For BIR Use Only Republic of the Philippines of Internal Revenue

BCS/ Item: Department of Finance Bureau

BIR Form No.

Annual Income Tax Return
1701A Individuals Earning Income PURELY from Business/Profession
[Those under the graduated income tax rates with OSD as mode of deduction 1701A 01/18
January 2018
OR those who opted to avail of the 8% flat income tax rate] P1
Page 1 Enter all required information in CAPITAL LETTERS using BLACK ink. Mark applicable boxes with an “X”.
Two copies must be filed with the BIR and one held by the Tax Filer.

1 For the Year (12/2022) 2 Amended Return? Yes 3 Short Period Return? Yes
Part I – Background Information on Taxpayer/Filer

4 Taxpayer Identification Number (TIN) 5 RDO Code 6 Taxpayer Type

- - - Single Proprietor
00000
1 2 3 4 5 6 7 8 9 1

7 Alphanumeric Tax Code (ATC) II012 Business Income - Graduated IT Rates II014 Income from Profession – Graduated IT Rates

II015 Business Income - 8% IT Rate II017 Income from Profession – 8% IT Rate

8 Taxpayer’s Name (Last Name, First Name, Middle Name)

Padayao, Domenique, R.

9 Registered Address (Indicate complete address. If the registered address is different from the current address, go to the RDO to update registered address by using BIR FormNo. 1905)

135, Rizal Avenue Brgy. Dolores Taytay Rizal

9A ZIP Code 1920

10 Date of Birth 11 Email Address

(MM/DD/YYYY)

10 17 1999 [email protected]

12 Citizenship 13 Claiming Foreign Tax 14 Foreign Tax Number, if applicable

Credits?

Filipino Yes

15 Contact Number (Landline/Cellphone No.) 16 Civil Status

09204647513 Single

17 If married, spouse has income? Yes No 18 Filing Status Joint Filing Separate Filing

19 Tax Rate Graduated rates with OSD as Percentage Tax under Sec. 116 of NIRC [available if
method of deduction gross sales/receipts and other non-operating income do not
8% in lieu of Graduated Rates under Sec. 24(A) & exceed Three million pesos (P3M)]

Part II – Total Tax Payable (DO NOT enter Centavos; 49 Centavos or Less drop down; 50 or more round up)

Particulars A) Taxpayer/Filer B) Spouse

20 Tax Due (Either from Part IV.A Item 46 OR Part IV.B Item 56) 172,000

21 Less: Total Tax Credits/Payments (From Part IV.C Item 64) 50,000

22 Net Tax Payable/(Overpayment) (Item 20 Less Item 21) (From Part IV Item 65) 122,000

23 Less: Portion of Tax Payable Allowed for 2nd Installment to be paid on or before October 0
15 (50% or less of Item 20)

24 Amount of Tax Payable/(Overpayment) (Item 22 Less Item 23) 122,000

Add: Penalties 25 Surcharge 0

26 Interest 0

27 Compromise 0

28 Total Penalties (Sum of Items 25 to 27) 0

 29 Total Amount Payable/(Overpayment) (Sum of Items 24 and 28) 122,000

30 Aggregate Amount Payable/(Overpayment) (Sum of Items 29A & 29B) 122,000

If overpayment, mark one (1) box only. (Once the choice is made, the same is irrevocable)

To be refunded To be issued a Tax Credit Certificate (TCC) To be carried over as a tax credit for next year/quarter

I declare under the penalties of perjury that this return, and all its attachments, have been made in good faith, verified by me, and to the best of my knowledge and belief, are true and correct,
pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof. Further, I give my consent to the processing of my
information as contemplated under the *Data Privacy Act of 2012 (R.A. No. 10173) for legitimate and lawful purposes. (If signed by an Authorized Representative, indicate TIN and attach authorization letter)

31 Number of
Attachments

Printed Name and Signature of Taxpayer/Authorized Representative

Part III - Details of Payment

Particulars Drawee Number Date (MM/DD/YYYY) Amount

Bank/Agency

32 Cash/Bank Debit
Memo

33 Check

34 Tax Debit Memo

35 Others (specify below)

Machine Validation/Revenue Official Receipt Details (if not filed with an Authorized Agent Bank) Stamp of Receiving Office/AAB and Date of
Receipt (RO’s Signature/Bank Teller’s Initial)

*NOTE: The BIR Data Privacy Policy is in the BIR website (www.bir.gov.ph)
BIR Form No.
Annual Income Tax Return
1701A Individuals Earning Income PURELY from
January 2018 Business/Profession [Those under the graduated income tax rates with
OSD as mode of deduction OR those who opted to avail of the 8% flat income 1701A 01/18
Page 2 P2
tax rate]

