BIR FORM 1921... & Oe al ANALAPI waa REVENUE REGION NO. 098 ~ (LAGUNA-QUEZON-MARINDUQUE) REVENUE DISTRICT OFFIC "ABLO CITY, EAST LAGUNA OCN: 055AU20210000001218 Date of ATP: November 3, 2021 Expiry Date: November 2, 2026 TIN & BRANCH CODE NAME 911-342-431-00000 |_DIZON, LARRY ROBLES BUSINESS/TRADE NAME LARRY AND LANY'S MEAT STALL REGISTERED ADDRESS PUBLIC MARKET BINAN 4008 PAGSANJAN LAGUNA PHILIPPINES TIN AND BRANCH CODE NAME 006-998-673-00000 PRINCESS SOFIA PRINTING PRESS CO. REGISTERED ADDRESS | PUROK 18 SAN PABLO CITY 4000 SAN PABLO CITY LAGUNA PHILIPPINES. [ACCREDITATION NO ‘ACCREDITATION ISSUE DATE(MM/DDIYYYY) (055MP20210000000019 10/22/2021 rs ‘A. PRINCIPAL RECEIPTSINVOICES | SERIAL NUMBERS no.oF | NoorseTs DESCRIPTION TPE | MANNER | BOXES: Pen. | NO.OF COPIES BOOKLETS | BON/BOOKLET a ‘SALES INVOICE- 5 ON wonvar | souno | 20 » 2 cao 1000 REMINDERS: 4. BIR accredited printer shall have the printer's certificate of delivery (PCD) of receipts/invoices stamped "Registered" by the concerned RDOILT office of the taxpayer before delivery of the printed receipts/invoices to the taxpayer — user. The certified photocopy of the ATP and the Taxpayer — user's ‘sworn statement shall likewise be Filed/Distributed together with the PCD to the concerned RDO/LT office within Thirty (30) days from date of PCD. 2. A Taxpayer with expiring Principal and Supplementary receipts/invoices shall apply for new ATP not later than Sixty (60) Days prior to the actual expiry date. B. LUCES ISTRICT OFFICER ROSEMART ASST. REVENUE DANILO G. LINO REVENUE DISTRICT OFFICER (Signature over Printed Name) Page 1 of 1