DLN: Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas

PSOC:

PSIC: BIR Form No.

Compensation and Final Withholding Taxes

X No 132

Annual Information Return of Income Taxes Withheld on

1604-CF
July 2008 (ENCS)

Fill in all applicable spaces. Mark all appropriate boxes with an X. 1 For the Year 2Amended Return? 2 0 1 0 (YYYY) Part I Background Information 4 TIN

3 No of Sheets Attached

Yes

0 0 6

5RDO Code

6 Line of Business/ Occupation

FOOD PROCESSING 286 - 0621

10 Zip Code

7 9 11

Withholding Agent's Name

(Last Name, First Name, Middle Name for Individuals)/(Registered Name for Non-Individuals) 8 Telephone No.

SAGREX FOODS, INCORPORATED

Registered Address

KM. 9, TCG COMPOUND, SASA, DAVAO CITY

8000

In case of overwithholding/overremittance after the year-end adjustment on compensation, If yes, specify have you released the refund/s to your employee/s? YesNo the date of refund 12 Total Amount of Overremittance on 13 onth of First Crediting of M 14Category of Withholding Agent 0.00 Tax Withheld under Compensation Overremittance Private Government Part II S u m m a r y o f R e m i t t a n c e s Schedule 1 R e m i t t a n c e p e r B I R F o r m N o. 1601-C NAME OF BANK/BANK CODE/ DATE OF TOTAL AMOUNT MONTH TAXES WITHHELD ADJUSTMENT PENALTIES REMITTANCE ROR NO., IF ANY REMITTED

JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC TOTAL
Schedule 2

2/11/2010 3/10/2010 4/8/2010

LBP-BAJADA BDO-BANGOY LBP-BAJADA LBP-BAJADA LBP-BAJADA LBP-BAJADA LBP-BAJADA LBP-BAJADA LBP-BAJADA LBP-BAJADA LBP-BAJADA LBP-BAJADA

3,042.98 4,871.91

3,042.98 4,871.91

R e m i t t a n c e DATE OF REMITTANCE
NAME OF BANK/BANK CODE/

MONTH
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC TOTAL Schedule 3

ROR NO., IF ANY

p e r B I R TAXES WITHHELD

F o r m

N o. 1601-F

PENALTIES

TOTAL AMOUNT REMITTED

MONTH
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC TOTAL Schedule 4

DATE OF REMITTANCE

NAME OF BANK/BANK CODE/ ROR NO., IF ANY

R e m i t t a n c e p e r B I R TAXES WITHHELD

F o r m

N o. 1602

PENALTIES

TOTAL AMOUNT REMITTED

R e m i t t a n c e DATE OF REMITTANCE
NAME OF BANK/BANK CODE/ ROR NO., IF ANY

QUARTER
1ST QTR 2ND QTR 3RD QTR 4TH QTR TOTAL

p e r B I R TAXES WITHHELD

F o r m

N o. 1603

PENALTIES

TOTAL AMOUNT REMITTED

We declare, under the penalties of perjury, that this declaration 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.

Stamp of Receiving Office and Date of Receipt

15

President/Vice President/Principal Officer/Accredited Tax Agent/ Authorized Representative/Taxpayer (Signature Over Printed Name) Title/Position of Signatory TIN of Signatory Date of Issuance

Treasurer/Assistant Treasurer 16 (Signature Over Printed Name)

Title/Position of Signatory Date of Expiry of Signatory TIN

Tax Agent Acc. No./Atty's Roll No.(if applicable)

(Use Schedule 7.5 for Minimum Wage Earner) Schedule 7.1

ALPHABETICAL LIST OF EMPLOYEES/PAYEES FROM WHOM TAXES WERE WITHHELD (FORMAT ONLY)
ALPHALIST OF EMPLOYEES TERMINATED BEFORE DECEMBER 31 (Reported Under BIR Form No. 2316)

