Application for Registration BIR Form No.

(To be filled up by BIR) DLN: __________________________

Republic of the Philippines

Department of Finance

Bureau of Internal Revenue

Application for Registration

BIR Form No.

1901

January 2018(ENCS)

For Self-Employed (Single Proprietor/Professional),

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Mixed Income Individuals, Non-Resident Alien

Engaged in Trade/Business, Estate and Trust

TIN to be issued, if applicable (To be filled in by BIR)

Fill in all applicable white spaces. Mark all appropriate boxes with an “X”.

Part I – Taxpayer Information

1 PhilSys Number (PSN)

2 Registering Office

3 BIR Registration Date

(To be filled up by BIR)(MM/DD/YYYY)

Head Office

Branch Office

4 Taxpayer Identification Number (TIN)

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0

5 RDO Code

(For Taxpayer with existing TIN)

(To be filled up by BIR

6 Taxpayer Type

Single Proprietorship Only (Resident Citizen)

Mixed Income Earner – Compensation Income Earner & Professional

Resident Alien – Single Proprietorship

Resident Alien – Professional

Non – Resident Alien Engaged in Trade/Business

Professional – Licensed (PRC, IBP)

Estate – Filipino Citizen

Professional – In General

Estate – Foreign National

Professional and Single Proprietor

Trust – Filipino Citizen

Trust – Foreign National

7 Taxpayer’s Name (If Individual) (Last Name) (First Name) (Middle Name) (Suffix) (Nickname)

(If ESTATE, ESTATE of First Name, Middle Name, Last Name, Suffix) (If TRUST, FAO: First Name, Middle Name, Last Name, Suffix)

8 Gender

Male

Female

9 Civil Status

Single

Married

Widow/er

Legally Separated

10 Date of Birth/Organization Date (In case of Estate/Trust) (MM/DD/YYYY))

11 Place of Birth

12 Mother’s Maiden Name

13 Father’s Name

14 Citizenship

15 Other Citizenship

16 Local Residence Address

Unit/Room/Floor/Building# Building Name/Tower Lot/Block/Phase/House No. Street Name Subdivision/Village/Zone

Barangay Town/District Municipality/City Province ZIP Code

17 Business Address

Unit/Room/Floor/Building# Building Name/Tower Lot/Block/Phase/House No. Street Name Subdivision/Village/Zone

Barangay Town/District Municipality/City Province ZIP Code

18 Foreign Address

19 Municipality Code

(To be filled up by BIR)

20 Purpose of TIN Application

21 Identification Details (e.g. passport, government issued ID, company ID, etc.)

Type ID Number Effective Date (MM/DD/YYYY) Expiry Date (MM/DD/YYYY) Issuer Place/Country of Issue

22 Preferred Contact Type

Landline Number Fax Number Mobile Number Email Address (required)

23 Are you availing of the 8% income tax rate option in lieu of Graduated Rates?

Yes

No

PART II - Spouse Information

24 Employment Status of Spouse Unemployed Employed Locally Employed Abroad Engaged in Business/Practice of Profession

25 Spouse Name (Last Name) (First Name) (Middle Name) (Suffix)

26 Spouse TIN

27 Spouse Employer’s Name (Last Name, First Name, Middle Name, if Individual)(Registered Name, if Non-Individual)

28 Spouse Employer’s TIN

PART III – Authorized Representative

29 Relationship Name (For Authorized Representative)

If Individual (Last Name) (First Name) (Middle Name) Suffix

If Non-Individual (Registered Name)

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Mixed Income Earner – Compensation Income Earner &

Single Proprietor

Mixed Income Earner – Compensation Income Earner, Single

Proprietorship & Professional

-

0 0 0 0 0

-

0 0 0 0 0

Page 2 – BIR Form No. 1901

30 Relationship Start Date (MM/DD/YYYY)

31 Address Types Residence Place of Business Employer Address

32 Local Residence Address

Unit/Room/Floor/Building# Building Name/Tower Lot/Block/Phase/House No. Street Name Subdivision/Village/Zone

Barangay Town/District Municipality/City Province ZIP Code

33 Preferred Contact Type

Landline Number Fax Number Mobile Number Email Address (required)

Part IV – Business Information

34 Single Business Number

35 Primary/Secondary Industries (Attach additional sheet/s, if necessary)

Industry

Trade/Business Name

Regulatory Body

Primary

Secondary

Industry

Business Registration Number

Business Registration Date

(MM/DD/YYYY)

PSIC Code

(To be filled up by BIR)

Line of Business

Primary

Secondary

36 Incentives Details

36A Investment Promotion

36B Legal Basis

(e.g. RA, EO)

36C Incentive Granted

(e.g. Exempt from IT,VAT,etc.)

