Series of 2015

APPLICATION FORM FOR ACCREDITATION OF IMPORTER

(To be accomplished and signed by the individual applicant or by the
authorized officer of a non-individual applicant)

PLEASE CHECK APPLICABLE BOX: INDIVIDUAL APPLICANT NON-INDIVIDUAL APPLICANT

NAME OF APPLICANT:
DTI-REGISTERED BUSINESS NAME (IF ANY):
TAXPAYER IDENTIFICATION NUMBER (TIN): E-MAIL ADDRESS:
RESIDENTIAL ADDRESS:
CONTACT NO.:
PRINCIPAL PLACE / HEAD OFFICE OF BUSINESS ADDRESS:
CONTACT NO.:
LINE BUSINESS: PSIC:
NAME OF AUTHORIZED OFFICER (FOR NON-INDIVIDUAL APPLICANTS):
POSITION/DESIGNATION: TIN:
ENCLOSED ARE THE FOLLOWING SUPPORTING DOCUMENTS TO THIS APPLICATION:
PHOTOCOPY OF THE LATEST BIR CERTIFICATE OF REGISTRATION OF PRINCIPAL PLACE/HEAD OFFICE OF BUSINESS AND OF ANY BRANCH/FACILITY
PHOTOCOPY OF LATEST ANNUAL INCOME TAX RETURN (WITH ATTACHMENTS) / AFFIDAVIT OF NO TAXABLE INCOME FROM PREVIOUS YEARS
CERTIFIED TRUE COPY OF LATEST MAYOR’S PERMIT OR DULY RECEIVED APPLICATION FOR SUCH PERMIT
PROOF OF OWNERSHIP/LAWFUL OCCUPANCY OF PRINCIPAL PLACE / HEAD OFFICE OF BUSINESS (TCT/OCT/CTC/LEASE CONTRACT)
VICINITY MAP, LOCATION PLAN (SUBJECT TO ADDITIONAL REQUIREMENTS FOR SPACE-SHARING ARRAGEMENTS)
PHOTOGRAPHS OF PRINCIPAL PLACE / HEAD OFFICE OF BUSINESS
PHOYOCOPY OF LATEST UTILITY BILLS FOR THE PRINCIPAL PLACE / HEAD OFFICE OF BUSINESS
UNDERTAKING TO COMPLY WITH THE DUTY TO PRESERVE AND MAINTAIN RECORDS FOR A PERIOD OF TEN (10) YEARS AND ALLOW TO ACCESS TO
EXAMINATION BY THE BIR, BOC, AND THE DOF-FIU
AUTHORITY TO PRINT (ATP) WITH PRINTER’S DELIVERY RECEIPT
PROOF OF TWO (2) MONTHS ELECTRONIC FILLING AND PAYMENT SYSTEM (EEPS) USAGE
ANNEX A (RFV-REVENUE DISTRIC OFFICE / HEAD OF OFFICE HAVING JURISDICTION OVER THE APPLICANT’S REGISTERED ADDRESS)
ANNEX B (RFV-REGIONAL LEGAL DIVISION HAVING JURISDICTION OVER THE APPLICANT’S REGISTERED ADDRESS)
ANNEX C (RFV-REGIONAL COLLECTION DIVISION HAVING JURISDICTION OVER THE APPLICANT’S REGISTERED ADDRESS)
ANNEX E (RFV-AUDIT INFORMATION TAX EXEMPTION AND INCENTIVE DIVISION) FOR VAT REGISTERED APPLICANTS
ANNEX F (RFV-MISCELLANEOUS OPERATIONS MONITORING DIVISION) FOR WITHHOLDING TAX REGISTERED APPLICANTS
PHOTOCOPY OF THE OFFICIAL RECEIPT FOR THE PAYMENT OF THE BIR ACCREDITATION PROCESSING FEE IN THE AMOUNT OF PHP 2,000.00 DULY PAID
AT THE BIR NATIONAL OFFICE CASHIER, GENERAL SERVICE DIVISION

ADDITIONAL REQUIREMENTS FOR INDIVIDUAL APPLICANTS:

CERTIFIED TRUE COPY OF DTI CERTIFICATE OF REGISTRATION OF BUSINESS NAME (IF A BUSINESS TRADE NAME IS USED)
ORIGINAL COPY OF THE APPLICANT’S PERSONAL PROFILE / RESUME
TWO (2) RECENT 2X2 PICTURES WITH THE APPLICANT ‘S SIGNATURE AT THE BACK

ADDITIONAL REQUIREMENTS FOR NON-INDIVIDUAL APPLICANTS:

CERTIFIED TRUE COPY OF COOPERATIVE DEVELOPMENT AUTHORITY (CDA) COR AND ARTICLES OF INCORPORATION (FOR COOPERATIVES)
CERTIFIED TRUE COPY OF LATEST GENERAL INFORMATION SHEET FILED WITH THE SEC
ORIGINAL COPY OF THE CERTIFICATE OF GOOD STANDING ISSUED BY THE SEC OR THE CDA
ORIGINAL COPY OF THE PROFILE OF THE CORPORATION, PARTNERSHIP, COOPERATIVE AND ASSOCIATION
ORIGINAL COPY OF THE PROFILE OF EACH MEMBER OF THE BOARD, CORPORATE OFFICER, PARTNERS
ORIGINAL COPY OF THE PROFILE OF EMPLOYEES, REPRESENTATIVES OR AGENTS DEALING WITH THE BUREAU OF CUSTOMS
ORIGINAL COPY OF THE SECRETARY’S CERTIFICATE OF THE MINUTES / CONTENTS OF THE BOARD RESOLUTION AUTHORIZING THE DESIGNATED
REPRESENTATIVE TO SIGN THIS APPLICATION

I HEREBY DECLARE, UNDER THE PENALTIES OF PERJURY, THAT THIS APPLICATION HAS BEEN MADE IN GOOD FAITH,
AND THAT THE REPRESENTATIONS INCLUDING THE ACCOMPANYING SUPPORTING DUCOMENTS HAVE BEEN VERIFIED BY
ME AND TO THE BEST OF MY KNOWLEDGE., BELIEF, AND INFORMATION ARE CORRECT, COMPLETE AND TRUE.

Signature over Printed Name of Individual Applicant/

Authorized officer of Non-Individual Applicant

SUBSCRIBED AND SWORN to before me this day of 20 in ,

Applicant exhibiting to me his/her competent evidence of identity (government issued identification) No. bearing
His photograph and signature, issued on by at .
NOTARY PUBLIC