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01558543
Republika ng Pilipinas Certificate of Compensation BIR Form No.
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas
14 Minimum Wage Earner whose compensation is exempt from B. TAXABLE COMPENSATION INCOME
withholding tax and not subject to income tax
REGULAR
Part II Employer Information (Present)
15 Taxpayer 42 Basic Salary 42
Identification No. 007 128 890 000 83,775.84
16 Employer's Name 43 Representation 43
0.00
TATA CONSULTANCY SERVICES (PHILIPPINES) INC.
44 Transportation 44
17 Registered Address 17A Zip Code
0.00
10 F, PANORAMA TOWER, 34TH STREET, LANE A,
45 Cost of Living Allowance 45
BONIFACIO GLOBAL CITY, TAGUIG CITY, PHILIPPINES 1634
0.00
\/ Main Employer Secondary Employer 46 Fixed Housing Allowance 46
Part III Employer Information (Previous)
0.00
18 Taxpayer
Identification No. 47 Others (Specify)
SUPPLEMENTARY
Part IV-A Summary
48 Commission 48
21 Gross Compensation Income from 21 118,678.79 0.00
Present Employer (Item 41 plus Item 55)
49 Profit Sharing 49
22 Less: Total Non-Taxable/ 22 22,492.88 0.00
Exempt (Item 41)
23 Taxable Compensation Income 23 96,185.91 50 Fees including Director's 50
0.00
from Present Employer (Item 55) Fees
24 Add: Taxable Compensation 24 0.00
Income from Previous Employer 51 Taxable 13th Month Pay 51 0.00
and Other Benefits
25 Gross Taxable 25 96,185.91 52 Hazard Pay 52
Compensation Income 0.00
26 Less: Total Exemptions 26 0.00
53 Overtime Pay 53
9,435.26
27 Less: Premium Paid on Health 27 0.00
and/or Hospital Insurance (if applicable)
28 Net Taxable 28
96,185.91 54 Others (Specify)
Compensation Income
54A 54A
29 Tax Due 29
0.00 Salaries and other form of compensation 2,974.81
30 Amount of Taxes Withheld
30A Present Employer 30A
0.00 54B 54B
30B Previous Employer 30B 0.00
0.00
55 Total Taxable Compensation 55 96,185.91
31 Total Amount of Taxes Withheld 31 Income
As adjusted 0.00
We declare, under the penalties of perjury, that this certificate has been made in good faith, verified by us, and to the best of 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.
56 HIMANSHU AGRAWAL Date Signed
Present Employer/Authorized Agent Signature Over Printed Name
CONFORME:
57 Seniel, Carl Wency, BOLODO Date Signed
CTC No. Employee Signature Over Printed Name Amount Paid
of Employee Place of Issue Date of Issue