: Tax Re#itted in Return 8re0iously Filed/ 21$
if this is an a#ended return
ther 8ay#ents Made (please attach 21B
proof of pay#ent BIR For# 'o. @6@5)
22
22 Total Tax 8ay#ents Made (7u# of Ite# 'os. 2A" 2AB)
'o. of 7heets "ttached & "ny Taxes
% ine of Business%
11 Cip *o
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16$ 7tatutory Mini#u# +a,e (M+=s)
16B ;oliday 8ay/0erti#e 8ay/ 'i,ht 7hift
16C ther 'on1Taxable *o#pensation
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'ont()* +,mittanc, +,turnof Incom, "a#,- .it((,)d on Com!,n-ation
BIR For# 'o.
3 6 2 -
COOPERATIVE
2 0 1 4
0 0 0 08 6 23 8 94 1 6 0 2 4
CORE STRATA MULTI-PURPOSE COOPERATIVE (CSMPC)
1
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B2L2 STRAWBERRY ST. !ATIVI"A" TOW!#OMES PU!TURI! VALE!$UELA
CITY
0 6
!O TRA!SACTIO!
1601Euly 2@@ (=
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25 Total "#ount 7till ue%(0erre#ittance)
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26 Total (3a plus 3b) (To Ite# A4) +e declare/ under the penalties of per?ury/ that this return has been #ade in ,ood faith/ 0erified by us/ and to the best of our knowled,
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DLN: PSOC: PSIC:
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1 For the Month 2 "#ended Return$
(MM % &&&&)
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Part I B a c k g r o u n d I n f o r m a t i o n
5 TI' 6 R *ode
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8 +ithholdin, ",ent-s 'a#e (ast 'a#e/ First 'a#e/ Middle 'a#e for Indi0iduals)%(Re,istered 'a#e for 'on1Indi0iduals) 9 Teleph
10 Re,istered "ddress
12 *ate,ory of +ithholdin, ",ent 1 "re there payees a0ailin, of tax relief under 7pecial aw
or International Tax Treaty$
8ri0ate 9o0ern#ent &es 'o If yes/ speci fy
Part II C o m ! u t a t i o n o f " a #
8articulars "#ount of *o#pensation Tax ue
15 Total "#ount of *o#pensation 15
16 ess: 'on1Taxable *o#pensation
16$
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16C
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18 Tax Re>uired to be +ithheld 18
19 "dd%ess: "d?ust#ent (fro# Ite# 26 of 7ection ") 19
20 Tax Re>uired to be +ithheld for Re#ittance 20
21 ess: Tax Re#itted in Return 8re0iously Filed/ 21$
if this is an a#ended return
ther 8ay#ents Made (please attach 21B
proof of pay#ent BIR For# 'o. @6@5)
22
22 Total Tax 8ay#ents Made (7u# of Ite# 'os. 2A" 2AB)
'o. of 7heets "ttached & "ny Taxes
% ine of Business%
11 Cip *o
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16B ;oliday 8ay/0erti#e 8ay/ 'i,ht 7hift
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CORE STRATA MULTI-PURPOSE COOPERATIVE (CSMPC)
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7urchar,e Interest *o#pro#ise
2&$ 2&B 2&C 2&D
25
25 Total "#ount 7till ue%(0erre#ittance)
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8re0ious Month(s) ate 8aid Bank Galidation% Bank *o
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for the Month for the Month Fro# *urrent &ear Fro# &ear 1 =nd "d?
(5) (6) (3a) I##ediately 8receed
26 Total (3a plus 3b) (To Ite# A4) +e declare/ under the penalties of per?ury/ that this return has been #ade in ,ood faith/ 0erified by us/ and to the best of our knowled,
is true and correct/ pursuant to the pro0isions of the 'ational Internal Re0enue *ode/ as a#ended/ and the re,ulations issued under autho
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