(To be filled up by the BIR) DLN: PSIC: Republika ng Pilipinas EXCISE TAX BIR Form No. Kagawaran ng Pananalapi Kawanihan ng Rentas Internas RETURN for MINERAL PRODUCTS 2200-M September 2005 (ENCS) Fill in all applicable spaces. Mark all appropriate boxes with an "X". 1 Date 2 Amended 3 Quarterly 4 No. of sheets (MM/ DD/ YYYY) Return Yes No Return Yes No attached PART I BACKGROUND INFORMATION 5 TIN 6 RDO Code 7 Line of Business 8 Taxpayer's Name (Last Name, First Name, Middle Name for Individuals) / (Registered Name for Non-Individual) 9 Telephone Number 10 Registered Address (Please indicate complete address) 11 Zip Code 12 Place of 13 Place of Production Extraction 14 Are you availing of tax relief under 15 If yes, please Special Law or International Tax Treaty? Yes No specify PART II MANNER OF PAYMENT 16 Payment on Actual Removal Prepayment/Advance deposit/ Other similar schemes (please specify) PART III PAYMENTS AND APPLICATION Amount 17 Excise Tax Due 17 18 Less: Balance Carried Over from Previous Return 18A Creditable Excise Tax, if applicable 18B 18C 19 Net Tax Due/(Overpayment) 19 20 Less: Payment on Returns Previously Filed for the Same Period, if amended return 20 21 Tax Still Due/(Overpayment) 21 22 Add: Penalties Surcharge Interest Compromise 22A 22B 22C 22D 23 Amount Payable 23 24 Less: Payment Made Today Tax Payment/Deposit 24A Penalties (from 22D) 24B 24C 25 Balance to be Carried Over to Next Return 25 PART IV 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 knowledge and belief, is true and correct, pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof. 26 27 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 Part V DETAILS OF PAYMENT Stamp of Drawee Bank/ Date Receiving Office/AAB Particulars Agency Number MM DD YYYY Amount and 28 Cash/Bank 28A 28B 28C 28D Date of Receipt Debit Memo (RO's Signature/ 29 Check 29A 29B 29C 29D Bank Teller's Initial) 30 Tax Debit 30A 30B 30C Memo 31 Others 31A 31B 31C 31D Machine Validation/Revenue Official Receipt Details (If not filed with an Authorized Agent Bank) SCHEDULE I SUMMARY OF REMOVALS AND EXCISE TAX DUE ON MINERAL PRODUCTS CHARGEABLE AGAINST PAYMENTS Volume of Provisional Final Tax Due Total Place of Mineral Removed Market Value Actual/Fair2200-M page2 Tax Tax Actual/Fair Market Value Tax Tax Adjustment Tax ATC Description Due Removal Taxable Exempt Taxable Exempt Rate Due Taxable Exempt Rate per Final Value Due (A) (B) (C ) (D) (E) (F) (G) (H) (I) (J) (K) (L) = (F+J+K) XM010 Coal and Coke P10/MT P10/MT Non-metallic minerals XM020 2% 2% and quarry resources Copper and Other XM030 2% 2% Metallic Minerals XM040 Gold and Chromite 2% 2% XM050 Indigenous Petroleum 3% 3% Natural Gas or Liquefied XM051 Natural Gas (locally extracted) 0% 0% XM060 Other metallic minerals (please specify) Total Tax Due Guidelines and Instructions Who Shall File Penalties This return shall be filed in triplicate by the following: 1. A surcharge of twenty five percent (25%) for each of the following violations: 1. Owner, lessee, concessionaire or operator of the mining claim; a) Failure to file any return and pay the tax due thereon on the date prescribed; 2. First buyer, purchaser or transferee for local sale, barter, transfer or exchange of indigenous petroleum, b) Unless otherwise authorized by the Commissioner, filing a return with a person or office other than those with whom it is required to be natural gas or liquefied natural gas; and filed; 3. Owner or person having possession of the minerals and mineral products which were mined, extracted or c) Failure to pay full or part of the amount of tax shown on the return, or the full amount of tax due for which no return is required to be quarried without the payment of excise tax filed on or before the due date; For imported minerals and mineral products, the excise tax shall be paid by the importer or owner to the Bureau of d) Failure to pay the deficiency tax within the time prescribed for its payment in the Notice of Assessment. Customs before removal of such imported articles from the customshouse. 