Certificate of URdate of Exem-.

ption and of Employer's and Employee's Information

BIRFonn No.

2305

I declare, under the penaltles of perjury. that this certificate has been made in good faith, verified by me and 10 the besl of my knowledge.and belief, is true ;l.nd correl,t, pursuant to the provisions of the Nationalln!"",,,1 Revenue Code, as amended, and the regulations issued undet authority thereof.

24

EmployerEAuthorized Agent Signature

25~____~~~"-=~"-=~~___
TitleJPosition of Signatory

Annex .oF" S;WORN DECLARATION AND WAIVER OF RIGHT

TO CLAIM EXEMPTIONS OF QUALIFIED DEPENDENT CHILDREN
In accordance with the provisions of Section 29 (1) (2) (A) of the National Internal Revenue Code, as amended, I ..", hereby voluntarily depose and say: 1. my are earners; 2. That we file a joint income tax return on our taxable income; 3. That I arn a (check pis): _ self employed: engaged in business; _ practice profession; 4. That this waiver will be effective for the and shall continue for the succeeding years unless sooner revoked; ? That I hereby waive my right to for all our qualified dependent children in favor of my wife presently Nameofwire: __~~____~~~~~~~ Mr.

This is

of Mr. MrslMs. :xernptllons for all

Name of wife's employer ______~_ Address of employer _ _ _ _ _-=--:-:-::--_ TIN of,f'mnl(lvf'r

(Signature over printednarne of wife's employer! Chief AccountanVHead, Personnel Office) Note:

Date (mmlddlyyy)

If husband engaged in business, disregard the portion on Acknowledgement of Husband's Employer. Must be signed by both employers of husband and wife before effecting changes in the payroll of their respective employers. Must be attached to BIR: Form No. 2305 or BIR Form No. 1902.