(Use the same format as in Schedule 7.3 but prepare a separate column (before Gross Compensation) for inclusive date of employment. The annualized method should have been applied in computing the tax due from the employee upon termination of the employment contract.)
Schedule 7.2 SEQ TIN NO (1) (2) NAME OF EMPLOYEES Last First Middle Name Name Name (3a) (3b) (3c) ALPHALIST OF EMPLOYEES WHOSE COMPENSATION INCOME ARE EXEMPT FROM WITHHOLDING TAX BUT SUBJECT TO INCOME TAX (Reported Under BIR Form No. 2316) (Applicable from January 1 to July 5, 2008) (4) GROSS COMPENSATION INCOME Gross NON - TAXABLE Total Non-Taxable/Exempt TAXABLE EXEMPTION Premium Paid Compensation 13th Month Pay De Minimis SSS,GSIS,PHIC, & Pag - ibig Salaries & Other Forms Compensation Basic Salaries & Other Forms Code Amount on Health and/or Income & Other Benefits Benefits Contributions, and Union Dues of Compensation Income Salary of Compensation Hospital 4(a) 4(b) 4(c) 4(d) 4(e) 4(f) 4(g) 4(h) ( 5a) ( 5b) Insurance (6) Net Taxable Compensation Income (7) Tax Due (8)

TOTALS Schedule 7.3 SEQ TIN NO (1) (2) NAME OF EMPLOYEES Last First Middle Name Name Name (3a) (3b) (3c)

Gross Compensation Income 4(a)

13th Month Pay & Other Benefits 4(b)

ALPHALIST OF EMPLOYEES AS OF DECEMBER 31 WITH NO PREVIOUS EMPLOYER WITHIN THE YEAR (Reported Under BIR Form No.2316) (4) GROSS COMPENSATION INCOME NON - TAXABLE De Minimis SSS,GSIS,PHIC, & Pag - ibig Salaries & Other Forms Total Non-Taxable/Exempt Basic 13th Month Pay Benefits Contributions, and Union Dues of Compensation Compensation Income Salary & Other Benefits 4(c) 4(d) 4(e) 4(f) 4(g) 4(h)

TAXABLE Salaries & Other Forms of Compensation 4(i)

Total Taxable Compensation Income 4(j)

TOTALS Schedule 7.3 (continuation) Premium Paid on EXEMPTION Health and/or Hospital Insurance Code Amount (5a) (5b) (6)

P Net Taxable Compensation Income (7)

P TAX DUE (JAN. -DEC.) (8)

P AMOUNT OF TAX WITHHELD AS ADJUSTED ( to be reflected in BIR Form No. 2316) (11)=(9+10a) or (9-10b)

P Substituted Filing? Yes/No (12)

ALPHALIST OF EMPLOYEES AS OF DECEMBER 31 WITH NO PREVIOUS EMPLOYER WITHIN THE YEAR TAX WITHHELD YEAR - END ADJUSTMENT (10a or 10b) (JAN. - NOV.) AMOUNT WITHHELD OVER WITHHELD TAX AND PAID FOR REFUNDED TO IN DECEMBER EMPLOYEE (9) (10a) = (8) - (9) (10b)=(9) - (8)

P Schedule 7.4 SEQ TIN NO

P NAME OF EMPLOYEES Last Name First Name (3b) Middle Name (3c)

Gross Compensation Income (4a)

(1)

(2)

(3a)

13th Month Pay & Other Benefits (4b)

ALPHALIST OF EMPLOYEES AS OF DECEMBER 31 WITH PREVIOUS EMPLOYER/S WITHIN THE YEAR (Reported Under BIR Form No. 2316) GROSS COMPENSATION INCOME PREVIOUS EMPLOYER NON - TAXABLE TAXABLE Total Non-Taxable De Minimis SSS,GSIS,PHIC & Salaries Basic 13th Month Pay Salaries & Compensation Income Benefits Pag - ibig Contributions, Other Forms Salary & Other Other Forms (Previous) and Union Dues Of Compensation Benefits of Compensation (4c) (4d) (4e) (4f) (4g) (4h) (4i)

PRESENT EMPLOYER NON - TAXABLE Total Taxable 13th Month De SSS,GSIS,PHIC & Salaries & (Previous Employer) Pay & Other Minimis Pag - ibig Contributions, Other Forms Benefits Benefits and Union Dues of Compensation (4k) (4l) (4m) (4n) (4j= 4g+4h+4i)

Total Non-Taxable Compensation Income (Present) (4o)

TOTALS

P
Total Compensation Present

P Total Taxable (Previous & Present

Employers )

P Premium Paid on Health and/or Hospital Insurance (6) Net Taxable

Compen-

P TAX DUE (JAN. DEC.) (8)

P TAX WITHHELD (JAN. - NOV.) PREVIOUS EMPLOYER (9a)

