BIR Form No.

2000 Page 1 of 2

BIR Form No.

Documentary Stamp Tax
2000
Republika ng Pilipinas
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas
Declaration/Return June 2006 (ENCS)
1 Date of Transaction/Purchase (MM/DD/YYYY) 2 Amended Return? 3 No. of Sheets Attached? 4 ATC
10 - October 15 2016 0
DS120
Yes No

Part I B a c k g r o u n d I n f o r m a t i o n
5 TIN 303 203 154 002 6 RDO 060 7 Line of Business/Occupation WHOLESALE AND RETAIL TRADE
Code
8 Taxpayer's Name (Last Name, First Name, Middle Name for Individuals) /(Registered Name for Non-Individuals) 9 Telephone Number
GAVIOLA CHRISTOPHER REVOTE/SAVIN TRADING 09178011286
10 Registered Address 11 Zip Code
RAC BUILDING DIVERSION ROAD GULANG-GULANG, LUCENA CITY, QUEZON PROVINCE 4301
Part II Details of Transactions
Section A ( For constructive affixture of documentary stamps )
12 Details of Documentary Stamps Purchased/Paid
Nature of Transaction/Particulars Tax Base Tax Rate Tax Due
12A LEASES AND OTHER HIRING AGREEMENTS
12B 4,973,068.80 12C 1ST P2000.0 = P3.0 IN EXCESS
12D P1.0/P1000.04,975.00
Parties to the Transaction
one party the other party
12E CECILIA ANGLO 12F CHRISTOPHER R. GAVIOLA
(Creditor/Mortgagor/etc.) (Debtor/Mortgagee/etc.)
12G 142817919000 12H 303203154000
Taxpayer Identification Number Taxpayer Identification Number

Section B ( For a metering machine user ) *

13 Computation of Documentary Stamps Inventory Before this Purchase as well as of Consumption Since
Last Purchase Date
Last Purchase Date
Last Purchase Amount Beginning Balance Less: Consumed Balance Before this Purchase
(mm/dd/yyyy)
13A 13B 0.00 13C 0.00 13D 0.00 13E 0.00

Metering Machine Information

Machine Brand Serial Number BIR Permit Number Account Number
13F 13G 13H 13I

Section C ( For Loose Documentary Stamps ) *

14 Upon Remittance of sold loose documentary stamps( to be accomplished by collection agents )
INCLUSIVE TRANSACTION DATES
RDO CODE DATE OF REMITTANCE To Amount
From
14A 14B 14C 14D 14E
(mm/dd/yyyy) (mm/dd/yyyy) (mm/dd/yyyy)

Part III C o m p u t a t i o n o f T a x
15 Total Tax Due/Amount Purchased/Amount Remitted 15 4,975.00
16 Less: Tax Paid in Declaration/Return Previously Filed, if this is an Amended Declaration/Return 16 0.00
17 Tax Still Due/(Overpayment) 17 4,975.00
18 Add: Penalties
Surcharge Interest Compromise
18A 18B 18C
18D 0.00
0.00 0.00 0.00

19 Total Amount Payable/(Overpayment) (Sum of Items 17 and 18D) 19 4,975.00

Schedule 1 Details of Transactions

Details of Documentary Stamp Tax Consumptions for Replenishment or Loading in the DST Metering Machine
Inclusive Dates of Transaction
ATC Tax Base Tax Rate Tax Due
(A) From (mm/yyyy) (B) To (mm/yyyy)

0.00

I declare, under the penalties of perjury, that this return has been made in good faith, verified by me, and to the best of my Stamp of Receiving
knowledge and belief, is true and correct, pursuant to the provisions of the National Internal Revenue Code, as amended, and the Office/AAB and
regulations issued under authority thereof. Date of Receipt
(RO's Signature/
20________________________________________________________________________ 21_____________________________ Bank Teller's Initial)
President/Vice President/Principal Officer/Accredited Tax Agent/ Treasurer/Assistant Treasurer
Authorized Representative/Taxpayer (Signature Over Printed Name)
(Signature Over Printed Name)
_____________________________________ ___________________________________ ______________________________
Title/Position of Signatory TIN of Signatory Title/Position of Signatory
_____________________________________ _______________ _______________ ______________________________
Tax Agent Acc. No./Atty's Roll No.(if applicable) Date of Issuance Date of Expiry TIN of Signatory

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BIR Form No. 2000 Page 2 of 2

Machine Validation/Revenue Official Receipt Details (If not filed with the bank)

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