Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
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PART I.
Taxpayers Name____________________________________________________________________ Plant Address:_________________________________________________________Zip Code______ Taxpayer Identification No. ________________________Assessment No._______________________ Home RDO Code _________ Telephone/Mobile Phone No.___________________________________ E-mail address:______________________________________________Fax No.__________________ PART II. DETAILS OF PRODUCTS APPLIED FOR REPLENISHMENT
Quantity
Volume Unit of measure
TOTAL
PART III.
Bilateral air agreement with the foreign country of destination, in case of international airlines Certificate of Registration issued by the Maritime Authority of the Philippines (MARINA) certifying that the marine vessel is exclusively engaged in the international shipping Sales invoice and delivery receipt duly acknowledged by the purchaser or his authorized representative Purchase order or supply agreement Proof of payment of the excise tax Withdrawal Certificate, Official Delivery Invoice or any BIR-prescribed forms to document removal of excisable articles from the place of production Batch liquidation statements indicating receipts and removals Proof that excise tax was not billed to the customer Others, please specify _________________________________________________________
PART III.
PERJURY DECLARATION
I declare, under penalties of perjury, that this application including the accompanying documents, has been made in good faith, verified by me and to the best of my knowledge and belief, is true and correct, and that all accompanying documents, if any, are valid. ________________________________ Applicants signature over printed name Position:_________________________ ___________________________________________________________________________________ For BIR Use:
Stamp of Receiving Office Stamp ofof Receiving and Date ReceiptOffice
and Date of Receipt
Application Form No._________________ Remark/s: ____________________________ ____________________________ Reviewed by: _______________________________ Name & Signature of Revenue Officer
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