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Travel Tax DepartmentPRIVILEGE ADMINISTRATION DIVISION |
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| TIEZA Online Form 353 | Revised 2020 | ||||||||
APPLICATION FOR ONLINE TRAVEL TAX REFUND |
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AR Number |
ONREF-2020-0001 |
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| NAME OF PASSENGER | {{ $ta->ffull_name }} | ||||||||
| AIRLINE TICKET NUMBER/S | DATE ISSUED | ||||||||
| SALES REPORT NO. | |||||||||
| AMOUNT OF TRAVEL TAX | {{ $ta->travel_tax_amount }} | AMOUNT OF REFUND | {{ $ta->refund_amount }} | ||||||
| TIEZA OFFICIAL RECEIPT NO. | {{ $ta->tieza_official_receipt_no }} | DATE OF PAYMENT | {{ date('m/d/Y', strtotime($ta->payment_date)) }} | ||||||
| REASON FOR REFUND | |||||||||
| reason_refund == '1' ? 'checked' : '' }}> EXEMPTION | reason_refund == '2' ? 'checked' : '' }}> REDUCED RATE | reason_refund == '3' ? 'checked' : '' }}> NON-COVERAGE | |||||||
| reason_refund == '4' ? 'checked' : '' }}> UNUSED TICKET | reason_refund == '5' ? 'checked' : '' }}> DOUBLE PAYMENT | reason_refund == '6' ? 'checked' : '' }}> OTHERS {{ $ta->reason_refund == '6' ? ": ".$ta->reason_refund_others : '' }} | |||||||
| NOTES: > Applications for travel tax refunds should be filed within two (2) years from the date of payment. > The travel tax paid to the airline is due for remittance to TIEZA on ___________________. |
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| This is to certify that the above-mentioned information are true and correct and that the travel tax collected on the above-mentioned ticket has not been previously refunded. | |||||||||
| SUBMITTED BY: ___________________________________ ___________________________________ (Name and signature of passenger) Address: _____________________________________ _____________________________________________ Contact No: __________________________________ Email Address : _______________________________ |
CERTIFIED BY: ___________________________________ (Name and signature of airline representative) ___________________________________ (Position) Carrier _____________________________ Date _________________________ NOTE: FOR UNUSED TICKET ONLY |
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| PROCESSING OF ONLINE REFUND APPLICATION | |||||||||
| PROCESS | DATE | POINT PERSON | REMARKS | ||||||
| Receipt/Evaluation of Application | |||||||||
| Review/Recommendation for Payment | |||||||||
| Print/ Collate of Documents | |||||||||
| Verification of Travel Tax Collection | |||||||||
| Preparation of Disbursement Voucher | |||||||||
| Certification for Payment | |||||||||
| Transmittal of Voucher to Accounting Division | |||||||||