(e.g. PEZA, BOI)

36D No. of Years

36E Incentive Start Date

36F Incentive End Date

(MM/DD/YYYY)

37 Details of Registration / Accreditation FROM TO

37A Registration / Accreditation Number

37B Effectivity Date (MM/DD/YYYY)

(MM/DD/YYYY)

37C Date Issued (MM/DD/YYYY)

37D Registered Activity

37E Tax Regime (Regular, Special,

Exempt)

37F Activity Start Date

(MM/DD/YYYY)

37G Activity End Date

(MM/DD/YYYY)

38 Facility Details (PP-Place of Production/Plant; SP-Storage Place; WH-Warehouse; SR-Showroom; GG-Garage; BT-Bus Terminal; RP-Real Property for Lease with No Sales Activity)

38A Facility Code

(To be filled up by BIR)

38B Facility Type PP SP WH SR GG BT RP Other (specify)

38C Facility Address

Unit/Room/Floor/Building# Building Name/Tower Lot/Block/Phase/House No. Street Name Subdivision/Village/Zone

Barangay Town/District Municipality/City Province ZIP Code

Part V – Tax Type

39 Tax Types (this portion determines your tax liability/ies) (To be filled up by BIR)

Form Type ATC Form Type ATC

Withholding Tax

Registration Fee

Compensation

Percentage Tax

Expanded

Stocks

Final

Overseas Dispatch And

Amusement Taxes

Fringe Benefits

Under Special Laws

VAT & Other Percentage

Percentage Tax

Other Percentage Tax under NIRC (specify)

ONETT not subject to

CGT

Percentage Tax on

Winnings & Prizes

Documentary Stamp Tax

On Interest Paid On Deposits And

Yield on Deposits/Substitutes

Regular

Income Tax

One-Time Transactions

(ONETT)

Excise Tax

Capital Gains – Real

Property

Alcohol Products

Capital Gains – Stocks

Automobile & Non-

Essential Goods

Donor’s Tax

Cosmetics Procedures

Estate Tax

Mineral Products

Miscellaneous Tax (specify)

Petroleum Products

Sweetened Beverages

Others (specify)

Tobacco Products

Tobacco Inspection Fees

F

Page 3 – BIR Form No. 1901

Part VI – Authority to Print

40 Authority to Print Receipts and Invoices

40A Printer’s Name

40B Printer’s TIN

40C Printers Accreditation Number

40D Date of Accreditation (MM/DD/YYYY)

40E Registered Address

Unit/Room/Floor/Building# Building Name/Tower Lot/Block/Phase/House No. Street Name Subdivision/Village/Zone

Barangay Town/District Municipality/City Province ZIP Code

40F Contact Number

40G E-mail Address

40H Manner of Receipt/Invoices

Bound

Loose Leaf

Others

40I Descriptions of Receipts and Invoices (Additional Sheet/s if Necessary)

Description

TYPE

NO. OF

BOXES/BOOKLETS

NO. OF

SETS PER

BOX /

BOOKLET

NO. OF

COPIES

PER SET

SERIAL NO.

VAT

NON-VAT

LOOSE

BOUND

START

END

Part VII - For Employee with Two or More Employees (Multiple Employments) Within the Calendar Year

41 Type of Multiple Employments

Successive employments (With previous

Concurrent employments (With two or more employers at the same time

employer/s within the calendar year)

with the calendar year)

(If successive, enter previous employer/s; if concurrent, enter secondary employer/s)

Previous and Concurrent Employments During the Calendar Year

41A Name of Employer

41B TIN of Employer

41C Name of Employer

41D TIN of Employer

42 Declaration

I declare, under the penalties of perjury, that this application has been made in good faith, verified by me and to the best of my knowledge and belief, is true and correct, pursuant to the provisions of the National

Internal Revenue Code, as amended, and the regulations issued under the authority thereof. Further, I give my consent to the processing of my information as contemplated under the *Data Privacy Act of 2012 (R.A.

