Application For Registration: Republic of The Philippines Department of Finance Bureau of Internal Revenue

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(To be filled up by BIR) DLN: __________________________

Republic of the Philippines Application for Registration BIR Form No.

Department of Finance
Bureau of Internal Revenue 1903
January 2018(ENCS)

For Corporations, Partnerships (Taxable / Non-Taxable), - - -


Including GAIs, LGUs, Cooperatives and Associations TIN to be issued, if applicable (To be filled in by BIR)
Fill in all applicable white spaces. Mark all appropriate boxes with an “X”.

Part I – Taxpayer Information


1 Registering Office Head Office Branch Office Facility 2 BIR Registration Date
(To be filled up by BIR)(MM/DD/YYYY)
3 Taxpayer Identification Number (TIN) 4 RDO Code
(For Taxpayer with existing TIN) - - - 0 0 0 0 0 (To be filled up by BIR
5 Taxpayer Type
Corporation Regional Operating Headquarter
General Professional Partnership Regional or Area Headquarter
General Partnership Joint Venture
Limited Partnership Cooperative
National Government Agency Resident Foreign Corporation
Local Government Unit Non-Resident Foreign Partnership
Government Owned and Controlled Corporation Non-Resident Foreign Corporation
Non-Stock, Non-Profit Organization Foreign Embassy and International Organization
6 Registered Name (Copy exact name appearing in SEC Certificate of Registration / Charter / Cooperative Development Authority / HLURB)

7 Date of Incorporation/Organization/Cooperation 8 Taxable Year/Accounting Period Accounting Start Year


(MM/DD/YYYY) (MM/DD/YYYY)
Calendar Year Fiscal Year
9 Business Address
Unit/Room/Floor/Building# Building Name/Tower Lot/Block/Phase/House No. Street Name Subdivision/Village/Zone

Barangay Town/District Municipality/City Province ZIP Code

10 Foreign Address
11 Municipality Code 12 Purpose of TIN Application
(To be filled up by BIR)
13 Preferred Contact Type
Landline Number Fax Number Mobile Number Email Address (required)

Part II – Authorized Representative


14 Relationship Name (For Authorized Representative)
If Individual (Last Name) (First Name) (Middle Name) Suffix

If Non-Individual (Registered Name)

15 Relationship Type 16 TIN of Authorized Representative


Stockholder Member Tax Agent Employee Agent - - -
17 Relationship Start Date
(MM/DD/YYYY)
18 Address Type Residence Place of Business
19 Local Residence Address
Unit/Room/Floor/Building# Building Name/Tower Lot/Block/Phase/House No. Street Name Subdivision/Village/Zone

Barangay Town/District Municipality/City Province ZIP Code

20 Preferred Contact Type


Landline Number Fax Number Mobile Number Email Address (required)

Part III – Business Information


21 Single Business Number
22 Primary/Secondary Industries (Attach additional sheet/s, if necessary)
Industry Trade/Business Name Regulatory Body
Primary

Secondary

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