(To be filled up by BIR) DLN:
BIR Form No.
Republic of the Philippines
Department of Finance
Application for Registration 1901
Bureau of Internal Revenue
For Self-Employed (Single January 2018(ENCS)
000 - 000 - 000 - 00000
Proprietor/Professional), 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)
Branch Office
0 00 0 0 0 0 00 00 0 0 00 0000 Head Office
4 Taxpayer Identification Number (TIN)
(For Taxpayer with existing TIN) 000
-- 000 -- 000 -- 0 0 0 0 0 5 RDO Code
6 Taxpayer Type (To be filled up by BIR
Single Proprietorship Only (Resident Citizen) Mixed Income Earner – Compensation Income Earner & Professional
Mixed Income Earner – Compensation Income Earner, Single
Resident Alien – Single Proprietorship
Proprietorship & Professional
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
Mixed Income Earner – Compensation Income Earner & Trust – Foreign National
Single Proprietor
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)) Place of Birth
12 Mother’s Maiden Name
13 Father’s Name
14 Citizenship
15 Other Citizenship
16 Local Residence Address
11
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 20 Purpose of TIN Application
(To be filled up by BIR)
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
- - -00000
27 Spouse Employer’s Name (Last Name, First Name, Middle Name, if Individual)(Registered Name, if Non-Individual) 28 Spouse Employer’s TIN
- - - 00000
PART III – Authorized Representative
29 Relationship Name (For Authorized
Representative)
If Individual (Last Name) (First Name) (Middle Name) Suffix
If Non-Individual (Registered Name)
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 Date PSIC Code
Business Registration Number Line of Business
(MM/DD/YYYY (To be filled up by BIR)
Primary )
Secondary
36 Incentives Details
36A Investment Promotion
(e.g. PEZA, BOI) 36B Legal Basis 36C Incentive Granted
(e.g. RA, EO) (e.g. Exempt from IT,VAT,etc.)
36E Incentive Start Date
36D No. of Years (MM/DD/YYYY) 36F Incentive End Date
37 Details of Registration / Accreditation (MM/DD/YYYY)
FROM TO
37A Registration / Accreditation Number 37B Effectivity Date (MM/DD/YYYY) (MM/DD/YYYY) 37C Date Issued (MM/DD/YYYY)
37D Registered Activity 37F Activity Start Date
37E Tax Regime (Regular, Special, (MM/DD/YYYY) 37G Activity End Date
Exempt) (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
38B Facility Type PP SP WH SR GG BT RP Other (specify)
(To be filled up by BIR) F
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
Overseas Dispatch And
Final Amusement Taxes
Fringe Benefits Under Special Laws
VAT & Other Percentage
Percentage Tax Tobacco Products
ONETT not subject to
CGT
Percentage Tax on
Winnings & Prizes
On Interest Paid On Deposits And
Yield on Deposits/Substitutes
Income Tax
Excise Tax
Alcohol Products
Automobile & Non-
Essential Goods
Cosmetics Procedures
Mineral Products
Petroleum Products
Sweetened Beverages
Other Percentage entary Stamp Tax Regular
Tax under NIRC
One-Time Transactions
(specify) (ONETT)
Capital Gains – Real
Property
D Capital Gains – Stocks
o Donor’s Tax
c Estate Tax
u Miscellaneous Tax (specify)
Others (specify)
Tobacco Inspection Fees
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) NO. OF NO. OF
SETS PER COPIES
SERIAL NO.
Description NO. OF
TYPE BOXES/BOOKLETS BOX / PER SET
BOOKLET START END
VAT NON-VAT LOOSE BOUND
Part VII - For Employee with Two or More Employees (Multiple Employments) Within the Calendar Year
Successive employments (With previous Concurrent employments (With two or more employers at the same
41 Type of Multiple time employer/s within the calendar year) with the calendar year)
Employments
(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
44 TIN - -
Branch
Head Office Office - 45 RDO Code
46 Employer Name If (First Name)
(Last Name) (Middle Name)
Individual (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
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 and Date of Receipt
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)
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
