Contractor Tax Withholding Certificate
Contractor Details
Name:
Address:
Tax Identification Number (TIN):
Contact Number:
Company Name:
Company Registration No.:
Email:
Client / Withholding Agent Details
Name:
Address:
Tax Identification Number (TIN):
Contact Number:
Company Name:
Company Registration No.:
Email:
Contract Details
| Contract/Agreement No. |
|
| Project / Work Description |
|
| Contract Value |
|
| Duration |
|
| Location |
|
Withholding Tax Details
| Withholding Tax Rate |
|
| Total Amount Withheld |
|
| Date of Payment |
|
| Certificate Number |
|
Declaration
I hereby certify that the above information is true and correct to the best of my knowledge.
Contractor / Authorized Representative
Date:
Withholding Agent / Authorized Representative
Date: