be filled out by DLN

BIR Form No.

Republic of the Philippines Appl ication for Reg istration 901
@ Department of Finance
Bureau of lnternal Revenue

For Self-Employed (Single Proprietor/Professional),

Mixed lncome lndividuals, Non-Resident Alien
1
July 2021(ENCS)P'l

tn Estate and Trust to

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L 3 0 0 0 0 0

LSwl

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- Re
40 BIR
40A Do y0u intend USE BIR Printed Receipts and lnvoices? 408 Type 40C No. of Booklets 40D Serial Number
Start End

1
tr Yes
to Print Recei
tr No
and lnvoices
E vAT I uoru-ver tttl
41A Printer's Name
1B 41C 41D of
l-
II I

F Contact Number

41H Type of Receipt/lnvoice fl eound t]. Loose

411 of and lnvoices additional sheet/s,
of No,
TYPE Serial No. No. of Copies
Description per 8ox/
per Set
VAT N0n-vAl Loose Bound Booklet Start End

or overs Calendar Year

Type of tululti
enter
n
42A Name of Employer Primary Employer 42B TIN of Employer

I I ttlt
42C Name of Employer Primary Employer 42D TIN of Employer

PrimarylCurrent lnformation
Start
Date Landline Number Fax Number

45 Declaration ReceMng and Date of Receipt

I declare, under the penalties of perjury, that this application has been made in good faith, verilled by me and to the best of my knowledge and
belief, is true and correct, pursuant to the provisions of the National lnternal Revenue Code, as amended, and the regulations issued under the authority
thereof. Further, I give my consent to tire processing of my information as contemplated under the 'Data Privacy Act of 2012 (R.A. No. 10173) for
legitimate and lawful purposes.

?tNN{t C. pAlD
@e ovet Pinled

BIR Form No. T, 47 Code ear

0605 N

@artof BIR Forn No.1901)

be
50 Date of Payment (\i\M/DDNYYY)
eROR/ROR No. ATC articulars
51 MC180 Registration Fee 5tA
52 MC200
53 Add: Penalties Surcharqe lnterest Compromise
53A 538 I sec 53D
54 Total Amount Pavable {Sum of ltems 56A. 57A and 58D) 54A
Documentary Requirements:

0t. For Sole Proprietor/Professionals not regulated by the Professional Regulaiion

BRANCH AND FACILITY
REGISTRATION OF BRANCH
Commission (PRC):
. Any govemmenrissued lD (e.9., Birth Certificate, passport, driver's license,
D t. ngtn Printed Receipulnvoice (Avallable for sale at the New Business Registrant
Counter); or
Community Tax Certificate, PhillD) that shows the name, address and birthdate of
t1Final and clear sample of OWN Principal Receipts/lnvoices. (1 original)
the applicant. ln case the lD has no address, any proof of residence or business
(Sample layout is also available at the New Business Regishant Counter)
address; (1 photompy) or
ln case of the practice of profession regulated by PRC: Nofer /n case taxpayerapplicant will opt to pint its own re@ipts/invoices, taxpayer-
. Valid PRC lD and govemment lD showing address or proof of residence or applicant should choose an Accredited Pinter who will pintthe receipts/invoices.
business address. (1 photompy)
O 2. Payment of P530.00, if applicable, for the following:
Note: /Ds shall be presented and should be readable, untampered and contains . P500.00 Annual Registration Fee (RF);
consistent informatian with the documents submitted upon application. . P30.00 Loose Stamp/s (DST) to be affixed on the Certificate of
Az. trBlR Printed ReceipUlnvoice (Available for sale at he New Business Registrant Registration.
Note: lf the Registration Fee of P5N.00 was already paiC, the proof of
Counted; or
paynent (1 photocopy) shall be submifred.
nFinal and dear sample of OWN Principal Receiptsllnvoices. (1 original)
(Sample layout is also available at the New Business Regishant Counter)
REGISTRATION OF FACILITY
Note: case taxpayer-applicant will opt to print its awn receipts/invoices, taxpayer-
ln f'l t . BIR Form No. 1901. (2 originals)
applicant should choose an Accredtted Printer wha wiil pint the receiptsfinvoices.
ADDITIONAL DOCUMENTS FOR BRANCH/FACILITY. IF APPLICABLE:
Os. Payment of P530.00. if applicable, for lhe following:
. P500.00 Annual Registration Fee (RF); CJt lf transacting through a RepresenEtive:
. P30.00 Loose Stamp/s (DST) to be affixed on the Certrficate of 1.1 Special Power of Attomey (SPA); (1 original)
Registration. 1-2 Any govemment-issued lD of the taxpayer and authorized
Note: lf the Registration Fee of P500.A0 was aheady paid, the proof of representative; ('1 photocopy)
payment (1 photocopy) shall be submifted. Oz. DTI Certiflcate (ifwrth business name); (1 photocopy) (for Branch only)
Os. Franchise Documents (e.9., Certificate of Public Convenience) (for Common
Additional documents. if aoolicable: Carrier); (1 photocopy) ({or Branch only)
Oa. Franchise Agreement (1 photocopy) (for Branch only)
0t lf transacting through a Representative:
1.1 Special Power of Attomey (SPA); (l original)
Os. Memorandum of Agreement (for JOINT VENTURE); (1 photompy) (for
Branch only)
1.2 Any govemment-issued lD of the taxpayer and authorized representative; (1 Oo. Certificate of Authority, if Barangay Micro Business Enterprises (BMBE)
photocopy) registered entity; (1 photocopy) (for Branch only)
o 2. DTI Certificate (if with business name); (1 photocopy) At. Proof of Registration/Permit to Operate B0liBOl-ARt\,'lM, PEZA, BCDA,
o 3. Work Visa (99) for Foreign Nationals; (1 photocopy) TIEZAIIEZA, SBMA, etc. (1 photocopy) (for Branch only)
o 4. Franchise Doorments (e.9., Certificate of Public Convenience) (for Common
CarrleQ; (1 photocopy)
Cs. Trust Agreement (for Trusts); (1 photompy)
00. Death Certificate of the deceased (for Estate under ludicial settlement); (1
photocopy)
Oz. Certificate of Authority, if Barangay Micro Business Enterprises (BMBE)
registered entity; (1 photocopy)
Ca. Proof of Registration/Permit to Operate BOI/B0I-ARMM, PEZA, BCDA,
TIEZA/TEZA, SBfi/A, etc. (1 photocopy)

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

Vol ry and Date of Receipt

I declare, under the penalties of periury that this document has been made in good faith, verified by me and lo the best of my knowledge
and belief, is true and correct, pursuant to lhe provisions ofthe National lntemal Revenue Code, as amended, and the regulations issued under
the authority thereof.

Signature over Printed Name of Taxpayer/Authorized Representative Title/Position of Signatory