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NOTE: This form shall be used in RDOs with eTIS-1 ony) BIR Form No 1901 November 2074 (ENCS) (Tobe filed vo by BIR) DLN: Republic ofthe Philipines Department of Faunce ‘Bureau of Internal Revenue Application for Registration “TN to; issued, applicable (To be med up by BR) 5 Tespayerss Name (f inividval) (ast Name), (ESTATE, STATE oie Nar Mee ae Las Nea). TRUST, FAO Fist None, me Nara, Last ene) Tis Clee }eenals || poo | + rain a Ciizenshio \ Tei caon Data epson eowner asd, per D- Type ‘Number 7 7 L J 14 Preferred Contact Tyne a e ¥ Phone Number] Mobile Number ‘Fax Number _|_] Email Address (requice@)_ s eel = J a +t 75 (pal Resigancs Adaress— = TT { = T } ___Lemanavenssetro veel incon Fong Su Steet __ Bato yotone_ E Pownce i f ae : e ra 7 = piri ae i NaS a x Bim | 17 Forigh Rares aa 78 Mumnapalty Code ] (To bed op by 2) 30 TawayerTy Sea Pontes ony eet Oke) (Cl Resitent Alien -Single Proprietor Ei) resident ten -Professional [E marpinal income Earner esac Som Setemen Profressional-- Licensed (PRC. IBP) spe Earner & Professional Earner, Single Proprietor & [E]miaed income Earner- Compensation [limes income eamer- Compensation Professional [Onion Resident Aion Engsoed i — Professional - in Generat Estate -Filpin Citizen, Estate - Foreign Nationals [Ele rotessional and Single Proprietor Trust Fligino Gitzen | Tus Foreign Nationals "i FrimanySecondery lndusition Ateo-clina. Industiy: ‘Trade/Business Name Rega Laerioil Date as oa oor | "Soe" | acorn Seateaten mar secancay wo ose i pan eecmaen ‘228 Facisty Type (_] PP {_] sp (_]WH [_] se (Cer _] re bc Fecy Adress = Clots coon : [ ees - ii ATES $ _MonicpayOnyOiset_ i er a tote ieenives Daal as enen Poneto Amann. 01_ a oz oon og ett 5 | 2 cent En [ I 2a Detais of RegevatonAccreatation Page 2 aaRegstatensesesiain Number 24B fey Oa 240 | ia stared Activity: =e (246 Tax! 725 Tax Types (this partion determines your tax Wabiltyhes) (To be filed up by BIR) fomipn ATC fomiye ATC Resatration Fee Value-Added Tax Witinolaing Tax Porconteatiigs ; Comancsaton Stocks { | Ey eens cr veep 8A i Final Under Special Laws i ] | [J Fringe Genet the: Percentage Tax under NIRG (peo VAT & Otter Parentage Taxes ONETT not subject to CCT “I Documentary Stamp Tax | Percentage Taxon Winnings & Pies Reguar ; On Interest Paid on Deposits & Yield . ‘One-Time Transactons | y ‘on Deposits Substitutes/TrussEc. Capital Geine - Real Pre income Tox Donors Tax Excise Tax. estate Tax [J NeonotPreduets Tobacco Inspection Foes ufone & Non-Essenal Good iscotaneous Tax pe | Mineral Products S 4 Peuleum Products | uners coe I Tobacco Produls rt 76 Regitaton of Boots of Reson 5 Ga Sen aeosneseeed | Owe [pee Pe | Pema | rs a) Tos | ‘flndividual (Last Name: i 1 ice ame) (Sut) a ee z E i . [28 Relationship Type Co Adteninistator Date namnvery | 2 Address (Cl twstec C] taxAgent L) employer [) Agent 30 Retaonship St BH Ages Type _| Residence i pace of Bu Cltmieyer access snes 3H Preferred Contact TWP Phone Number [1 Mobile Number 34 CNISIBtUS [J Husban ‘36 Cras for Aditional Exempion/Preniur | Wie claims additional exemption and premium deduction 36 claims additional exemption and premium deduction (aie abe Hasan rtd: pled cava eyagedn Busnes re Of OS) ‘37 Spouse Name (LastName) fest Name) {nscale Nee) —_ [ Td = es Hata aN eM, dl spre ane Nowa. zt - z a 5 a aie erage artes Tre Deg ot and not ga yof ape, is incapable of LastName. ‘Fret Name Middle Name sutic| Reteorrey i haa : Oo tI 1 oz ine QO lic) I O hi —— oO [paren a he * [SS amc, loners no nti one i Declaration T eclre, under he panaltes of peru th \strue and core, pursuant fo the rowaions 0 at tis applcaton nas been made in 900d ft, verifd by me ac othe bet ot my knowedge anc ate a hs Sra asl Revere Gade, os amended, and te equations issued undor autor thereof ——TarpayerTRathonized Representaive anne tnt incet tes 1 jess tfes |_| Branch fe = ' | Enpayes Name indie Re = J Ts a Raa aS eT EE 4 | Eis ia will | | en ee L 3 Decaraton Aaralin san yonstes of pray bal is apcaton hasbeen made gona verb be aioe es toons Cae tae a cores pusuart fe powers he Naso haral Ravens Code, ak amend ane uso ve nde utr eee ay op YB = Gianpo B Receving Ofce tnd Dae of Rocoet ee ee ae se ee ENPTOVERIAUTHORIZED REPRESENTATIVE THerPostion of Signatory (Sanature over Prine Name) Documentay Requrements A" Photocopy of Mayor's Business Perm (or duly received Apprcation | for Mayor's Business Per rt Maye vt LU, ara NBG Cer Btn Corie of Me appa atten asin oto Je O71 Certiicate of Registration of Business Name, it 8 busin FF cecttr aor tony hoo Bares Grereens (BE epee ety [Es Proot of Reaistraton/Perms to Operate with Board of investment (BO!)/Board of Investment for Autonomous Region for Musiry Mindanao (BOVARMM), Philippine ae ey Pe non sen nee DN "Sane Sy coatan Rar (SBN, (Eo Wawer of nusband on ris right to claim adcttonal exemptions, I wife wal claim, [de rage con. nna [Enso cents ttn Cotte of cece deperers ET Novresden i acoton ote above spins ecuraers, Wenig Fem Coenen naconrercnene-masonr ote toon spsoe reverse Farce Awana coer ene enon tote euremeis enor ne'er, apnea es owen Coen teen canonberesuenens wamanes ne © npn ft Dae Conta tase ‘nd ude! settee ic ha cave of regisraton of branchesfacity pes CpeeSsrar seer of Repsvaton (COR) othe Heas Ofce forty yes be used ye Head fos sr {Je ayers tuanese Peni day eaves Azpcabonr Majrs Business Pet te forme i npocne wh MeL [Ei br content o Repitraion of Business Name, 9 waness tradename sal be used, apres and 5s convactor Lease, aopteabie POSSESSION OF MORE THAN ONE TAXPAYER IDENTIFICATION NUMBER (TIN) i CRIMINALLY PUNISHABLE PURSUANT TO THE AOUISIONS OF THE NATIONAL INTERNAL REVENUE CODE OF 1987, AS AMENDED. vi fe former i iin process wih he LGU) 4 trade name shal be used (COR ofthe branch for facity types tobe