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No.

:
MDS Check Commercial Check ADA Others Date:
TIN: ObR/BUS No.:
Date:
Code:
Amount
To payment of water bill for the month of February, 2014 of Lakandula ES

Gross Amount 2,309.10
Less: Withholding Taxes
Percentage Tax (2,309.10 x 2%) 46.18
EWT (2,309.10 x 2%) 46.18 92.36 2,216.74
Net amount due 2,216.74
TOTAL 2,216.74
Certified Supporting documents complete and proper Approved for Payment: .
Cash Available
Subject to ADA (where applicable)
PRISCILLA G. DELOS REYES
Principal
Date: ___________________ Date: ___________________
Received Payment:
Check/ ADA No.:
Date: ______________ Date:
Bank Name: No.: ___________
OR No./ Other relevant documents Date: ___________
BALIBAGO WATERWORKS

Principal
DISBURSEMENT VOUCHER
MODE OF PAYMENT
Payee/Office:
BALIBAGO WATERWORKS
Address: Responsibility Center:
Angeles City
PARTICULARS
PRISCILLA G. DELOS REYES
Tel. No.: (045) 331-8143/Email Add: depedmabalacatdiv@yahoo.com
Department of Education
Region III
CITY SCHOOLS DIVISION OF MABALACAT
Mabalacat City, Pampanga
B A
C D
A

1 For the Period
From (MM/DD/YY) To (MM/DD/YY)
Part I Income Recipient/Payee Information Withholding Agent/Payor Information
2 TIN 3 TIN
4 Payee's Name (For Non-Individuals ) 5 Payor's Name (For Non- Individuals)
6 Payee's Name (Last Name, First Name, Middle Name) For Individuals 7 Payor's Name (Last Name, First Name, Middle Name) For Individuals
8 Registered Address 9 Registered Address
8A Zip 9A Zip
Code Code
10 Foreign Address 10A Zip Code 10B ICR No. (For Alien Income Recipient Only)
Part II Details of Income Payment and Tax Withheld (Attach additional sheet if necessary)
PURCHASE OF SERVICES (2%) 2309.10 46.18
FEBRUARY, 2014
Total
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.
SchoolS Division Superintendent
CONFORME:
Payee/Payee's Authorized Representative/Accredited Tax Agent
Signature Over Printed Name
Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry
TIN of Signatory Title/Position of Signatory Date Signed
Signature Over Printed Name
Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Date of Issuance Date of Expiry
Nature of Income Payment A T C Amount of Payment Tax Withheld
Payor/Payor's Authorized Representative/Accredited Tax Agent TIN of Signatory Title/Position of Signatory Date Signed
PRISCILLA G. DELOS REYES
000 743 345 000 001 694 405 000
DEPED, DIVISION OF PAMPANGA





BIR Form No.
2306
September 2005 (ENCS)
3923 MCARTHRU HIWAY, BALIBAGO, ANGELES CITY CITY OF SAN FERNANDO, PAMPANGA
Certificate of Final Tax
Withheld At Source
Republika ng Pilipinas
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas
BALIBAGO WATERWORKS
I declare, under the penalties of perjury, that the information I declare under the penalties of perjury that I am qualified under substituted filing of Percentage
herein stated are reported under BIR Form No. 1600 which Tax/Value Added Tax Returns (BIR Form 2551M/2550M/Q), since I have only one payor from
have been filed with the Bureau of Internal Revenue. whom I earn my income; that, in accordance with RR 14-2003, I have availed of the Optional
Registration under the 3% Final Percentage Tax Wthholding/10% Final VAT Withholding in lieu
of the 3% Percentage Tax/10% VAT in order to be entitled to the privileges accorded by the
Substituted Percentage Tax Return/Substituted VAT Return System prescribed in the aforesaid
Payor/Payor's Authorized Representative/Accredited Tax Agent Regulations; that, this Declaration is sufficient authority of the withholding agent to withhold 3%
Final Percentage Tax/10% Final VAT from my sale of goods and/or services.
Payee/Payee's Authorized Representative/Accredited Tax Agent
Tax Agent Accreditation No./Attorney's Roll No. (if applicable)
Date of Issuance Date of Expiry Date of Issuance Date of Expiry
Signature Over Printed Name
Tax Agent Accreditation No./Attorney's Roll No. (if applicable) TIN of Signatory
Signature Over Printed Name
TIN of Signatory Title/Position of Signatory Title/Position of Signatory
To be accomplished for Value-Added Tax/Percentage Tax Withholding (substituted filing)

1 For the Period
From (MM/DD/YY) To (MM/DD/YY)
Part I
2 Taxpayer
Identification Number
3 Payee's Name
4 Registered Address 4A Zip Code
5 Foreign Address 5A Zip Code
6 Taxpayer
Identification Number
7 Payor's Name
8 Registered Address 8A Zip Code
PART II
PURCHASE OF SERVICES (2%)
FEBRUARY, 2014
Total
Total
Money Payments Subject to Withholding
of Business Tax (Government & Private)
Payee Information
(Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals)
Payor Information
(Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals)
Details of Monthly Income Payments and Tax Withheld for the Quarter
46.18
Income Payments Subject to
ATC
AMOUNT OF INCOME PAYMENTS
Expanded Withholding Tax 1st Month of 2nd Month of 3rd Month of Total Tax Withheld
the Quarter the Quarter the Quarter For the Quarter
2309.10












000 345 743 000
BIR Form No.
Republika ng Pilipinas
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas
3293, MC ARTHUR HI-WAY, BALIBAGO, ANGELES CITY
000
0000
405 694 001
DEPED, DIVISION OF PAMPANGA

City of San Fernando, Pampanga

BALIBAGO WATERWORKS
Certificate of Creditable Tax
Withheld At Source
2307
September 2005 (ENCS)
We declare, under the penalties of perjury, that this certificate 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.
Payor/Payor's Authorized Representative/Accredited Tax Agent
(Signature Over Printed Name)
Tax Agent Accreditation No./Attorney's Roll No. (if applicable)
Conforme:
Payee/Payee's Authorized Representative/Accredited Tax Agent
Tax Agent Accreditation No./Attorney's Roll No. (if applicable)
TIN of Signatory Title/Position of Signatory Date Signed
(Signature Over Printed Name)
Date of Issuance Date of Expiry
TIN of Signatory Title/Position of Signatory
Date of Issuance Date of Expiry
PRISCILLA G. DELOS REYES