BIR Form No.

1901 (ENCS)-P
Part II
26

Personal Exemptions
Civil Status

27

Employment Status of Spouse

Single

Widow/Widower

Unemployed

Legally separated

Married

Employed Locally
Employed Abroad

with qualified dependent/s

28

without qualified dependent/s

Engaged in Business/Pra

Claims for Additional Exemptions/ Premium Deductions for husband and wife whose aggregate family income does not exceed P250,000.00/annum.
Husband claims additional exemption and any premium deductions

Wife claims additional exemption and any pre

(Attach Waiver of the Husband)

29

Spouse Information
Spouse Taxpayer Identification Number

Spouse Name

29A

29B
Last Name
Spouse Employer's Taxpayer Identification Number

29C
Part III

First Name

Spouse Employer's Name

29D

Additional Exemptions

Section A

Names of Qualified Dependent Children

Last Name

First Name

Middle Name

Date of Birth

( MM / DD / YYYY )

30A

30B

30C

30D

31A

31B

31C

31D

32A

32B

32C

32D

33A

33B

33C

33D

Part IV
34

For Employee With Two or More Employers (Multiple Employments) Within the Calendar Year
Type of multiple employments
Successive employments (With previous employer(s) within the calendar year), for late registrants if applicable
Concurrent employments (With two or more employers at the same time within the calendar year)

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

Previous and Concurrent Employments During the Calendar Year
TIN

35

Name of Employer/s

Declaration

I declare, under the penalties of perjury, that this form 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.

TAXPAYER / AUTHORIZED AGENT

(Signature over printed name)

Part V

Current Main Employer Information

36

Taxpayer Identification Number

37

38

Employer's Name (Last Name, First Name, Middle Name, if Individual/ Registered Name, if Non-Individuals)

39

Employer's Business

RDO Code

(To be filled up by BIR)

Address
40

Zip Code

41

Municipality Code

(To be filled

43

Effectivity Date

up by the BIR)
42

44

(Date when Exemption Information is applied)

Date of Certification

(Date of Certification of the Ac

Exemption Information)

Telephone Number
(MM/ DD/ YYYY)

45

Declaration

Stamp of BIR Receiving

I declare, under the penalties of perjury, that this form has been made in good faith, verified by

and Date of Receipt

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.

Attachments Complete?
(To be filled up by BIR)
EMPLOYER / AUTHORIZED AGENT

Title / Position of Signatory

(Signature over printed Name)

ATTACHMENTS: (Photocopy only)

A.

Mayor's Permit / PTR issued by the LGU

B.

Lease Contract, if applicable

C.

DTI Certificate of Registration of Business Name, if a trade name shall be used

D.

Certificate of Authority, if Barangay Micro Business Enterprise (BMBE) registered entity

E.

Proof of Registration / Permit to Operate with Board of Investment (BOI)/ Board of Investment
for Autonomous Region for Muslim Mindanao (BOI-ARMM), Philippine Export Processing Zone
Authority (PEZA), Bases Conversion Development Authority (BCDA) and Subic Bay Metropolitan
Authority (SBMA), if applicable

F.

Franchise Agreement, if applicable

G.

Sworn Statement of Capital, if applicable

Additional attachments:
A. For Self-Employed / Professional / Mixed Income Earners
1. Working Permit for Non-Resident
2. Waiver of husband to claim additional exemption, if applicable
3. Marriage Contract, if applicable
4. Birth Certificate/s of dependent/s, if applicable
B. For Estate under Judicial Settlement
1. Death Certificate of Decedent
2. Judicial Settlement of the Estate
C. For Trust - Trust Agreement

NOTE:
1. Any changes on the above information after registration, taxpayer should notify the BIR thru BIR Form No. 1905
2. Taxpayer should attend the required taxpayers briefing before the release of the BIR Certificate of Registration

Before the release of Certificate of Registration (COR):

Contract of Lease for basis of computing Documentary Stamp Tax.
Bank validated BIR Form 2000

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.

27

BIR Form No. 1901 (ENCS)-PAGE 2

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

ceed P250,000.00/annum.

s additional exemption and any premium deductions

aiver of the Husband)

First Name

Date of Birth

Middle Name

Mark if Mentally
/ Physically

( MM / DD / YYYY )

Incapacitated

30D

30E

31D

31E

32D

32E

33D

33E

regulations issued

RDO Code
(To be filled up by BIR)

Date of Certification
(Date of Certification of the Accuracy of the
Exemption Information)
(MM/ DD/ YYYY)
Stamp of BIR Receiving Office
and Date of Receipt

Attachments Complete?
(To be filled up by BIR)
Yes

No