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BIR Form 1601-E

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Monthly Remittance Return
of Creditable Income Taxes
Withheld (Expanded)
1601-E

January 2004 (ENCS)
1
For the Month of:
  Year: 		2  Amended Return?
   Yes No 		3  Attached Sheets:
    		4  Any Taxes Withheld?
    Yes No
Part I                                                                  B a c k g r o u n d     I n f o r m a t i o n
5



8


10


12 		TIN                  6     RDO Code            7     Line of Business

Taxpayers Name (for individual) Last Name, First Name, Middle Name (For Non-Individual) Registered Name           9     Telephone Number

Registered Address
        11     Zip Code

Category of Withholding Agent
Private Government 		13  Are you availiing of tax relief under Special Law or Treaty?
    Yes  No     If yes, specify
Part II                                                                               Computation of Tax
NATURE OF INCOME PAYMENT A T C TAX BASE TAX
RATE 		TAX REQUIRED
TO BE WITHHELD
14   Total tax required to be witheld and remitted. 14
15   Less: Tax remitted in return previously filed (if this is an amended return). 15
16   Tax still due (over-remittance). 16
17    Add penalties:     Surcharge                         Interest                        Compromise
                 17A      17B      17C   17D
18   Total amount still due (over-remittance) (Sum of items 16 & 17D) 18
      If over remittance, mark one box only: To be refunded        To be issued a Tax Credit Certificate
I declare, under the penalties of perjury, that this return 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.
           19  ______________           20  ________
                President/Vice President/Principal Officer/Accredited Tax Agent/                      Treasurer/Assistant Treasurer
                                 Authorized Representative/Taxpayer.                                         (Signature Over Printed Name)
                                    (Signature Over Printed Name)
                ______________                 ________
                                          Title/Position of Signatory                                                   Title/Position of Signatory
               ____________________________________                ________
                               TIN of Accredited Tax Agent (if applicable)                        Tax Agent Accreditation No. (if applicable)


  

Notes

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