REPUBLICOFTHEPHILIPPINESDEPARTMENTOFFINANCE

BUREAUOFINTERNALREVENUE

FILING REFERENCE NO.

TIN : 104480617000

Name : ROLDANAGNESRELAMPAGOS

RDO : 104

FormType : 1701

ReferenceNo. : 221500010688836AmountPayable(OverRemittance)

: 22,748.00

AccountingType : CCalendar

ForTaxPeriod : 12/31/2014

DateFiled : 03/04/2015

TaxType : IT

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