TIN Tax Filer’s Last Name

00000
Part IV – Computation of Income Tax

If Optional Standard Deductions (OSD), fill in items 36 to 46; if 8%, fill in items 47 to 56 (DO NOT enter Centavos; 49 Centavos or Less drop down; 50 or more round up)

IV.A – For Graduated Income Tax Rates A) Taxpayer/Filer B) Spouse

36 Sales/Revenues/Receipts/Fees 1,100,000

37 Less: Sales Returns, Allowances and Discounts 1,100,000

38 Net Sales/Revenues/Receipts/Fees (Item 36 Less Item 37) 1,100,000

39 Less: Allowable Deduction - Optional Standard Deduction (OSD) (40% of Item 160,000
38)

40 Net Income (Item 38 Less Item 39) 940,000

Add: Other Non-Operating Income (specify below)

4
1

4
2

43 Amount Received/Share in Income by a Partner from General Professional Partnership (GPP)

44 Total Other Income (Sum of Items 41 to 43)

45 Total Taxable Income (Sum of Items 40 and 44)

46 TAX DUE (Item 45 x Applicable Tax Rate based on Tax Table below) (To Part II – Item 20)

IV.B – For 8% Income Tax Rate (Those whose sales/receipts/others did not exceed P3M and opted at the initial quarter for this rate)

47 Sales/Revenues/Receipts/Fees

48 Less: Sales Returns, Allowances and Discounts

49 Net Sales/Revenues/Receipts/Fees (Item 47 Less Item 48)

Add: Other Non-Operating Income (specify below)

5
0

5
1

52 Total Other Non-operating Income (Sum of Items 50 and 51)

53 Total Taxable Income (Sum of Items 49 and 52)

54 Less: Allowable reduction from gross sales/receipts and other non-operating income of PURELY self-
employed individuals and/or professionals in the amount of P 250,000

55 Taxable Income/(Loss) (Item 53 Less Item 54)

56 TAX DUE (Item 55 x 8% Income Tax Rate) (To Part II - Item 20)

IV.C - Tax Credits/Payments (attach proof)

57 Prior Year’s Excess Credits

58 Tax Payments for the First Three (3) Quarters

59 Creditable Tax Withheld for the First Three (3) Quarters

60 Creditable Tax Withheld per BIR Form No. 2307 for the 4 th Quarter

61 Tax Paid in Return Previously Filed, if this is an Amended Return

62 Foreign Tax Credits, if applicable

63 Other Tax Credits/Payments (specify)

_______________________________________

64 Total Tax Credits/Payments (Sum of Items 57 to 63) (To Item 21)

 65 Net Tax Payable/(Overpayment) (Item 46 OR 56 Less Item 64) (To Part II - Item 22)
Part V – Background Information on Spouse

66 Spouse’s Taxpayer Identification Number (TIN) 67 RDO Code 68 Filer’s Spouse Type

- - - 00000 Single Proprietor Professional

69 Alphanumeric Tax Code (ATC) II012 Business Income - Graduated IT Rates II014 Income from Profession – Graduated IT Rates

II015 Business Income - 8% IT Rate II017 Income from Profession – 8% IT Rate

70 Spouse’s Name (Last Name, First Name, Middle Name)

71 Contact Number 72
Citizenship

73 Claiming Foreign Tax Credits? Yes No 74 Foreign Tax

Number (if applicable)

75 Tax Rate Graduated rates with OSD as Over P 8,000,000 P 2,202,500 + 35% of the excess over P 8,000,000
method of deduction
8% in lieu of Graduated Rates under Sec. 24(A) &
Percentage Tax under Sec. 116 of NIRC [available if
gross sales/receipts and other non-operating income do not
exceed Three million pesos (P3M)]
TABLE 1 – Tax Rates (effective January 1, 2018 to December 31, 2022)

If Taxable Income is:

Not over P 250,000

Over P 250,000 but not over P 400,000

Over P 400,000 but not over P 800,000 P 30,000 + 25% of the excess over P 400,000

Over P 800,000 but not over P 2,000,000 P 130,000 + 30% of the excess over P 800,000

Over P 2,000,000 but not over P 8,000,000 P 490,000 + 32% of the excess over P 2,000,000

Over P 8,000,000 P 2,410,000 + 35% of the excess over P 8,000,000

TABLE 2 – Tax Rates (effective January 1, 2023 and onwards)

If Taxable Income is:

Not over P 250,000

Over P 250,000 but not over P 400,000

Over P 400,000 but not over P 800,000 P 22,500 + 20% of the excess over P 400,000

Over P 800,000 but not over P 2,000,000 P 102,500 + 25% of the excess over P 800,000

Over P 2,000,000 but not over P 8,000,000 P 402,500 + 30% of the excess over P 2,000,000