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Sworn Application For Tax Clearance: Annex C

1. The document is a sworn application for a tax clearance submitted by Patrick Kaye O. Bula to the Bureau of Internal Revenue in the Philippines. 2. Bula owns a business and is applying for a tax clearance, which is required to enter into contracts with government agencies. 3. The application includes details about Bula, his business, tax registrations, and confirms that all required documentary attachments are included to support his application for a tax clearance.

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319 views1 page

Sworn Application For Tax Clearance: Annex C

1. The document is a sworn application for a tax clearance submitted by Patrick Kaye O. Bula to the Bureau of Internal Revenue in the Philippines. 2. Bula owns a business and is applying for a tax clearance, which is required to enter into contracts with government agencies. 3. The application includes details about Bula, his business, tax registrations, and confirms that all required documentary attachments are included to support his application for a tax clearance.

Uploaded by

patrickkaye
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, PATRICK KAYE O. BULA, Filipino (indicate nationality for non-Filipino citizenship), of legal age, married
to TRICHE BERNAL AMAT, permanently residing at 248 Carolina st. Brgy. 13, Dolores Eastern Samar with Taxpayer
Identification Number (TIN) 438-714-311-000, 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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