Professional Documents
Culture Documents
2550-M
(MM/YYYY)
TIN
Taxpayer's Name
111
222
9 Registered Address
333
12 - December
Page 1 of 4
Amended Return?
2016
000
5RDO
Code
Yes
6 Line of Business
082
8Telephone No.
11 Are you availing of tax relief under Special Law / International Tax Treaty?
Yes
10Zip Code
No
14
1,000,000.00
16A
9,800,000.00
15 Exempt Sales/Receipts
13A
15
13B
500,000.00
300,000.00
Purchases
0.00
60,000.00
40,000.00
17C
0.00
0.00
0.00
0.00
17F
40,000.00
18B
0.00
18D
0.00
960,000.00
17A
17E
17EOthers
1,020,000.00
17D
6000
16B
17B
17BInput Tax Deferred on Capital Goods Exceeding P1Million from Previous Period
2353365
If yes, specify
0.00
18F
780,000.00
18J
54,000.00
240,000.00
18N
18O
18N/OOthers
18PTotal Current Purchases (Sum of Item 18A, 18C, 18E, 18G,
8,000,000.00
18P
18I, 18K, 18M & 18N)
19
19Total Available Input Tax (Sum of Item 17F, 18B, 18D, 18F, 18H, 18J, 18L & 18O)
20 Less: Deductions from Input Tax
20A Input Tax on Purchases of Capital Goods exceeding P1Million deferred for the succeeding period (See Sch. 3 )20A
28,800.00
18G
18K
6,500,000.00
18H
600,000.00
18I
450,000.00
18M
210,000.00
18L
0.00
20B
20D
20C
20E
20E Others
20F
20F Total (Sum of Item 20A, 20B, 20C, 20D & 20E)
21
22
Interest
0.00
25C
Compromise
0.00
0.00
0.00
0.00
-41,200.00
1,016,000.00
0.00
23G
23GTotal Tax Credits/Payment (Sum of Item 23A, 23B, 23C, 23D & 23E)
0.00
-41,200.00
23C
23F
23FOthers
974,800.00
0.00
23E
23EAdvance Payments made (please attach proof of payments - BIR Form No. 0605)
0.00
23A
23D
72,000.00
4,000.00
23B
24
26
25D
0.00
0.00
0.00
0.00
0.00
4,000.00
4,000.00
0.00
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Page 2 of 4
Schedule1ScheduleofSales/ReceiptsandOutputTax(Attachadditionalsheet,ifnecessary)
IndustryCoveredbyVAT
AmountofSales/ReceiptsFor
thePeriod
ATC
VM010
ToItem12A/B
Schedule2
OutputTaxforthePeriod
8,000,000.00
8,000,000.00
Purchases/ImportationofCapitalGoods(AggregateAmountNotExceedingP1Million)
DatePurchased
Description
Amount(NetofVAT)
ToItem18A/B
960,000.00
960,000.00
InputTax
0.00
0.00
Schedule3Purchases/ImportationofCapitalGoods(AggregateAmountExceedsP1Million)
A)Purchases/ImportationsThisPeriod
Date
Purchased
Description
Amount(NetofVAT)
InputTax(C*TaxRate)
Est.Life(in
months)
Total(ToItem18C/D)
0.00
0.00
Recognized
Life(In
Allowable
BalanceofInputTaxto
Months)Useful InputTaxfor
becarriedtoNext
lifeor60mos. thePeriod(D)
Period(D)less(G)
(whicheveris dividedby(F)
shorter)
F
G
H
0.00
B)Purchases/ImportationsPreviousPeriod
DatePurchased
Description
Amount(Netof
VAT)
BalanceofInput
Taxfrom
previousperiod
Est.Life(in
months)
Total
RecognizedLife
AllowableInput
(InMonths)Useful
BalanceofInputTaxto
Taxforthe
lifeor60mos.
becarriedtoNext
Period(D)
(whicheveris
Period(D)less(G)
dividedby(F)
shorter)
F
G
H
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0.00
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Page 3 of 4
Total
C)TotalInputTaxDeferredforfutureperiodfromcurrentandpreviouspurchase(Toitem20A)
0.00
Schedule4InputTaxAttributabletoSaletoGovernment
28,800.00
--------------------------------------------Total Sales
500,000.00
9,800,000.00
0.00
0.00
28,800.00
-41,200.00
70,000.00
Schedule5InputTaxAttributabletoExemptSales
0.00
--------------------------------------------Total Sales
PeriodCovered
0.00
0.00
0.00
Schedule6TaxWithheldClaimedasTaxCredit
NameofWithholdingAgent
IncomePayment
TotalTaxWithheld
Total(ToItem23A)
PeriodCovered
NameofMiller
Schedule7ScheduleofAdvancePayment
NameofTaxPayer
OfficialReceiptNumber
AmountPaid
0.00
AppliedCurrentmo.
0.00
Schedule8VATWithheldonSalestoGovernment
NameofWithholdingAgent
AppliedCurrentmo.
0.00
Total(ToItem23B)
PeriodCovered
0.00
IncomePayment
TotalTaxWithheld
0.00
0.00
AppliedCurrentmo.
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0.00
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Page 4 of 4
Total(ToItem23C)
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