Form 2316 Eb Member Regular
Form 2316 Eb Member Regular
4 Employee's Name (Las t Nam e, Firs t Nam e, Middle Nam e) 5 RDO Code 27 Basic Salary (including the exempt P250,000 & below)
or the Statutory Minimum Wage of the MWE
TOLENTINO, MA. ANGELICA LAINEZ 0 5 8
28 Holiday Pay (MWE)
6 Registered Address 6A ZIP Code
DILAO, BALAYAN, BATANGAS 29 Overtime Pay (MWE)
6B Local Home Address 6C ZIP Code
30 Night Shift Differential (MWE)
6D Foreign Address
31 Hazard Pay (MWE)
13 Employer's Name
37 Basic Salary
COMMISSION ON ELECTIONS
14 Registered Address 14A ZIP Code 38 Representation
39 Transportation
15 Type of Employer Main Employer Secondary Employer
40 Cost of Living Allowance (COLA)
Part III - Employer Information (P re v iou s )
16 TIN
- - - 41 Fixed Housing Allowance
I/We declare, under the penalties of perjury that this certificate has been made in good faith, verified by me/us, and to the best of my/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. Further, I/we give my/our consent to the processing of my/our information as contemplated under the *Data Privacy Act of 2012
(R.A. No. 10173) for legitimate and lawful purposes.
51 NONNATO M. MABUTAS Date Signed
Present Employer/Authorized Agent Signature over Printed Name
CONFORME:
52 MA. ANGELICA L. TOLENTINO Date Signed 1 1 0 4 2 0 2 3
Employee Signature over Printed Name Amount paid, if CTC
CTC/Valid ID No. Place of
of Employee
00098426 Issue BALAYAN, BATANGAS Date Issued 0 1 2 3 2 0 2 3 366.00
To be accomplished under substituted filing
I declare, under the penalties of perjury that the information herein stated are
reported under BIR Form No. 1604-C which has been filed with the Bureau of
Internal Revenue. I declare, under the penalties of perjury that I am qualified under substituted filing of Income Tax
Return (BIR Form No. 1700), since I received purely compensation income from only one employer in the
Philippines for the calendar year; that taxes have been correctly withheld by my employer (tax due equals tax
53 withheld); that the BIR Form No. 1604-C filed by my employer to the BIR shall constitute as my income tax
Present Employer/Authorized Agent Signature over Printed Name return; and that BIR Form No. 2316 shall serve the same purpose as if BIR Form No. 1700 has been filed
(Head of Accounting/Human Resource or Authorized Representative) pursuant to the provisions MA. ANGELICA L. TOLENTINO
54 of Revenue Regulations (RR) No. 3-2002, as amended.
Employee Signature over Printed Name
*NOTE: The BIR Data Privacy is in the BIR website (www.bir.gov.ph)