Bir 2551 Q 3 RD
Bir 2551 Q 3 RD
Bir 2551 Q 3 RD
2551Qv2018 Page 1 of 2
8 Taxpayer's Name (Last Name, First Name, Middle Name for Individual OR Registered Name for Non-Individual)
ELREEN ANN JALBUENA JAVIERTO
Registered Address (Indicate complete address. If branch, indicate the branch address. If the registered address is different from the current address, go to 9A Zip Code
9 the RDO to update registered address using BIR Form No. 1905)
4327
30F BALTAZAR ST. BRGY SAN DIEGO ZONE 3 TAYABAS CITY QUEZON PROVINCE
10 Contact Number (Landline/Cellphone No.) 11 Email Address
09612660411 javiertodian16@gmail.com
Are you availing of tax relief under
12 Yes No 12A If yes, specify
Special Law / International Tax Treaty?
13 Only for individual taxpayers whose sales/receipts are subject to Percentage Tax under section 116 of the Tax Code, as amended:
What income tax rates are you availing? (choose one)
(To be filled out only on the initial Graduated income tax rate on net taxable
quarter of the taxable year) income 8% income tax rate on gross sales/receipts/others
Signature over Printed Name of Taxpayer/Authorized Representative/Tax Agent Signature over Printed Name of President/Vice President/
(Indicate Title/Designation and TIN) Authorized Officer or Representative/Tax Agent (Indicate Title/Designation and TIN)
Tax Agent Accreditation No./ Date of Issue Date of Expiry
Attorney's Roll No. (If applicable) (MM/DD/YYYY) (MM/DD/YYYY)
Part III - Details of Payment
Particulars Drawee Bank/Agency Number Date (MM/DD/YYYY) Amount
25 Cash/Bank Debit Memo
26 Check
Machine Validation/Revenue Official Receipt (ROR) Details Stamp of Receiving Office/AAB and Date of Receipt
(If not filed with an Authorized Agent Bank) (RO's Signature/Bank Teller's Initial)
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BIR Form No. 2551Qv2018 Page 2 of 2
*NOTE: Please read the BIR Data Privacy Policy found in the BIR website (www.bir.gov.ph)
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