Blll BCS/

!te*1
,t Republic 0f the Phitippines
Oepartffent of Finance
gures.i ot lnle.nal Revenue

BIR Ftrm NE. Annual I ncome Tax Return

1701 lndividuals {including MIXED lncome Earner),
January 2018 {ENCS)
Prge I
Estates and Trusts
Ente. all .equired inlormation t! CAFI IAL LETTERS usicg BLt{CK ink- ilrart( all appii.abie
bcxfi
Ifltfiffiffi$uffiffiililt 1"01 0.1I8ErutrS F1
"x' IT,lUST the
I FortheY%r(yyyy) IEQiE.* 2 Arrended Retxm? fYs 6lto Shsd PtritrC Reiun? fys 6No
PART I BACKGROUND INFORMATION OF TAXPAYER/F'LER
Taxpayer ldentiimlion Number (Tllj)
ffi* S55-* iffii-- Fs5"-- ROO Code
!ffi8
Taxsayef Type 1', Sinsie Pr@ridar Proiesioai f g*"1e f rrusa f cer*spatla Eama
Alphanum€ric Tax Code {ATCJ # |rc1-: Br"i** ir**scrddurkd lT Rdt€s f &@ fr* profEslon-GrsdEstsd tr Rab6 f
,is=r4
mrg ukrd tn*G$dBrd lTts6b6
f tlgt 1 comps{aa{@ lrrgg f' :6fs gre;rw tnma*y. ff n* f' qfiz blcre ir@ Frofu*e-e* lT ftrts f *fi6 tfxed tllffiB8% i? Rds
I Taxpayei$ liame {Last Nanie, Firsl Narne, triddte Namei,€STATF
OF iFirst !{aine. tJiidle Name, Last Name)ffRUST
{F;rsi Name, Middte }Iame. Lasl Name)
=AO:
, JESSEL,
g Rsgisis.ed Addrss ad{,.E ftkqM
irrdi.ai+ L:ohrdei, dls kCflERttsl+iri]Ma{fu. $eROae*pddc.AtsM
Sa{o ae*h}i *!rS 6lR Fflnt &c 1s5l
?47-c ST SFDI/| CiTY

9A :lP code
liios--
0 0ate ol Birth ifi,{tull0$i}1 fy) 'l Enail . rdress
t'l
:

1 2 citi:enstrip
13 Clain*agFd€€tgnT4SreS6? 14 Foeign T;r fOrrnb$. if applisble
lFrLtPtNo f yes {X No
1 5 Conlact Number tlandtineicethhone Ns,)
{6 ci'/i! s*nJs (;i aFplicrbie}
14531s81 Single , Manied a'LegallySeparated . Widoder
t 7 l{ maried, spcuse has income'l f ,8 slaks {^
Yes No F,liins Jainr F'ilinc f sepamts Filing
g incrrne EX€ldPT frln lncctre ia:a,> fiyo 6 as ?0 !ri41e ftbieri i. *pEclAt_iF*s.ggREHTtAL RATE? f yes {t ruo
8f y6s, fill out also eolislidalis* ol ALL aclivities p€r Tex Rcg'me {Pa't X}j
llf yte, fill oul alss mnsrlida{ion cf Aj-L astiY;tite FB. Tar Rsgime {pert Xll
t1A tfe*roU ct *eductiffi i6ho6se cne,:
I GBduated Rat€s
2{ Tax Rate' (Cfloose Methsd of Deductlo. in iteh 2lA) ' ltemi:ed Deduction : Cpriorral Standard Deddctjon iOSDi
(choose one) 140% ai Gross iSec,
' A% ifl iieu of Graduat3d Rates under Sec. 24{A} & p€rcentage Tax under Sec. 1 1 6 of NIRC
iavailable if gre s;aiesirsr"iFts ard olher non{FeBling incorne dc nol ex.*d itr# reillioa p*se {F31,{}i

PART N . TAX PAYABLE It" 43 Cenlavos il Lss

Pafiicular A, B.
Due (Fronr Part Vl liem 5) 205,16?-00 0.oo
Less; Total Tax Creditslpayments iFroft part Vll i(etr 10]
158.753.*0 0.00
Tax Payablel(Overpayme.rt) iltErr A2 le* !ter :.3)
6,414,il0 0.00
Lessi Pafiion af iax Payab{e Allsre.d ,or 2ft6 lrstallfr*nl io be piid cr cr betore
October 1 5 (5C% or less of ltem 22) 0.00 0.00
{k"m ?4 L6s ,tem 25) s,414.00 0,00
Add: Peralties 27 lnterest
0.00
28 Surchsrge 0.00 0.00
29 compromise
0.00
Total Penallies isuFt of ltffis ?7 t+ ?g)

