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DATE:

To: BIPO Service Philippines Inc.

Unit 1004 10th Floor The Mega Tower EDSA,

corner Doña Julia Vargas Ave,

Mandaluyong City 1555, Metro Manila

CERTIFICATION

This is to certify that I, Mr. / Ms. _ of legal age,


with postal address at and
presently working at BIPO Service Philippines Inc. as with TIN _
certify that I was not able to submit the required Certificate of Income Tax on Compensation (BIR Form
No. 2316) from my previous employer due to: Please check reason:

No previous employer for _


✓ Certificate of Income Tax Withheld on Compensation (BIR Form No. 2316) is not yet available
from my previous employer

I further certify that whatever taxes due from me as a result of my failure to submit the above
documents to BIPO Service Philippines Inc. will be borne by me and I will pay directly to the Bureau of
Internal Revenue (BIR) upon filing of my Income Tax Return (ITR) for the year 2023.

Signed

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