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Annex D Sworn Bir

The document is a sworn declaration by Jed Anthon Maruya, the owner of Bax's Coffee Station, certifying compliance with Revenue Regulations regarding the submission of inventory summaries for the taxable year ending December 31, 2024. It confirms that the submitted DVD-R contains the required schedules in the prescribed format and that the information is true and correct. The declaration is made under the penalties of perjury and is notarized.

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Jerlyn Cadinas
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15 views1 page

Annex D Sworn Bir

The document is a sworn declaration by Jed Anthon Maruya, the owner of Bax's Coffee Station, certifying compliance with Revenue Regulations regarding the submission of inventory summaries for the taxable year ending December 31, 2024. It confirms that the submitted DVD-R contains the required schedules in the prescribed format and that the information is true and correct. The declaration is made under the penalties of perjury and is notarized.

Uploaded by

Jerlyn Cadinas
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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ANNEX D

SWORN DECLARATION

REPUBLIC OF THE PHILIPPINES


PROVINCE OF DAVAO DEL SUR
DAVAO CITY

I, MARUYA, JED ANTHON, FILIPINO, of legal age, designated as the OWNER of BAX’S COFFEE
STATION with business address located at PUROK 7 IMMACULATE CONCEPTION UBOGAN
TORIL DAVAO CITY DAVAO DEL SUR, do hereby certify the following:

 That in compliance with Section 13 of Revenue Regulations No. V-1, otherwise known
as the Bookkeeping Regulations, submitted herewith is the DVD-R containing the
summary list(s) / schedule(s) of inventory ( materials, supplies and other goods, etc.)
and/or other schedules as of taxable year ending DECEMBER 31, 2024.

 That the contents of the DVD-Rs being submitted herewith conform to the prescribed
format as required by the Bureau of Internal Revenue under Revenue Memorandum
Circular No. 57-2015.

 That the summary list(s)/ schedule(s) of inventory and/or other schedules 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 NIRC, as amended, and the rules and
regulations and other revenue issuances issued under authority thereof.

I HEREBY DECLARE UNDER THE PENALTIES OF PERJURY THAT THE FOREGOING ATTESTATIONS
ARE TRUE AND CORRECT.

MARUYA, JED ANTHON


Name and Signature of Authorized Representative
TIN: 273-368-460

SUBSCRIBED and sworn to before me, in the City of Davao, this _________________ by
the affiant who exhibited his/her government issued ID.

Notary Public

Doc. No.____
Page No. ____
Book No. ____
Series of ____

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