BIR Form No.

1601Cv2018 Page 1 of 3

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BIR Form No. 1601Cv2018 Page 2 of 3

BIR Form No.

Monthly Remittance Return
1601-C of Income Taxes Withheld on Compensation
January 2018 (ENCS) Enter all required information in CAPITAL LETTERS using BLACK ink. Mark all applicable boxes
Page 1 with an "X". Two copies MUST be filed with the BIR and one held by the Tax Filer.

1 For the Month (MM/YYYY) 2 Amended Return? 3 Any Taxes Withheld? 4 Number of Sheet/s Attached 5 ATC
01 - January 2021 Yes No Yes No 0 WW010

PART I - BACKGROUND INFORMATION

6 Taxpayer Identification Number (TIN) 000 / 000 / 000 / 001 7 RDO Code 018
8 Withholding Agent's Name (Last Name, First Name, Middle Name for Individual OR Registered Name for Non-Individual)
CGGGCG COMPANY
Registered Address (Indicate complete address. If branch, indicate the branch address. If the registered address is different from the current address, go to the RDO to update registered address by using BIR
9 Form No. 1905)
PHILIPPINES
9A Zip Code 2200

10 Contact Number 0000000 11 Category of Withholding Agent Private Government

12 Email Address samplebusiness@gmail.com

13 Are there payees availing of tax relief under Yes No 13A If yes, specify
Special Law or International Tax Treaty?
PART II - COMPUTATION OF TAX
14 Total Amount of Compensation 14 323,087.18
Less: Non-Taxable/Exempt Compensation
15 Statutory Minimum Wage for Minimum Wage Earners (MWEs) 15 129,234.87
16 Holiday Pay, Overtime Pay, Night Shift Differential Pay, Hazard Pay (for MWEs only) 16 11,200.00
17 13th Month Pay and Other Benefits 17 0.00
18 De Minimis Benefits 18 0.00
19 SSS, GSIS, PHIC, HDMF Mandatory Contributions & Union Dues (employee's share only) 19 0.00
20 Other Non-Taxable Compensation (specify) 20 0.00
21 Total Non-Taxable Compensation (Sum of Items 15 to 20) 21 140,434.87
22 Total Taxable Compensation (Item 14 Less Item 21) 22 182,652.31
Less: Taxable compensation not subject to withholding tax (for employees, other than MWEs, receiving P250,000 & 23
23 below for the year)
0.00
24 Net Taxable Compensation (Item 22 Less Item 23) 24 182,652.31
25 Total Taxes Withheld 25 0.00
26 Add/(Less): Adjustment of Taxes Withheld from Previous Month/s (From Part IV-Schedule 1, Item 4) 26 0.00
27 Taxes Withheld for Remittance (Sum of Items 25 and 26) 27 0.00
28 Less: Tax Remitted in Return Previously Filed, if this is an amended return 28 0.00
29 Other Remittances Made (specify) 29 0.00
30 Total Tax Remittances Made (Sum of Items 28 and 29) 30 0.00
31 Tax Still Due/(Over-remittance) (Item 27 Less Item 30) 31 0.00
Add: Penalties 32 Surcharge 32 0.00
33 Interest 33 0.00
34 Compromise 34 0.00
35 Total Penalties (Sum of Items 32 to 34) 35 0.00
36 TOTAL AMOUNT STILL DUE/(Over-remittance) (Sum of Items 31 and 35) 36 0.00
I/We declare under the penalties of perjury that this remittance return, and all its attachments, have 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 give my consent to the processing of my information as contemplated under the *Data Privacy Act of 2012 (R.A. No. 10173) for legitimate and lawful purposes. (If
Authorized Representative, attach authorization letter)
For Individual: For Non-Individual:

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
37 Cash/Bank Debit Memo
38 Check
39 Tax Debit Memo
40 Others (specify below)

Stamp of Receiving Office/AAB and Date of Receipt (RO's Signature/Bank

Machine Validation/Revenue Official Receipt Details (If not filed with an Authorized Agent Bank)
Teller's Initial)

*NOTE: Please read the BIR Data Privacy Policy found in the BIR website (www.bir.gov.ph)

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BIR Form No. 1601Cv2018 Page 3 of 3

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