2. A surcharge of fifty percent (50%) of the tax or of the deficiency tax, in case any payment has been made on the basis of such return before the discovery of the falsity or fraud, for each of the following violations: Time and Manner of Filing and Payment a) Willful neglect to file the return within the period prescribed by the code or by rules and regulations; or For each place of production, a separate return shall be filed and the excise tax shall be paid upon removal of the mineral b) In case a false or fraudulent return is willfully made. products from the place of production with any Authorized Agent Bank (AAB) located within the territorial jurisdiction of the 3. An interest of twenty percent (20%) per annum on any unpaid amount of tax, from the date prescribed for the payment until it is fully paid. Revenue District Office where the taxpayer is required to register. In places where there are no AABs, the return shall be filed 4. Compromise penalty. and the tax due shall be paid with the Revenue Collection Officer or Duly Authorized City or Municipal Treasurer of the Attachment Required: municipality or city falling under the jurisdiction of the aforesaid Revenue District Office. In the case of locally produced or § All returns filed by an authorized representative must attach authorization letter. extracted minerals or quarry resources where the mine site or place of extraction is not the same as the place of processing or production, the return shall be filed with and the excise tax paid to the Revenue District Office having jurisdiction over the Note: locality where the same are mined, extracted or quarried. § This return shall be used in the following instances: On locally produced or extracted metallic mineral or mineral products, the person liable shall file a return and pay the tax 1. For payment of excise tax due on the actual volume of mineral products to be removed from the place where the same are mined, extracted or within fifteen (15) days after the end of the calendar quarter when such products were removed, subject to the filing of a bond in quarried, including the quarterly payment of excise tax due thereon; an amount which approximates the amount of excise tax due on the removals for the said quarter. 2. For prepayments, advance deposits or other similar schemes in payment of excise tax on locally mined, extracted or quarried minerals. The Identified large excise taxpayers duly informed in writing as such by the Commissioner of Internal Revenue, or his duly balance of advance payment or deposit of excise tax shall, in no case, be utilized in payment of penalties. In the event that the balance is authorized representative, shall file the excise tax return and pay the corresponding excise tax due with the Authorized Agent insufficient to cover the excise tax due, penalties shall be computed and imposed on the difference. These shall be computed from the date of Bank located in the BIR National Office, Diliman, Quezon City. removal when the insufficiency shall have been incurred. § All returns filed by an accredited tax agent on behalf of a taxpayer shall bear the following information: How to Fill-up Schedule I 1. For CPAs and others (individual practitioners and members of GPPs); In cases where the mineral products are subject to assay, Schedule 1 shall be accomplished as follows: 1.1 Taxpayer Identification Number (TIN); and 1. If the final values of all removals of minerals during the return period have been determined during the same 1.2 Certificate of Accreditation Number, Date of Issuance, and Date of Expiry. return period, fill up Columns A, B (if applicable), G, H (if applicable), J, and L. 2. For members of the Philippine Bar (individual practitioners, members of GPPs); 2. If the final values of all removals of minerals are not yet determinable during the return period, fill up 2.1 Taxpayer Identification Number (TIN); and Columns A, B (if applicable), C, D (if applicable), F and L. 2.2 Attorney’s Roll number or Accreditation Number, if any. 3. If only the adjustment to the tax due based on the difference between the provisional and final values on ENCS removals from previous return period(s) are to be declared during the return period, fill up Columns K and L. 2200-M 4. If the total tax due consists of taxes due on provisional, final and adjusted values, fill up all applicable columns. However, in cases where the mineral products are not subject to assay, fill up Columns G, H (if applicable), J and L.