3.| Total AHoqnt Payabl€{$rerpa}B€Bt} {Sun af !teF$ :6 6Dd '}0} 6,414-00

1 i 0,00
Aggregate Amaunt Payalrlei(Oyerpayfrent) i$Lnr of ttem! 26 and 30] 6,414.00
li overpayftert. mark one r.lJ box o.ly_ {Once tle lh+ice is made. fre same is irre.seable)
' .
To be retunded To be issued a Tax Cieciif Cet.iifiste fICC) Ic hre carried over as a lax crecjil ior next y€ar./quader
perjury
ate
and aolrect, It the Frevisions of the i{aiienai lrrternal as amended, there.F" my to
procs5$ing informati6h as undsr the "Bata {R.A. No. o1 73) and (tf sigDed by

M 33 :"luroer o1 Ahacnme{s 00
A
FART III - DETAILS OF PAYI'ENT
P6rtieula16
34 CashlBanir Oebrt lVemo

35 ctect
35 lax Oebit r..,teno

3? otnes belowJ

Iiaehihe vaiidalionlRevenue o{$cial Receipt Detalls ill not tle{l wtrh an Au&orized Aqdrt Bark} Stamp ot Heceruflg OfiicetAAB end ilale of Receipt
(8.O's Sig*alureJBank T€litr's Iriijail

iOTE: 'The BIR Dala Pn'vacv Fr

 BiR Form No.

1701 Annual Income Tax Return

ianuary 2018 (ENCSi lndividuals {including MIXED lncome Earner},
Page 2 Estates and Trusts ,
lIOJ PT
'1JlEE'.J[.S

PART I\I - lnfsrmation of

I Spause3 Ta:payer ldBnlification Number filNi
2 RDO Code
,
3 FiterhspouseType (* f **-T"1,1:.'
singleFmprietor f cmgelsatim..*"1..-.
. .
Aiphanumeric Tax code {ATC} f not: B*in* t *Fc.€dus@d r Rscs f fi&4leElmFdd#GrsdudedtTRa* f nrlsu*"au*GB6H€dtTR#
f tBtt compwtion tnmme f larss*in***dti fiqrte f llo1TrrmrekdnProtssihsliffRsk .* Xu6Mitedhffie{16rRd1e
5 Spouse's Name flasl Narne, Frs, I&rre Middle ttame)

6 Contact Number
7 Citizenship i

I Ctaiming Foreian Tax Credits? yes No g Foreign tax numb et iil apptHbte)
10 Income EXEItiiPT from lnGome Tax? i yes No 1 1 tnmnre sutrjec't 1o SPECIALIPREFEEEHTIAL iATE? yes , No
flf yes' fill out also cssolidation of ALL activities per Tax Regime {Fart x)l (lt yes, till out also consolidati6 sf ALL activities per Tax Regime (part x}t

1 2A Merhod ql ileduction idroose 6ne)

Graduated Rates
1 2 Tax Rale. (Choose i!.lethod ot Dedu6t;oD in ltetr : l A) ltemEed Deduction Optional Standa(, Deductron {OSD)
ir}loose onei l$ec. 34(A-J). t{tRcl l,l0% cf G.ffi Sales/'iecdpts/*eeenues,/Fees JSer. 34iL), Nti{cjl
' 8ti
in lisu of Gredlaled fiates under $ec. 24(A) & Percenrale Tax under Sec. .i
16 of tilRC
Iayailable if gross salesr'receipts and lriler nBn-sperating inadms do nor erceed lhree miilion pesos (P3Mil

PART V. of Tax
Gross tompensatiotr lnrcl*s and tax Withheld
iAitaEh A'Jditioitaf Sllesa/s, iiff€ssaryJ
Items ard 2, enter the required lnformalion fsr Eslch of
!rur eniDloyels and nra* {n wether the ,ntDrmation for the Taxpayer or lhe SpEuSe. On Item 34, enter the
Gross and Totai t3x l4/rlhheld for lhe and cn liem for tlE t{6T 6ek € 5' uP)
a-bJafie of €mplcyer

