Application For Registration: Taxpayer Identification Number (TIN)
Application For Registration: Taxpayer Identification Number (TIN)
Application For Registration: Taxpayer Identification Number (TIN)
Mixed Income Earner – Compensation Income Earner & Trust – Foreign National
Single Proprietor
7 Taxpayer’s Name (If Individual) (Last Name) (First Name) (Middle Name) (Suffix) (Nickname)
MEER FRANCIS JAMES ENDAYA F.J.
(If ESTATE, ESTATE of First Name, Middle Name, Last Name, Suffix) (If TRUST, FAO: First Name, Middle Name, Last Name, Suffix)
8 Gender X Male Female 9 Civil Status X Single Married Widow/er Legally Separated
10 Date of Birth/Organization Date (In case of Estate/Trust) (MM/DD/YYYY)) 0 1 0 5 1 9 8 0 11 Place of Birth MANILA
12 Mother’s Maiden Name JOCELYN SALUDO ENDAYA 13 Father’s Name FELICISIMO DEGUZMAN MEER
14 Citizenship FILIPINO 15 Other Citizenship N/A
16 Local Residence Address
Unit/Room/Floor/Building# Building Name/Tower Lot/Block/Phase/House No. Street Name Subdivision/Village/Zone
25 Spouse Name (Last Name) C(First Name) C (Middle Name)C (Suffix) 26 CSpouse TIN
i i i i
v v v v - - - 00000
i i i i
27 Spouse Employer’s Name (Last Name, First
l
Name, Middle Name, if Individual)(Registered Name, if Non-Individual)
l l
28 lSpouse Employer’s TIN
- - - 00000
PART III – Authorized Representative
29 Relationship Name (For Authorized Representative)
If Individual (Last Name) (First Name) (Middle Name) Suffix
30 Relationship Start Date (MM/DD/YYYY) 31 Address Types Residence Place of Business Employer Address
Primary
Secondary
36 Incentives Details
36A Investment Promotion 36B Legal Basis 36C Incentive Granted
(e.g. PEZA, BOI) (e.g. RA, EO) (e.g. Exempt from IT,VAT,etc.)
37E Tax Regime (Regular, Special, 37F Activity Start Date 37G Activity End Date
37D Registered Activity Exempt) (MM/DD/YYYY) (MM/DD/YYYY)
38 Facility Details (PP-Place of Production/Plant; SP-Storage Place; WH-Warehouse; SR-Showroom; GG-Garage; BT-Bus Terminal; RP-Real Property for Lease with No Sales Activity)
38A Facility Code 38B Facility Type PP SP WH SR GG BT RP Other (specify)
(To be filled up by BIR) F
38C Facility Address
Unit/Room/Floor/Building# Building Name/Tower Lot/Block/Phase/House No. Street Name Subdivision/Village/Zone
Expanded Stocks
Overseas Dispatch And
Final Amusement Taxes
Petroleum Products
Tobacco Products
Part VII - For Employee with Two or More Employees (Multiple Employments) Within the Calendar Year
Successive employments (With previous Concurrent employments (With two or more employers at the same time
41 Type of Multiple Employments employer/s within the calendar year) with the calendar year)
(If successive, enter previous employer/s; if concurrent,Center secondary employer/s) C
i Previous and Concurrent Employments During the Calendar
i Year
41A Name of Employer v v 41B TIN of Employer
i i
l l - - -
41C Name of Employer 41D TIN of Employer
- - -
42 Declaration
I declare, under the penalties of perjury, that this application 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 the authority thereof. Further, I give my consent to the processing of my information as contemplated under the *Data Privacy Act of 2012 (R.A.
No. 10173) for legitimate and lawful purposes.
___________________________
Taxpayer/Authorized Representative
(Signature over Printed Name)
Part VIII – Primary/Current Employer Information
Branch
43 Type of Registered Office Head Office
Office 44 TIN - - - 45 RDO Code
C
46 Employer Name If Individual (Last Name) C (First Name) (Middle Name) (Suffix)
i i
v v
If Non-Individual i
(Registered Name)
i
l l
47 Employer Address
Unit/Room/Floor/Building# Building Name/Tower Lot/Block/Phase/House No. Street Name Subdivision/Village/Zone
48 Contact Details
Landline Number Fax Number Mobile Number Email Address (required)
_____________________________________________ ________________________
EMPLOYER/AUTHORIZED REPRESENTATIVE Title/Position of Signatory
(Signature over Printed Name)
Part IX – Payment Details
52 For the Year 53 Date of Payment (MM/DD/YYYY) 54 ATC MC180
55 Tax Type RF 56 Manner of Payment REGISTRATION FEE 57 Type of Payment FULL PAYMENT
58 Registration Fee 58A
1. Any identification issued by an authorized government body (e.g. Birth Certificate, passport, driver’s license, Community Tax Certificate) that
shows the name, address and birthdate of the applicant;
2. Photocopy of Mayor’s Business Permit; or Duly received Application for Mayor’s Business Permit, if the former is still in process with the LGU;
and/or Professional Tax Receipt/Occupational Tax Receipt issued by the LGU;
3. Proof of Payment of Registration Fee (RF) (if with existing TIN or applicable after TIN issuance);
4. BIR Form No. 1906; (Select an Accredited Printer)
5. Final & clear sample of Principal Receipts/ Invoices;
Additional documents, if applicable:
a. Special Power of Attorney (SPA) and ID of authorized person, in case of authorized representative who will transact with the Bureau;
b. Franchise Documents (e.g. Certificate of Public Convenience) (for Common Carrier);
c. Photocopy of the Trust Agreement (for Trusts);
d. Photocopy of the Death Certificate of the deceased (for Estate under judicial settlement);
e. Certificate of Authority, if Barangay Micro Business Enterprises (BMBE) registered entity;
f. Proof of Registration/Permit to Operate BOI/BOIARMM, PEZA, BCDA and SBMA
6. In case of registration of branches/facility types:
a. Photocopy of Mayor’s Business Permit; or Duly received Application for Mayor’s Business Permit, if the former is still in process with the
LGU; and/or Professional Tax Receipt/Occupational Tax Receipt issued by the LGU;
or DTI Certificate;
b. Special Power of Attorney (SPA) and ID of authorized person, in case of authorized representative who will transact with the Bureau; if
applicable
c. Proof of Payment of Registration Fee (RF)
d. BIR Form No. 1906; (Select an Accredited Printer)
e. Final & clear sample of Principal Receipts/ Invoices;
POSSESSION OF MORE THAN ONE TAXPAYER INDENTIFICATION NUMBER (TIN) IS CRIMINALLY PUNISHABLE PURSUANT TO THE
PROVISIONS OF THE NATIONAL INTERNAL REVENUE CODE OF 1997, AS AMENDED