Republika ng Pilipinas Kagawaran ng Pananalapi Kawanihan ng Rentas Internas

For Compensation Payment With or Without Tax Withheld Fill in all applicable spaces. Mark all appropriate boxes with an "X" 1 For the year (YYYY) 1

Certificate of Compensation Payment/Tax Withheld

2 For the period From (MM/DD)

BIR Form No.

2316
July 2008 (ENCS)
To (MM/DD)

2013 268 168 996 000

5 RDO Code

01

01

12

31

Part I Employee Information 3 Tax Payer 3 Identification No. 4 Employee's Name (Last Name, First Name, Middle Name)

Part IV-B Details of Compensation Income and Tax Withheld from Present Employer Amount A. NON-TAXABLE/EXEMPT COMPENSATION INCOME

Lariza, Karl, Monzon

6 Registered Address

000
6A Zip Code

32

Unit B403, Citihomes Cmpd.,

6B Local Home Address 6D Foreign Address 7 Date of Birth (MM/DD/YYYY) 8 Telephone number

1550
6C Zip Code 33 6E Zip Code 34 35 36

Basic Salary/ Statutory Minimum Wage Minimum Wage Earner (MWE) Holiday Pay (MWE) Overtime Pay (MWE) Night Shift Differential (MWE) Hazard Pay (MWE) 13th Month Pay and Other Benefits De Minimis Benefits Other Benefits SSS, GSIS, PHIC & Pag-ibig Contributions & Union dues (Employee share only) Salaries & Other forms of Compensation Total Non-Taxable/Exempt Compensation Income

32

33 34 35 36 37

10

11

1986
Single \

27190255

9 Exemption Status

Married 37

9A

Is the wife claiming the additional exemption for qualified dependent children? \

Yes

No 11 Date of Birth (MM/DD/YYYY) 38 39

30,000.00 40,805.77 11,225.00 0.00 82,030.77

10

Name of Qualified Dependent Children

38 39

40 12 13 14 Statutory Minimum Wage rate per day Statutory Minimum Wage rate per month 12 13 41

40 41

Minimum Wage Earner whose compensation is exempt from withholding tax and not subject to income tax 15

B. TAXABLE COMPENSATION INCOME REGULAR 42 Basic Salary 42

Part II Employer Information (Present) 15 Taxpayer Identification No. 16 Employer's Name

239

952

660

000
43 44 17A Zip Code 45 46 Representation Transportation Cost of Living Allowance Fixed Housing Allowance 43 44 45 46

310,541.01

JPMCB PHILIPPINE GSC

17 Registered Address

31F PhilamTwr,8767PaseoDeRoxas,Mkt
\

1200

main employer

secondary employer

Part III Employer Information (Previous)-1 18 Taxpayer Identification No. 19 Employer's Name 18 47 47A 47B 20 Registered Address 20A Zip Code Others (Specify) 47A 47B

SUPPLEMENTARY Part IV-A 21 22 23 24 25 26 27 28 29 30 Summary 21 22 23 24 25 26 27 28 29 30A 30B 31 55 Total Taxable Compensation Income 55 48 Commission 48

Gross Compensation Income from Present Employer (Item 41 plus Item 55) Less: Total Non-Taxable/ Exempt (Item 41) Taxable Compensation Income from Present Employer (Item 55) Add: Taxable Compensation Income from Previous Employer Gross Taxable Compensation Income Less: Total Exemptions Less: Premium Paid on Health and/or Hospital Insurance (if applicable) Net Taxable Compensation Income Tax Due Amount of Taxes Withheld 30A Present Employer 30B Previous Employer

548,691.59 82,030.77 466,660.82

49 Profit Sharing 49

50

Fees including Director's Fees Taxable 13th Month Pay and Other Benefits Hazard Pay Overtime Pay

50

51

51 52 53

55,609.39

466,660.82 75,000.00

52 53

92,498.38

391,660.82 92,498.25 92,498.25

54 54A

Others (Specify) 54A

8,012.04
54B 54B

31

Total Amount of Taxes Withheld As adjusted

92,498.25

466,660.82

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 Signed 16-Jan-2014 By Angeles Maricar the National Internal Revenue Code, as amended, and theOn regulations issued under authority thereof. 56 MARICAR C.ANGELES Date Signed 01 10 2014 Canlas (JP Morgan chase Bank N.A. Philippine Present Employer/Authorized Agent Signature Over Printed Name

CONFORME: 57 Lariza, Karl, Monzon

CTC No. of Employee

Global Service Center)

Date Signed Amount Paid Date of Issue To be accomplished under substituted filing

Employee Signature Over Printed Name Place of Issue

I declare, under the penalties of perjury, that the information herein stated are reported under BIR Form No. 1604CF which have been filed with the Bureau of Internal Revenue

58

I declare, under the penalties of perjury, that I am qualified under substituted filing of Income Tax Returns (BIR Form No. 1700), since I received purely compensation income from only one Signed On 16-Jan-2014 By Angeles Maricar employer in the Phils. for the calendar year; that taxes have been correctly withheld by my Canlas (JP Morgan chase Bank N.A. Philippine employer (tax due equals tax withheld); that the BIR form No. 1604CF filed by my employer to the MARICAR C.ANGELES BIR shall constitute as my income tax return and that BIR Form No. 2316 shall serve the same Present Employer/Authorized Agent Global Signature Service OverCenter) Printed Name purpose as if BIR Form No. 1700 had been filed pursuant to the provisions of RR 3-2002, as (Head of Accounting/Human Resource or Authorized Representative) amended. 59

Lariza, Karl, Monzon

Employee Signature Over Printed Name