a
r TaxFayer

Sp0use
:.**
b. Emptcyertrru
I f- f*
Taxpaya I
?
Spousa
I

({;ontinuation al Tabla Ahove}

, h.EmproyersrrN i I I I
.' -
,t
i.cqlplrg4*t i11ffi'.,_ : ,--."1._' :-- -, _ -, _ri.
iar ty'rhh.il*
s.00 0.00
0.00 0.00
Cross Ccrocnsatlon lncome a.d Totar Tax !^,lith,re;d ,ot
tA
*' ' nnn
TAXPAYER (To Fart V Schedr/e Z ltern 1A End part Vll lta,ne SAI 0.o0 U. UU
2E Gross CcnD:nsaticn lrcome and 1 otar Tax llitlrne.d lcr
*" SPOUSE {To PartV Sohedule Z ltem 48 and padVll lteme 58) c.00 f-** s.oo
2 . Taxable Compensation lncome
fDO HOT eilter Cenbvd6; ,tS Cenbvos or l*s dmp dowl 5t rr mdre

particula.s A B. Spouse
Gross Corngensation income {From part yscfie#ille 1 ltem 3ALigBti

Lass: NorTsffillie i

6 Trrab;e Ccnpensation
Exsrnpt Compens3t$fl

lncorne iltem 4 Less llem S!

0.00
nnn
0.00
r
r*
0.&0
0.00
0.00
7 Tax Due-eompensation lncome ilfen 6 x alttiimble lncame Tax Ra!e) 0.00 0.00
3 - T*xablB Braslit€ss al'csflre r*fes, frl rn ,feF6s t lo ff ,f* ffat tn &re tax r*fe, frrrn rfsms fS &
3.A - For Tax Rates

$ Sales/revenues/receiplElFees
f-*-iE37{ffiB.oo'
9
1
Less: Sales Retums, AllowanceB and

S Net SalesrReveffueslRsceiptsiFoes ftten I issi- ll€tr

Discilnts
g)
18,323.368.0C
0.00 r
f---*offi
0,00
0.00

1 1 Les: Cost of Saleslservices (appliczbie only if av"iling ltemized Deductians) tl,+so,osz.oo r****---6"ffi'
1 2 Gross lncomel(Los6) from Operation $teil 1O tess tten i1)
l-essr Ded!crofrs Altowaitle ur!der Existing Laws
f"** 6^BfuT?30 I 0.00

3 Ordinary A.ilowable tiemized Deductions (Frcm parl L/ SchedrJa 4

1

Special Allowable ltearized Deductiorls {Fren pai

lten lEj 5,822,756.00 f*-**-*--***T3o
44
, nttowabte for Net Operating Loss Camy' Over (NOLCOi
V Srhedule S \tern 3 andfilr

parl V Sctreflrle 5
T 0.00 r*-*- o'ool
'e_* ltem il ar,d/or ltetr 13)
{From
0.00 0.00
1 S
"olal
Allorvable ltemi?€d Dedrctiofl* (Si$fr ct tiitns 13 ia ti) 5,822.756.00 r
) 0.00
OR

1 ? Optionat Standard Deduction {ASDi i40% af tten 1E} 0.00 0.00

Ner lncome/LLost\ tll hemized: Ilen 1 2 Le6 ttafr iSt LlztA /rem ,n Less ltem
,sR t4
1
1,050.556.00
Add: Orhei Non-Operalihg lncotre (specf, bctad)

19 0.00 0.00
20 0.00 0.00
I
3,t

2?
Anrouni Receiyedlshtsre
- ' Pannechrp (cPPr
Torel Other Non.Op€rating lnc0rr€
in lnccme by ts

isrm ol
Par$rer from Ganeral professionel

fi.e ils lg ra 21]

0.o0
0.00
rr
I
0.00
0.00
Taxable lncomeBusiness (SrJr7 oflie,ns ?8 ird 221 I 556. 0.00
Total Taxable lncome - Compeasstion & Eusiaes lSam of lle ms 6 and 23) 1,050,556.00 0"00
rq Total Tax Due{omperction and Busines lncome {urdet,fnduated fttei.t 20S,162.00
" ,lrcr 14 v dDpucable lncomp ax Ratel ( lo Pafi \'l lteilt 1)
I LOO
 BIR Form Na.