No. 10173) for legitimate and lawful purposes.

___________________________

Taxpayer/Authorized Representative

(Signature over Printed Name)

Part VIII – Primary/Current Employer Information

43 Type of Registered Office

Head Office

Branch

Office

44 TIN

45 RDO Code

46 Employer Name If Individual (Last Name) (First Name) (Middle Name) (Suffix)

If Non-Individual (Registered Name)

47 Employer Address

Unit/Room/Floor/Building# Building Name/Tower Lot/Block/Phase/House No. Street Name Subdivision/Village/Zone

Barangay Town/District Municipality/City Province ZIP Code

48 Contact Details

Landline Number Fax Number Mobile Number Email Address (required)

49 Relationship Start Date (MM/DD/YYYY)

50 Municipality Code (To be filled up by BIR)

51 Declaration

Stamp of BIR Receiving Office

and Date of Receipt

I declare, under the penalties of perjury, that this application has been made in good faith, verified by me and to the best of my knowledge and belief, is true and

correct, pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof. Further, I give my consent

to the processing of my information as contemplated under the *Data Privacy Act of 2012 (R.A. No. 10173) for legitimate and lawful purposes.

_____________________________________________ ________________________

EMPLOYER/AUTHORIZED REPRESENTATIVE Title/Position of Signatory

(Signature over Printed Name)

Part IX – Payment Details

52 For the Year

53 Date of Payment (MM/DD/YYYY)

54 ATC

MC180

55 Tax Type

RF

56 Manner of Payment

REGISTRATION FEE

57 Type of Payment

FULL PAYMENT

58 Registration Fee

58A

59 BIR Printed Receipts / Invoices

59A

60 Add: Penalties Surcharge Interest Compromise

60A

60B

60C

60D

61 Total Amount Payable (Sum of Items 58A, 59A and 60D)

*NOTE: The BIR Data Privacy Policy is in the BIR website (www.bir.gov.ph)

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Documentary Requirements:

1. Any identification issued by an authorized government body (e.g. Birth Certificate, passport, driver’s license, Community Tax Certificate) that

shows the name, address and birthdate of the applicant;

2. Photocopy of Mayor’s Business Permit; or Duly received Application for Mayor’s Business Permit, if the former is still in process with the LGU;

and/or Professional Tax Receipt/Occupational Tax Receipt issued by the LGU;

3. Proof of Payment of Registration Fee (RF) (if with existing TIN or applicable after TIN issuance);

4. BIR Form No. 1906; (Select an Accredited Printer)

5. Final & clear sample of Principal Receipts/ Invoices;

Additional documents, if applicable:

a. Special Power of Attorney (SPA) and ID of authorized person, in case of authorized representative who will transact with the Bureau;

b. Franchise Documents (e.g. Certificate of Public Convenience) (for Common Carrier);

c. Photocopy of the Trust Agreement (for Trusts);

d. Photocopy of the Death Certificate of the deceased (for Estate under judicial settlement);

e. Certificate of Authority, if Barangay Micro Business Enterprises (BMBE) registered entity;

f. Proof of Registration/Permit to Operate BOI/BOIARMM, PEZA, BCDA and SBMA

6. In case of registration of branches/facility types:

a. Photocopy of Mayor’s Business Permit; or Duly received Application for Mayor’s Business Permit, if the former is still in process with the

LGU; and/or Professional Tax Receipt/Occupational Tax Receipt issued by the LGU;

or DTI Certificate;

b. Special Power of Attorney (SPA) and ID of authorized person, in case of authorized representative who will transact with the Bureau; if

applicable

c. Proof of Payment of Registration Fee (RF)

d. BIR Form No. 1906; (Select an Accredited Printer)

e. Final & clear sample of Principal Receipts/ Invoices;

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