DLN:

To be filled up by BIR

ANNEX 'B'

327

335

214

0000

Fill in all applicable white spaces. Mark all appropriate boxes with an 'X'.
Part I
1

Taxpayer Information

Registering Office

X
3

Head Office

Branch Office

04/13/2016

Date of Registration

Facility

Taxpayer Identification No.

RDO Code

5 Sex

024

(For taxpayers with existing TIN

or applying for a branch)

6

Female

Taxpayer Type

Single Proprietorship

Male

Mixed Income Earner (Compensation Earner with any of the following)

Professional (pls. specify)

Estate

Marginal Income Earner

Trust

Non-resident Alien Engaged in Trade/Business

Professional

Single Proprietor

Taxpayer's Name

Others (pls. specify)

8 Citizenship

9 Date of Birth/Organization Date

LAURINO, ARNALDO JR SAMSON

FILIPINO

ROSARIO EUROPEO SAMSON

07/09/1994

10 Residence Address (Please indicate complete address)

11 Zip Code

Que Grande St. Ugong 2nd VALENZUELA CITY, NCR

1440

13 Business Address (Please indicate complete address)

14 Zip Code

Que Grande St. Ugong 2nd VALENZUELA CITY, NCR

16

1440

Municipality Code (To be filled up by BIR)

17

E-Mail Address

12

Telephone No.

4430660
15

Telephone No.

4430660

arnaldolaurinojr@gmail.com

18 Primary/ Secondary Industries (Attach Additional Sheets, If Necessary)

Industry

Business / Trade Names

DTI

CODE

Registration

(To be filled up by the BIR)

Number

PSIC

PSOC

K70200

3429

REAL ESTATE
ARNALDO
ACTIVITIES
SAMSON LAURINO JR.

Line of Business/Occupation

OTHER BUSINESS SERVICES AGENTS AND TRADE BROKERS

Facility Details
Facility Code No.

Address of Facility/ties

Facility Type (pls. check applicable facility type)

Place of Production

19

Accreditation/Registration with any of the following

20

Barangay Micro Business Enterprise (BMBE)

Storage/Warehouse

Showroom

Details of Registration/Accreditation
Registration/Accreditation No.

BOI/BOI-ARMM

Effectivity from

Special Economic Zone (pls. specify)

to

Date Issued

Others (pls. specify)

21

Incentives granted
Income Tax Holiday (ITH) - Number of Years
Others (pls. specify)

22 Contact Person/ Accredited Tax Agent (if different from taxpayer)/Name of Administrator/Trustee (in case of Estate/Trust)

23

Telephone Number

Last Name, First Name, Middle Name (if individual) / Registered Name (if Non-individual)
24 Complete Address of Contact
Person/Accredited Tax Agent/
Administrator/Trustee
25

Tax Types (this portion determine your tax liability/(ties)

FORM TYPE

ATC

FORM TYPE

(To be filled up by BIR)

MC180

Registration Fee

0605

W/holding Tax - Compensation

1601-C/1604CF

W/holding Tax - Expanded

1601-E/1604E

Excise Tax - Mineral Products

2200-M

W/holding Tax - Final

1601-F/1604CF

Excise Tax - Petroleum Products

2200-P

W/holding Tax - Fringe Benefits

1603

Excise Tax - Tobacco Products

2200-T

W/holding Tax - VAT/Other

1600

Value-added Tax

2550M/2550Q

W/holding Tax - Others (ONET not

1606

zero-rated
exempt

1600-WP

Winnings and Prizes

W/holding Tax - Banks and Other

1602

Income Tax

1701/1701Q

Excise Tax - Alcohol Products

2200-A

Percentage Tax - Under NIRC

2551M

Percentage Tax-Overseas

2551Q

dispatch & Amusement

Financial Institutions

2200-AN

12%

subject to CGT)
W/holding Tax - Percentage Tax on

Excise Tax - Automobiles & NonEssential Goods

Percentage Taxes

II012

ATC
(To be filled up by BIR)

Percentage Tax - Stocks

2552

Percentage Tax - Under Special Laws

2553

Others (please specify)