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Sworn Application For Tax Clearance: Annex C

This document is a sworn application for a tax clearance from the Bureau of Internal Revenue of the Philippines. It contains information about the applicant such as their name, address, tax identification number, and business details. The applicant must provide documentary requirements like a tax compliance verification sheet, documentary stamp taxes, proof of payment for certification fees, and identification documents. By signing, the applicant asserts they have satisfied the criteria for issuance of a tax clearance, which is required for government contracting.

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Jose Edmundo Dayot
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2K views1 page

Sworn Application For Tax Clearance: Annex C

This document is a sworn application for a tax clearance from the Bureau of Internal Revenue of the Philippines. It contains information about the applicant such as their name, address, tax identification number, and business details. The applicant must provide documentary requirements like a tax compliance verification sheet, documentary stamp taxes, proof of payment for certification fees, and identification documents. By signing, the applicant asserts they have satisfied the criteria for issuance of a tax clearance, which is required for government contracting.

Uploaded by

Jose Edmundo Dayot
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines April 2018 Version

Department of Finance
BUREAU OF INTERNAL REVENUE
Quezon City ANNEX C

SWORN APPLICATION FOR TAX CLEARANCE


(To be accomplished by Individual Taxpayer Securing Tax Clearance for Bidding Purposes)

I, _________________________________________________, Filipino/_____________(indicate nationality


for non-Filipino citizenship), of legal age, single/married to_____________________________________, permanently
residing at _____________________________________________________________ with Taxpayer Identification
Number (TIN) __________________________________, after having been duly sworn in accordance with law hereby
depose and state:

1. That I am the Owner/Proprietor/Proprietress of _____________________________________________________


with business address at _________________________________________________________________________,
with Telephone/Cellular Phone No. ______________________ and email address ___________________________;

2. That my business trade name has been duly registered with the Department of Trade and Industry on
_____________________________ under DTI Registration Certificate No. _________________________________;

3. That I registered my business with BIR under Certificate of Registration No. ______________________ issued at
Revenue District Office/LTDO No. _____________ on _________________________________________________;

4. That, I am securing/applying for TAX CLEARANCE (for Bidding Purposes), a pre-requisite for entering into any
contract with the Government Agencies as required under Executive Order No. 398, and implemented by RR No. 3-
2005, as amended;

5. That, the following documentary requirements in relation to the aforesaid application are all authentic and hereto
attached in compliance with the existing policies.

_____ a. Tax Compliance Verification Sheet issued by ______________________on ________;


_____ b. Two (2) pieces of loose documentary stamp tax worth P30.00 each;
_____ c. Confirmation Receipt of Electronic payment of certification fee worth Php 100.00 or other proof of payment;
_____ d. Valid and properly accomplished authorization letter with photocopies of any government issued I.D. showing
the picture and signature of the applicant and the authorized representative; and
_____ e. Original unexpired Tax Clearance Certificate for Bidding Purposes (if applicable).

6. And that, to the best of my knowledge and belief, I have satisfied the prescribed criteria for the issuance of Tax Clearance.

__________________________________________
Signature over Printed Name of Applicant

SUBSCRIBED AND SWORN to before me this __________ day of ____________________________, ___ in


_______________________________. Applicant exhibited to me his/her valid and current Government Issued
Identification Card ___________________________with ID No. _________________.

Doc. No. __________


Page No. __________
Book No. _________ ________________________________________
Series of __________ Notary Public
-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.
! Affix !
! P30.00 !
! Documentary Stamp Tax !
!-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-!

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