FORM 0605 Payment Form

NOTES: a) Computation of tax and explanations thereto are based on the items/numbers provided in the above mentioned form b) Items 1 to 18 refer to the basic information. 19. Basic Tax is the amount of tax due. 20. Penalties Additional penalties are imposed in the following cases: 20A. 1. A penalty equivalent to 25% shall be imposed on the following cases: a. Failure to file any return and pay the amount of tax or installment due on or before the due dates; b. Unless otherwise authorized by the Commissioner, filing return with a person or office other than those with whom it is required to be filed; c. Failure to pay full or part of the amount of tax shown on the return, or full amount of tax due for which is required to be filed, on or before the due date; d. Failure to pay the deficiency tax within the time prescribed for its payment in the notice of assessment. 2. A surcharge of fifty percent (50%) of the tax or of the deficiency tax, in case any payment has been made on the basis of such return before the discovery of the falsity or fraud, for each of the following violations: a. Wilfull neglect to file the return within the period prescribed by the code or by rules and regulations; or b. In case a false or fraudulent return is wilfully made. 20B. Interest at the rate of 20% per annum or such higher rate as many be prescribed by rules and regulations, on any unpaid amount, from the date the payment until it is fully paid. 20C. Please do not fill up this portion. You will be properly notified if any compromise penalty will be imposed. 20D. Total Penalties Sum of 20A,20B and 20C 21. To get the Amount Payable, add Items 19 and 20. NOTES: Voluntary/Self-Assessment - means payment of tax upon the taxpayer's initiative without any notice from the BIR. Tax Deposit/Advance Payment- the amount paid is in the form of deposit or payment in advance (ex. Deposit or Advance Payment of Excise Tax on exciseable articles; Advance Payment of Value Added Tax by sugar millers or refiners under Revenue Regulation No. 7-89 and Revenue Memurandum No.46 89) Income Tax Second Installment ( Individual) - refers to the second installment payment of an individual taxpayer whose income tax due per return is P 2,000.00 or more, the due date of which is July 15 of the year the incoming tax return was filed. Preliminary/Final Assessment/Deficiency Tax - means payment is made based on the assessment notice sent by the BIR.

Accounts Receivable/Delinquent Account - means payment is made for delinquency internal revenue tax

Accounts Receivable/Delinquent Account - means payment is made for delinquency internal revenue tax per letter/demand notice from the BIR. Example: Assuming an individual taxpayer has a tax due per return amounting to P 5,668.00. The taxpayer paid P2,835.00 upon filing his income tax return on April 15, 2000 and availed the 2nd installment payment for the remaining amount of P2,833.00, which will be due on July 15 of the current year. However, the taxpayer paid his 2nd installment on July 18, 2000. The total amount payable shall be: Basic Tax (Item 19) Surcharge (Item 20A) (P2,833.00 x 25%) Interest (Item 20C) (P2,833.00 x 20% x 3/360) Compromise Penalty (Item 20C) Total Amount Payable (Item 21) P 2,833.00 708.25 4.72 1,000.00 P 4,545.97

(To be filled up the BIR)

DLN:
Republika ng Pilipinas Kagawaran ng Pananalapi

PSIC:

PSOC:
BIR Form No.

Kawanihan ng Rentas Internas

Payment Form

0605
July 1999 (ENCS)

Fill in all applicable spaces. Mark all appropriate boxes with an "X"
1 2 7 For the Fiscal 3 Quarter X Calendar Year Ended 1 2 2 0 1 4 1st 8 4 2nd 3rd 4th Due Date ( MM / DD / YYYY) 5 No. of Sheets Attached 6

( MM / YYYY ) Return Period ( MM / DD / YYYY ) 7

01

31

2 0 1 4

1 2

31

2 0 1 4

Tax Type Code 8

BCS No./Item No. (To be filled up by the BIR)

R F

Part I 9 Taxpayer Identification No.

Background

Information 11 Taxpayer Classification I N 14 Telephone Number 12 Line of Business/Occupation

10 RDO Code

2 6 6
13 Taxpayer's Name 15 Registered Address 13

8 0 8

000

0 4 3 STEEL ALLIANCE, INC.

Healthcare Services

(Last Name, First Name, Middle Name for Individuals) / (Registered Name for Non-Individuals)

Unit 2908 Raffles Corporate Center F. Ortigas Jr. Ave., Ortigas Center Pasig City
17 Manner of Payment Voluntary Payment Per Audit/Delinquent Account Penalties Preliminary/Final Assessment/Deficiency Tax Accounts Receivable/Delinquent Account

16 Zip Code 18 Type of Payment Installment No. of Installment Partial Payment

Self-Assessment Tax Deposit/Advance Payment Income Tax Second Installment (Individual)

X Others (Specify)
Part II 19 20

Registration Fee
Computation of Tax 19 Interest 20C Compromise 20D

x Full
Payment

Basic Tax / Deposit / Advance Payment Add: Penalties Surcharge 20A 20B

21

Total Amount Payable (Sum of Items 19 & 20D)

21 Stamp of Receiving Office and Date of Receipt

I declare, under the penalties of perjury, that this document has been 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.

22

ALEXANDER ARIZA

Signature over Printed Name/Title/Position of Signatory/Authorized Representative Part III Particulars 23 Cash/Bank Debit Memo 24A 24 Check 25 Tax Debit Memo 26A 26 Others Machine Validation/Revenue Official Receipt Details (If not filed with the bank) 25A 26B 19C 25B 26C 25C 26D 24B 17C 24C 24D Drawee Bank/Agency D e t a i l s of P a y m e n t Number MM DD YYYY 23 Amount

Taxpayer Classification:

I - Individual

N - Non-Individual

PSOC:
BIR Form No.

Payment Form

0605
July 1999 (ENCS)

ATC

Line of Business/Occupation

Healthcare Services
14 Telephone Number

Installment No. of Installment Payment Payment

500.00 0.00 500.00

Stamp of Receiving Office and Date of Receipt