Document Locator Number (DLN):
______________________
Batch Control Sheet (BCS) No./Item No.: ________________________
Republika ng Pilipinas
Kagawaran ng Pananalapi
BIR Form No.
AnnualForIncome
Tax Return
Individuals Earning Purely Compensation Income
Kawanihan ng Rentas Internas
1700
(Including Non-Business/Non-Profession Income)
All information must be written in CAPITAL LETTERS.
Fill in all blank spaces. Shade all applicable circles.
1 For the year
2 Amended
Return?
(YYYY)
Part 1
Yes
5 Taxpayer Identification Number (TIN)
3 Joint
Filing?
No
-
-
November 2011 (ENCS)
TO BE FILED IN THREE (3) COPIES: (1) BIR FILE COPY (2) BIR ENCODING COPY (3) TAXPAYER FILE COPY
4 Alphanumeric Tax
Yes
No
Other Income
Compensation Income
II 011
II 041
Code (ATC)
Background Information
Taxpayer/Filer
RDO Code
6
-
0
0
0
0
7 Taxpayer's Name
Last Name
First Name
Middle Name
8 Registered Address
(Unit/Room Number/Floor)
(Lot Number
Block Number
(Building Name)
Phase Number
House Number)
(Street Name)
(Subdivision/Village)
(Municipality/City)
10 Gender
Male
9 Date of Birth (MM/DD/YYYY)
(Barangay)
(Province)
11 Civil Status
Female
(Zip Code)
12 Contact Number
Single
Married
13 E-mail Address
Separated
Widow/er
15 If yes, number of Qualified
14 Claiming for Additional
Exemptions?
Yes
No
Dependent Children
Spouse
16 Spouse's Name
Last Name
17 Taxpayer Identification Number (TIN)
-
First Name
18 Date of Birth (MM/DD/YYYY)
-
Middle Name
19 Contact Number
-
20 E-mail Address
Exemptions?
Last Name
2
3
4
Yes
No
Dependent Children
Qualified Dependent Children
23
1
22 If yes, number of Qualified
21 Claiming for Additional
First Name
Middle Name
Date of Birth
(MM/DD/YYYY)
Mark if
Mentally/
Physically
Incapacitated
BIR Form No. 1700 - page 2
Computation of Tax
Part II
Taxpayer/Filer
24 Gross Compensation Income (from Schedule 1)
25 Less: Non-Taxable/Exempt Compensation
26 Gross Taxable Compensation