"Annex B-3"

NAME OF TAXPAYER: Estate of TIN:

DATE OF DEATH:

NAME OF EXEC./ADMIN./HEIR: TIN:

ADDRESS: DUE DATE (ET):

PER REVIEW

PARTICULARS

REAL PROPERTIES (Schedule 1) P P P P

PERSONAL PROPERTIES (Sum of Sched. 2 & 3)

TAXABLE TRANSFERS (Schedule 4)

GROSS ESTATE P P P

LESS: DEDUCTIONS

FUNERAL EXPENSES P P

JUDICIAL EXPENSES

CLAIMS AGAINST THE ESTATE

CLAIMS AGAINST INSOLVENT PERSON

UNPAID MORTGAGES

TRANSFERS FOR PUBLIC USE

PROPERTY PREVIOUSLY TAXED (vanishing deduction)

OTHERS

TOTAL P P

FAMILY HOME

STANDARD DEDUCTION

MEDICAL EXPENSES

OTHERS

TOTAL DEDUCTIONS P P

NET ESTATE P P

Less: Share of Surviving Spouse - (Schedule A)

NET TAXABLE ESTATE P P

ESTATE TAX DUE P P

LESS: Tax Paid per Return, if a return was filed ----------------------------------------------------------------

TAX PAYABLE--------------------------------------------------------------------------------------------------------------

P P

Add: 25% SurchargeP

Interest ( to )

Compromise Penalty P P

TOTAL AMOUNT PAYABLE ------------------------------------------------------------------------------------------------ P P

SCHEDULE A - COMPUTATION OF SHARE OF SURVIVING SPOUSE

Gross Conjugal Estate P P

Less: Total Conjugal Deductions

Net Conjugal Estate

Share of Surviving Spouse (Net Conjugal Estate / 2) P P

Remarks:

To be accomplished by ONETT Team. Payment Verified by: To be accomplished upon review.

Computed by: Reviewed by: ONETT Officer ONETT Member/ Collection Section Chief, Assessment Div.

(Signature Over Printed Name) (Signature Over Printed Name)

Approved by: Approved by: Head, ONETT Team Regional Director

(Signature Over Printed Name) (Signature Over Printed Name)

The BIR is not precluded from assessing and collecting any deficiency internal revenue tax(es) that maybe found from the taxpayer after examination or review.

CONFORME:

Instruction: Prepare in duplicate and ascertain that ONETT Computation Sheet is signed by Head ONETT Team before release to taxpayer. Please attach additional sheet, if necessary.

DateTelephone No.

TOTALCONJUGAL

RESIDENCE OF DECEDENT: (at the time of Death)

C O M P U T A T I O N D E T A I L S

Revenue Region No. ______ , Revenue District Office No. ______ - _______________________________

TAXPAYER/AUTHORIZED REPRESENTATIVE

TOTAL

(Signature Over Printed Name)

ONETT COMPUTATION SHEETONETT COMPUTATION SHEETESTATE TAX

PER AUDIT

EXCLUSIVE

OR No. Tax Type Date of Payment

Reference:

DETAILS OF PROPERTY:SCHEDULE 1 - REAL PROPERTIES

TOTAL P PPERSONAL PROPERTIESSCHEDULE 2 - SHARES OF STOCKS

TOTAL P P

SCHEDULE 3 - OTHER PERSONAL PROPERTIES

TOTAL P P

SCHEDULE 4 - TAXABLE TRANSFERS

TOTAL P P

Particulars

ParticularsFair Market Value

Exclusive Conjugal / Communal

Exclusive Conjugal / Communal

CONJUGAL

Tax Declaration No. (TD) LOCATION CLASS.

OCT/TCT CCT No. EXCLUSIVE

FMV whichever is higher

(FMV) per TD

Fair Market ValueZonal Value (ZV)AREA

FMV per BIR

Name of Corp.

Fair Market Value

CONJUGAL EXCLUSIVEStock Cert. No.

Fair Market Value

No. of Shares

FMV whichever is higher