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Sworn Application - Individual - General Purpose

This document is a sworn application for a tax clearance from the Bureau of Internal Revenue of the Philippines. It requires the applicant to provide identifying information, business details, tax filing history, and the purpose for requesting the tax clearance.

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28 views1 page

Sworn Application - Individual - General Purpose

This document is a sworn application for a tax clearance from the Bureau of Internal Revenue of the Philippines. It requires the applicant to provide identifying information, business details, tax filing history, and the purpose for requesting the tax clearance.

Uploaded by

cbsacctg0920
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Finance
BUREAU OF INTERNAL REVENUE
Revenue Region No. 10 - Legazpi
Legazpi City

SWORN APPLICATION FOR TAX CLEARANCE


(For Individual/Non-Individual Taxpayer Securing Tax Clearance for General Purposes)

I, _________________________________________________, Filipino/_____________(indicate nationality


for non-Filipino citizenship), of legal age, single/married to_____________________________________, permanently
residing at _____________________________________________________________ with Taxpayer Identification
Number (TIN) __________________________________, after having been duly sworn in accordance with law hereby
depose and say:

1. That I am the Owner/Proprietor/Proprietress of _____________________________________________________


with business address at
_________________________________________________________________________,
with Telephone/Cellular Phone No. ______________________ and email address
___________________________;

2. That I registered my business with BIR under Certificate of Registration No. ______________________ issued at
Revenue District Office/LTDO No. _____________ on _________________________________________________;

3. That for the last ____________ years, it has been engaged in the business as __________________________________
_____________________ and has consistently and faithfully paid all taxes, fees and imports due from it;

4. That for the last three (3) years, it has filed its Income Tax Returns at the following BIR Offices:
YEAR B.I.R. OFFICE/ADDRESS GROSS INCOME
__________________ _______________________________________ _____________________
__________________ _______________________________________ _____________________
__________________ _______________________________________ _____________________

5. That this affidavit is being submitted in order to secure a Tax Clearance Certificate for –
Purpose: ________________________________________________________________

__________________________________________
Signature over Printed Name of Applicant

SUBSCRIBED AND SWORN to before me this __________ day of ____________________________, ___ in


_______________________________. Applicant exhibited to me his/her valid and current Government Issued
Identification Card ___________________________with ID No. _________________.

Doc. No. __________


Page No. __________
Book No. _________
________________________________________
Series of __________ Notary Public
-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.
! Affix !
! P30.00 !
! Documentary Stamp Tax !
!-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-!

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