P AMOUNT OF TAX WITHHELD AS ADJUSTED (To be reflected in BIR Form No. 2316 issued by the present employer ) (11)=(9b+10a) or (9b-10b)

Schedule 7.4 (continuation)

PRESENT EMPLOYER

ALPHALIST OF EMPLOYEES AS OF DECEMBER 31 WITH PREVIOUS EMPLOYER/S WITHIN THE YEAR EXEMPTION
Code

Basic Salary (4p)

TAXABLE 13th Month Pay Salaries & & Other Other Forms Benefits of Compensation (4q) (4r)

(4s = 4p+4q+4r)

(4t = 4j+ 4s)

(5a)

Amount (5b)

sation Income (7)

PRESENT EMPLOYER (9b)

YEAR - END ADJUSTMENT (10a or 10b) AMOUNT W/HELD OVER WITHHELD TAX & PAID FOR REFUNDED TO IN DECEMBER EMPLOYEE (10a)=(8)-(9a+9b) (10b)=(9a+9b)-(8)

P NAME OF EMPLOYEES Last Name First Name (3b) Middle Name (3c)

Schedule 7.5 SEQ TIN NO

ALPHALIST OF MINIMUM WAGE EARNERS Region No. Where Assigned (4) TOTALS P

Gross Compensation
Income Previous

Basic/ SMW (5b) P

Holiday Overtime Pay Pay (5c) P P (5d)

(1)

(2)

(3a)

(5a)

Night Hazard Shift Pay Differential (5e) (5f) P P P

(Reported Under BIR Form No. 2316) GROSS COMPENSATION INCOME PREVIOUS EMPLOYER NON - TAXABLE 13th Month Pay De Minimis SSS,GSIS,PHIC & Salaries & Other & Other Benefits Pag - ibig Contributions, Forms of Benefits and Union Dues Compensation (5g) (5h) (5i) (5j) P P P P

Total NonTaxable/Exempt Compensation Income (5k)

13th Month Pay & Other Benefits (5l) P P

TAXABLE Salaries & Other Forms of Compensation (5m) P

Total Taxable
(Previous Employer)

(5n = 5l + 5m)

Schedule 7.5 (continuation)

Inclusive Date of Employment From To (5o) (5p) P

Gross Compensation Income (5q) P

Basic SMW Per Day (5r) P

Basic SMW Per Month (5s) P

Basic SMW Per Year (5t)

ALPHALIST OF MINIMUM WAGE EARNERS (Reported Under BIR Form No. 2316) GROSS COMPENSATION INCOME PRESENT EMPLOYER NON-TAXABLE Factor Used Holiday Overtime Night Shift Hazard 13th Month Pay De Minimis SSS,GSIS,PHIC & (No. of Pay Pay Differential Pay & Other Benefits Pag - ibig Contributions, Days/Year) Benefits and Union Dues (5u) (5v) (5w) (5x) (5y) (5z) (5aa) (5ab) P P P P P P P P

Salaries & Other Forms of Compensation (5ac)

TAXABLE 13th Month Pay SALARIES & & Other OTHER FORMS Benefits OF COMP. (5ad) (5ae) P P P

Total Compensation Present (5af) P

Total Compensation Income (Previous & Present Employers ) (5ag)

Schedule 7.5 (continuation) EXEMPTION Code (6a) Amount (6b) Premium Paid on Health and/or Hospital Insurance (7) Net Taxable Compensation Income (8) TAX DUE (JAN. - DEC.) (9)

ALPHALIST OF MINIMUM WAGE EARNERS TAX WITHHELD (JAN. - NOV.) PREVIOUS EMPLOYER (10a)

(Reported Under BIR Form No. 2316) YEAR - END ADJUSTMENT (11a or 11b) AMOUNT W/HELD OVER WITHHELD TAX & PAID FOR REFUNDED TO IN DECEMBER EMPLOYEE (11a) = (9) - (10a+10b) P (11b) = (10a+10b) - (9) P P AMOUNT OF TAX WITHHELD AS ADJUSTED
(To be reflected in BIR Form No. 2316 issued by the present employer )

PRESENT EMPLOYER (10b) P SMW - Statutory Minimum Wage

(12) = (10b+11a) or (10b -11b)

P P P P P Note: For schedule numbers 5, 6 and 7.1, 7.2, 7.3, 7.4 prepare separate schedules for foreign nationals/payees