Application For Registration: Last Name First Name Middle Name Suffix
Application For Registration: Last Name First Name Middle Name Suffix
Application For Registration: Last Name First Name Middle Name Suffix
6 Taxpayer’s Name
Last Name First Name
8 Civil Status
Single Married Widow/er Legally Separated
9 Date of Birth (MM/DD/YYYY) 10 Place of Birth
Subdivision/Village/Zone Barangay
Town/District Municipality/City
16 Foreign Address
17 Municipality Code
(To be filled out by BIR) 18 Tax Type INCOME TAX, 19 Form Type ,BIR Form No. 1700 , 20 ATC II 011
21 Identification Details (e.g. passport, government issued ID, company ID, etc.)
Type Number Effective Date (MM/DD/YYYY) Expiry Date (MM/DD/YYYY)
Taxpayer(Employee)/Authorized Representative
(Signature over Printed Name)
Part IV – Primary/Current Employer Information
33 Type of Registering Office
34 TIN - - - 35 RDO Code
Head Office Branch Office
36 Employer’s Name (Last Name, First Name, Middle Name, If Individual) (Registered Name, If Non Individual)
37 Employer’s Address
Unit/Room/Floor/Building No. Building Name/Tower
Subdivision/Village/Zone Barangay
Town/District Municipality/City
38 Contact Details
Landline Number Fax Number Mobile Number
Documentary Requirements:
POSSESSION OF MORE THAN ONE TAXPAYER IDENTIFICATION NUMBER (TIN) IS CRIMINALLY PUNISHABLE PURSUANT TO THE
PROVISIONS OF THE NATIONAL INTERNAL REVENUE CODE OF 1997, AS AMENDED.