TRANSMITTAL

TO: __________________________________________

PREPARED DATE: ______________________________

1._____________________________________
2._____________________________________
3._____________________________________
4._____________________________________
5._____________________________________
6._____________________________________

7._____________________________________

RECEIVED BY:
______________________________________
SIGNATURE OVER PRINTED NAME

DATE RECEIVED: _______________________

8._____________________________________________
9._____________________________________________

10.____________________________________
11.____________________________________
12.____________________________________

TRANSMITTAL
TO: __________________________________________

PREPARED DATE: ______________________________

1._____________________________________
2._____________________________________
3._____________________________________
4._____________________________________
5._____________________________________
6._____________________________________

7._____________________________________
8._____________________________________________
9._____________________________________________

10.____________________________________
11.____________________________________
12.____________________________________

RECEIVED BY:
______________________________________
SIGNATURE OVER PRINTED NAME

DATE RECEIVED: _______________________

FEBRUARY 16, 2016

DRA. LAGUNA, MARINELLE LAYO

OSPITAL NG MUNTINLUPA
CIVIC DRIVE FILINVEST, MUNTINLUPA CITY

STATEMENT OF ACCOUNT
PARTICULAR

AMOUNT

VAT FOR JANUARY 2016

6,237.05

RETAINERS FEE

2,000.00

QUARTERLY ITR

12,979.25

TOTAL

21,216.30

Note:

If paying through check, please make the check

Payable to Angeles J. Jimenez

Prepared by:

Approved by:

Joy Agullana

Angeles Jimenez

Received by:

QUARTERLY ITR - 2015

737,240.64
364,896.25
372,344.39
(250,000.00)

50,000.00

122,344.39
X

30%

36,703.31
86,703.31 TAX DUE
2307 W/TAX

73,724.06

TOTAL TAX DUE

12,979.25

23-Jun-16

DR. SANDOVAL, MAREON

429 PARANAQUE DOCTORS HOSPITAL
DON BOSCO, PARANAQUE

STATEMENT OF ACCOUNT
PARTICULAR

AMOUNT

RETAINERS FEE
JUNE

2016

1,000.00

2550-M
MAY

2016

240.00

TOTAL AMOUNT DUE

1,240.00

Note: If paying through check, please make the check

Payable to Angeles J. Jimenez

Prepared by:

Approved by:

Kristine Corales

Angeles Jimenez

Received by:
_______________________________

DECEMBER 17, 2015

DR. DETLEF GONZALES

LAS PINAS DOCTORS HOSPITAL
8009 J.P AGUILAR AVENUE CAA ROAD, LAS PINAS CITTY

STATEMENT OF ACCOUNT
PARTICULAR

AMOUNT

RETAINERS FEE
OCTOBER
NOVEMBER
DECEMBER

2015
2015
2015

1,000.00
1,000.00
1,000.00

VAT RETURNS
SEPTEMBER
OCTOBER
NOVEMBER

2015
2015
2015

124.00
150.00
152.40

RENEWAL OF BOOKS
RENEWAL OF REGISTRATION
TOTAL

Note:

1,000.00
500.00
4,926.40

If paying through check, please make the check

Payable to Angeles J. Jimenez

Prepared by:

Approved by:

Joy Agullana

Angeles Jimenez

Received by:

23-May-16

DRA. GONZALES, YOLANDA

UPHRM REAL ST., PAMPLONA
LAS PINAS CITY

STATEMENT OF ACCOUNT
PARTICULAR

RETAINERS FEE
MAY

AMOUNT

2016

1,000.00

1ST QTR

2016

105.00

APRIL

2016

595.00

2550-Q

2550 M

TOTAL AMOUNT DUE

Note:

1,700.00

If paying through check, please make the check

Payable to Angeles J. Jimenez

Prepared by:

Approved by:

Kristine Corales

Angeles Jimenez

Received by:

23-Jun-16

DR. GONZALES, JOSE P.

UPHMC ALABANG-ZAPOTE ROAD
LAS PINAS CITY

STATEMENT OF ACCOUNT
PARTICULAR
RETAINERS FEE
JUNE

AMOUNT

2016

2,000.00

2016

240.00

2550 M
MAY

TOTAL AMOUNT DUE

Note:

2,240.00

If paying through check, please make the check

Payable to Angeles J. Jimenez

Approved by:
Prepared by:
Angeles Jimenez
Kristine Corales

Received by:

DECEMBER 15, 2015

DR. ASCALON, PHILIP ROMMEL

LAS PINAS DOCTORS HOSPITAL
CAA ROAD, LAS PINAS CITY

STATEMENT OF ACCOUNT
PARTICULAR

AMOUNT

VAT

50,798.09

ITR

15,799.40

RENEWAL OF BOOKS

3,000.00

RETAINERS FEE

2,000.00
71,597.49

TOTAL AMOUNT DUE

Note:

If paying through check, please make the check

Payable to Angeles J. Jimenez

Prepared by:

Approved by:

Joy Agullana

Angeles Jimenez

JANUARY 5, 2016

DR. ERIC E. DESQUITADO

Las Pinas Doctors Hospital
8009 J.P.Aguilar Avenue
CAA Road, Las Pinas City

STATEMENT OF ACCOUNT
PARTICULARS
RETAINERS FEE
Dr. Desquitado
Dra. Desquitado

AMOUNT

JANUARY 2016
JANUARY 2016

2,500.00
1,500.00

VAT
Dr. Desquitado
Dra. Desquitado
CASA MEDICA RENTAL

DECEMBER 2015
DECEMBER 2015
JAN. 2015

10,412.00
10,200.00
291.75

0605
Dr. Desquitado
Dra. Desquitado
TOTAL

Note:

2,000.00
2,500.00
29,403.75

If paying through check, please make the check

Payable to Angeles J. Jimenez

Prepared by:

Approved by:

Joy Agullana

Angeles Jimenez

Received by:

FEBRUARY 29,2016

DR. ALMORO, EMIL BAUTISTA

PARANAQUE DOCTORS HOSPITAL
175 DONA SOLEDAD AVE.
PARANAQUE CITY

STATEMENT OF ACCOUNT
PARTICULARS

AMOUNT

AUDIT FEE - 2015

7,000.00

RETAINERS FEE
JANUARY 2016
FEBRUARY 2016
MARCH 2016

1,000.00
1,000.00
1,000.00

VAT

JANUARY 2016

133.20

TOTAL AMOUNT DUE

Note:

10,133.20

If paying through check, please make the check

Payable to Angeles J. Jimenez

Prepared by:

Approved by:

Joy Agullana

Angeles Jimenez

Received by: