Bir Form No. 1914
Bir Form No. 1914
Bir Form No. 1914
DLN:
BIR Form No.
Republika ng Pilipinas
Application for Tax
Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas Credits / Refunds 1914
January 2001
Fill in all applicable spaces. Mark all appropriate boxes with an "X"
Part I Background Information
1 Taxpayer 1 2 Home RDO Code 2
Identification No.
3 Taxpayer's Name 3
4 Registered 4A
Address
4A
8 Claim Amount 8
I declare, under the penalties of perjury, that this application has been made in good faith, Stamp of Receiving Office
verified by me and to the best of my knowledge and belief, is true and correct, and that no and Date of Receipt
refund or tax credit involving the same tax has previously been claimed or received.