DLN
: BIR Form No.
Republika ng Pilipinas
Certificate of Compensation
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas
For Compensation Payment With or Without Tax Withheld
Payment/Tax Withheld 2316
July 2008 (ENCS)
80,569.26
Fill in all applicable spaces. Mark all appropriate boxes with an "X"
1 For the Year 2 021 2 For the Period
( YYYY ) From (MM/DD) To (MM/DD)
Part I Employee Information Part IV-B Details of Compensation Income and Tax Withheld from Present Employer
3 Taxpayer Amount
Identification No. A. NON-TAXABLE/EXEMPT COMPENSATION INCOME
4 Employee's Name (Last Name, First Name, Middle Name) 5 RDO Code
32 Basic Salary/ 32
Pineda, Stephany Angel Waking
Statutory Minimum Wage
6 Registered Address 6A Zip Code Minimum Wage Earner (MWE)
Bakakeng Sur Ciudad Grande phase 2 tetep an Village Baguio City
33 Holiday Pay (MWE) 33 0.00
6B Local Home Address 6C Zip Code
34 Overtime Pay (MWE) 34
0.00
6D Foreign Address 6E Zip Code 35
35 Night Shift Differential (MWE) 0.00
7 Date of Birth (MM/DD/YYYY) 36 Hazard Pay (MWE) 36
8 Telephone Number
13,500
09 19 1998
9 Exemption Status
37 13th Month Pay 37
and Other Benefits
Single
9A Is the wife claiming the additional exemption for qualified dependent children? 38 De Minimis Benefits 38
Yes No
10 Name of Qualified Dependent Children 11 Date of Birth (MM/DD/YYYY)
39 SSS, GSIS, PHIC & Pag-ibig 39
Contributions, & Union Dues
5,156.28
(Employee share only)
12 Statutory Minimum Wage rate per day 12 40 Salaries & Other Forms of 40
0.00
Compensation
800 Total Non-Taxable/Exempt 41
13 Statutory Minimum Wage rate per month 13 Compensation Income
13,500 91,659.31
14 Minimum Wage Earner whose compensation is exempt B. TAXABLE COMPENSATION INCOME
from withholding tax and not subject to income tax REGULAR
Part II Employer Information
(Present) 15 Taxpayer 42 Basic Salary 42
Identification No.
16 Employer's Name
41
43 Representation 43
17 Registered Address 17A Zip
Code 44
44 Transportation
Main
Employer
Secondary Employer 45 Cost of Living Allowance 45
Part III Employer Information
(Previous) 18 Taxpayer 46 Fixed Housing Allowance 46
Identification No.
19 Employer's Name 47 Others (Specify)
47A 47A
20 Registered Address 20A Zip
Code 47B 47B
Part IV-A Summary
SUPPLEMENTARY
48 Commission 48
0.0021 Gross Compensation Income from 21
Present Employer (Item 41 plus Item 55) 91,659.31
22 Less: Total Non-Taxable/ 22 49 Profit Sharing 49
Exempt (Item 41) 91,659.31
23 Taxable Compensation Income 23
from Present Employer (Item 55) 0.00 50 Fees Including Director's 50
24 Add: Taxable Compensation 24 Fees
Income from Previous Employer 0.00
25 Gross Taxable 25 51 Taxable 13th Month Pay 51
0.00
Compensation Income 0.00 and Other Benefits
26 Less: Total Exemptions 26
0.00 52 Hazard Pay 52
27 Less: Premium Paid on Health 27
0.00
and/or Hospital Insurance (If applicable)
0.00
30 Amount of Taxes Withheld 54A 54A
30A Present Employer 30A 0.00
54B 54B
30B Previous Employer 30B 0.00
31 Total Amount of Taxes 31 55 Total Taxable Compensation 55
0.00 0.00
Withheld As adjusted Income
We declare, under the penalties of perjury, that this certificate has been made in good faith, verified by us, and to the best of our 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.
56 FRESH BUYS CONFORME:
Present Employer/ Authorized Agent Signature Over Printed Name
Date Signed
57 Stephany W. Pineda Date Signed
CTC No. Employee Signature Over Printed Name Amount Paid
of Employee Place of Issue Date of Issue
To be accomplished under substituted filing
I declare, under the penalties of perjury, that the information herein stated are reported I declare,under the penalties of perjury that I am qualified under substituted filing of
under BIR Form No. 1604CF which has been filed with the Bureau of Internal Revenue. Income Tax Returns(BIR Form No. 1700), since I received purely compensation
income from only one employer in the Phils. for the calendar year; that taxes have
been correctly withheld by my employer (tax due equals tax withheld); that the BIR
58 Form No. 1604CF filed by my employer to the BIR shall constitute as my income tax
Present Employer/ Authorized Agent Signature Over Printed Name return; and that BIR Form No. 2316 shall serve the same purpose as if BIR Form No.
(Head of Accounting/ Human Resource or Authorized Representative) 1700 had been filed pursuant to the provisions of RR No. 3-2002, as amended.
59
Employee Signature Over Printed Name