17A1 Annual lncome Tax Return

January 2018 (ENCS)
Individuals (including MIXED Income Earner!,
Page s Estates and Trusts J
N

I OY
3-B - For 8% FIat Income Tax Rate
lrloT rnter CertryG: ,19 Cstavos or l6s dmp down; 50 ot moE round
ParticulaE A. TaxpayerlFiler g. Spouse
26 Sales/ReverrueslReceipts/Fees fnel ofsa/es returns, allawances

Add: Oilier Non,OFcr6tiRg lncorne (spefjr|y betowl

and di€counfs)
I o.oo 0.00

27
0.00 0.00
28 Totai lncome /Sum of ftems 26 and 2Z)

re
0.00 0.00
29
Less; Allowable reduction from gross sales/ffieipls anc othel arcn-nparaling
ircrfie
of purely self-employed indirrduis ,ra;or proiuiJoi.i",, iir" r*ornt or pzss.000 **
30
31
{n6l appliC3bie i{ with canrpensation incemei
Taxable lnconre{Losi {ttem 28 Less ltem 2g)

Tax Due-Busin€ss lncome (ltem S0 xBr; Flat lncome

-fax
Rate)
re 0.oo {
o.So

0.00
0.00
Total Tax Due-Compen$ation & Business lncome (under flat ratexsum of ltems
7 and 31) (To Part Vl ltem I i 0.00 n Aa
u urj
ule4-

re
Allovyable ltemized Deductions {attach additiona! sheet/s. if
1 Amortizations
0.00
2 uao LJebts
I 0.00 0.00
3 Charilable 3nd Other Contributions
0.00 0.0c
4 Depleticn
0.00 0.00
5 Depreciation
f-*ts,ffi.'o"o
6 Enlertainnlent. Amusement and Reaeation

Fringe Eeneiits
re 0.00
i
0.00
0.00
0.00
lnterest
0.00 , 0,00
Losses
o.o0 o.00
1 0 Perisicn Trusts
****
o.o0 0.00
11 Rental
0.00 0.00
12 Research and Development
0.00 000
13 SataAes, Wages and Allowances
1 0.00
"3s4^s1oso
14 SSS, GSIS, Philheatrh, HDMF and Other Conrriburions
0.00 0.00
1 5 Tares and Licenses
-
244,17,1-tA 0.00
1 6 Transportation and Trave!
i*******?TsFs?.oo 0.00
7 Others (Deductions Subject to Withholding Tax and Other Expenses) ispecrfi trelow: Add addilrbnal sheeffsj, if necasaryl
a Janitorial and ltlessengarial Seruices
0.00 0.00
b Proiessional Fees
0.00 i

C Secunly Serviaes
0.00 i 0.00
d ICATION, LIGHT, WA R, OFFICE SU 0-00
t S I:lir?,:,1?#HY3i," itemized Deductions fsurn cr fienrs 1 to 17d) (ra part v
5,822,755.00 0.00
ule5- Allowable ltemized Beductions adddrbnai sheel/s-,

rffi
rl
2
ljE-Ig:rrv-"rtliiFl .- _?sff-qli.?n

re Legal Basis

0.00
I Amount

0.00
0,00
3 Tola! Special Allcwable ltemized Deduclions-Taxpayer/Fller (Sum cf lletns , and 2) (Tt par! V SchedLte 3.A ltetn 144) 0.00
5.B - Spouse

4r %
J 0.00 0.00
5 0.00
6 Total speciai Aliowable itemized Deductroars-SFarise tsum of ltems 4 and 5) {To part V Schetjule 3.A }tam 148}
.****----TIo 0.0G

6- of Het Loss Over

6"A " CoraputaUon ol NOLCO
Iles*iptiotr A. Taxpayer/Filer B. Spouse
1 Gross lncon,'e 0.00 0.00
Less; Ordinary Ailov/able ltemized Deductions
0.00 0.00
q Net Operating Loss lllern 1 lsss li€in ?) iTc Scheduie 6.A.1 ttem 7A atldlar
u $cheCale 6.A.2 ltetn 1?A) 0.00 :
0.00
6.A"1 - TaxpeysrlFileros Deteiled Computation of Available NOLC0

Net operatinq i.gss E- Net Operating Lcss

B. NOLCO Appiiead D. NOLCO Appliead
C. NOLCO Expired
Year lncured A. Amount Previous Yearis Cunent Yeaf
(Unappiied)
I{e=A-(8+c}D,
4 0.00 l 0.00, 0.00i r*
0.00 0.00
5l 0,00 '
0.00 0"00 ' 0.00 0"00
E fi.00 t|=LJrl 0^00 0.00 0.00
I
 BtrR Forrn Ne.

