Use Only
BCS/
Item
Republika ng Pilipinas
Kagawaran ng Pananalapi
Kawanihan ng Rentas
Internas
1 For the Year
(MM/20YY)
4 Alphanumeric Tax Code (ATC)
170106/13ENCSP1
BIR Form No.
1701
Enter all required information in CAPITAL LETTERS using BLACK ink. Mark applicable
boxes with an X. Two copies MUST be filed with the BIR and one held by the Tax Filer.
2 Amended
Return?
/20
Yes
No
Yes
No
2 /
1 /
12 Email Address
7 1
13 Contact Number
14 Civil Status
3 1
Single
With Income
17 Main Line of
Business
co
m mo n
c a r r
21 Method of Accounting
Cash
22 Income Exempt from Income Tax?
Accrual
Yes
No
Yes
With No Income
e r
Itemized Deduction
20 Method of Deduction
x Married
Legally Separated
16 Filing Status
Widow/er
Joint Filing
18 PSIC
Separate Filing
19 PSOC
Others (Specify)
Yes
No
No
Less: Portion of Tax Payable Allowed for 2nd Installment to be paid on or before July 15 (Not More Than 50% of
Item 26)
32 TOTAL AMOUNT PAYABLE Upon Filing (Overpayment) (Sum of Items 30 & 31)
If Overpayment, mark one box only (Once the choice is made, the same is irrevocable)
To be refunded
To be issued a Tax Credit Certificate (TCC)
To be carried over as a tax credit for next year/quarter
I declare under the penalties of perjury, that this annual 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. (If Authorized Representative, attach authorization letter and indicate TIN)
36 Place of Issue
37 Amount, if CTC
Drawee Bank/
Agency
Number
Date (MM/DD/YYYY)
/
/
/
/
Amount
Machine Validation / Revenue Official Receipt Details (if not filed with an Authorized Agent Bank)
1701
June 2013 (ENCS)
Page 2
170106/13ENCSP2
TIN
0
A) Taxpayer/Filer
B) Spouse
Tax Table
If Taxable Income is:
5%
Over P 10,000
but not over P 30,000
Over P 30,000
but not over P 70,000
Over P 70,000
but not over P 140,000
Over P 140,000
but not over P 250,000
Over P 250,000
but not over P 500,000
Over P 500,000
Page 3
1701
June 2013 (ENCS)
170106/13ENCSP3
TIN
0
0
Part V - Summary of Income Tax Due
A) Taxpayer/Filer
Description
B) Spouse
(Not More Than 50% of the Sum of Items 72A & 72B)
85 TOTAL AMOUNT PAYABLE UPON FILING (OVERPAYMENT) (Sum of Items 80 & 84)
A) Taxpayer/Filer
B) Spouse
1701
Page 4
170106/13ENCSP4
TIN
0
96 RDO Code
102 PSIC
103 PSOC
Itemized Deductions
Others
(Specify)
Accrual
Yes
No
Yes
No
Yes
No
Part VIIA - Qualified Dependent Children (If wife is claiming for additional exemption, please attach waiver of the husband)
Last Name
Date of Birth
(MM / DD / YYYY)
Mark if Mentally/
Physically
Incapacitated
Part VIIB - Current Address (Accomplish if current address is different from registered address)
Unit/Room Number/Floor
Building Name
Street Name
Subdivision/Village
Barangay
Municipality/City
Province
Zip Code
113 TIN
114 Name of Signing Partner (If External Auditor is a Partnership)