17A1 Annual Income Tax Return

January 2018 {ENCS)
lndividuals {including MIXED lncome Earner},
Page 4 Estates and Trusts ilr
i I01 flaEtJ*s F4

DOY
ofSctedule
5.A.2 - Spouse's Detailed Computation of Available
NOLCO
Net Operating Loss
B. NOLCO Appliead
Applieac E Net operating Loss
Year lncuned Previous yearls c. NoLCo Expired D' NoLCo
veir
r*
A. Amount
cunenr
09 *- t,.lY;7r1,81t,r

10
0.00 0.00 ili'il f-***-*6.0r T*****--Tril
0.00 0.00 i 0.00 o.bo 0.00
1{ 0.00 0.o0 l- o.bd 0.00 f-*0ffi
12 0.00 l 0.00 l
0.00 0.00 0.00
1 3 Total NOLCO - Spouse (SLm af ltens gD ro 12D)(Io part y
Srhedu te 3.A ltf;rrl 158)

PART VI - Summary of lncome Tax Due

f-*- o.oo'

1 Regular Rate-tn6ome Tax Due (From part V, Either ltem 25

:'- "
re
ar ttem SZ) 205,167.00 b.OO
2 Special Rate-lncome Tax Due fFrom partx ttem 178/1TF)
0.00
3 Less: Shar6 oi ether Govemment Ag€ncy,

d Net Sp*cial Raie-income Tax Due/Share of National Govt.

if renilied directly to lha Agetliy 0.00 I o.oo
2

rere
frrefi Less ltem J)
0.00 0.00
$ Total lncome Tax Due /Io pai l! ltem 22)

PART Vlt. Tac

1 Frior Year's Excess Credits
0.00 0.00
2 Tax Payments for the Firet Three (3) euarlers
17,284.00 0.00
3 Creditahle Tax Withheld for the First Th.ee (3) euartes
73,728.8Q 0.00
4 Creditable Tax Withheld per BtR Form No. 2307 for the 4th euaner
| 107.741.00 000
5 Tax yurthhetd per BIR Fontr No. 2316
-C.rgdllafle iFtom pai V SDhe{iute I it,m
" sAdtSBd) 0.00 000
6 Tax Paid in Return Previously Filed, if this is an Amended Retsrrr

Foreign Tax Credits, ilapplrcabie

I o.oo 0.00
| 0.00 0.00
B Special Tax Credits, it applicable (To paft Vilf ftem E)

U
^

I0
Other Tax CrBdits/Paymenhs (specity)
|
Tota! Tax CreditslFayments (Surn ofcerns
..'.@

I to g] {Ta part tt $em ZJ)

0.00
0.00
198,753.00
re 0.00

0,00
PART VIII - Tax Relief Ayailmen!
- Spacial Rate

1' reoulat
lncome Tax Orherwise Due ipad X ttefi 168 andlor tten
,TSSIITulcome tax
rcte)
Tax R*ilef on special Allowable ltemized Deduction*
X applit 4ble regulat income lax rcie )
{part
16F

x ltalr}lg and/ol
X applicabie

lter{t lF
re 0.00
0.00
0.00
SuU-f+tat - Tax Retiet (Sunt of ttems

re
l3 1 and 2)
0.00 0.00
l{ Less: lncorne T ax Due (From part X ftem 1 lB anilor ltem 1 7F)
0.00
5 Tax Relief Availment Before Special Tax Credit frtem tess ltern 4i
'3 0,00 0.00
6 AdC: Special Tax Cred(, if any (Fro,,t patt Vil ltem B)
0.00 0.00
7 Total Tax Relief Availment-SpECIAL iSum of ltems S arxl 6)
0.00 ,00

re
Vlll"8 - Exempt
g
-
g
tncorne Tax Othsnilrse Due ipartX#em 16A anrl/or lten 158 X applicable
-!99,u,.t31tncome
reqular
-Tax_Reiref
tax ralel,
on.Speoal Allowable ltemized Ded$ctlo rE (pad X ftemZA and/or llenr
re re
re
| tr appilcaote regular income lay rate )
^ 0.00
{ 0 Totat Tax Ref ief Avaiiment-EXEMpT (sun of ltens

PART lX - Reconciliation of Net tncome

I and g}

Books Taxafole lncome additlonal

r
if
0.00

Particulars A" TaxpayerlFil*r B. Spouse

1 Net inc.me/(Loss) per Books
0.00

re
ACC; Nofl-Deduciible Expenses,Taxable Other lncome

2i
3
re re
4,
$ total lsum a! ltetns 1 and 4)
re 1,050,557.00
I 0.oo
0.00
0.00
Less: A) Non"Taxable lncome and lnmme Subjected to FinalTax

6l 0.00 0.oo
7tr 0.00 0.00
Ei $peciat,'Otit€r Allowabls Deduclicns
o
U
0.00 0.00
b.oo t1.00
1 O Total fsum o, ,iems 5 lo g|
0,0s 0.00