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Application Form: Professional Regulation Commission

- The document is an application form for the Certified Public Accountant examination to be taken on October 11, 12, and 18, 2020 in Manila. - The applicant, Aleli Maryrose A. Arandid, graduated from Manuel L. Quezon University with a Bachelor of Science in Accountancy degree in May 2019. - She previously took the CPA exam in October 2019 and received a rating of 71.67 but failed the exam.

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hambog kasi
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90 views

Application Form: Professional Regulation Commission

- The document is an application form for the Certified Public Accountant examination to be taken on October 11, 12, and 18, 2020 in Manila. - The applicant, Aleli Maryrose A. Arandid, graduated from Manuel L. Quezon University with a Bachelor of Science in Accountancy degree in May 2019. - She previously took the CPA exam in October 2019 and received a rating of 71.67 but failed the exam.

Uploaded by

hambog kasi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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APPOINTMENT DATE: Jul 17, 2020 (10:00 AM TO 11:00 AM) - Robinsons Galleria (Ortigas) (Renewal, Application for Exam,

Duplicate)

Professional Regulation Commission

APPLICATION FORM

NOT FOR SALE (REPRODUCTION IS ALLOWED)


REFERENCE NO: EXVMBC7YK0GL
Application No.
OR: 018305961462 | AMOUNT: PHP 900
000244
First Timer
Name of Examination CERTIFIED PUBLIC ACCOUNTANT
_________________________________
X Repeater
Conditioned Date of Examination OCTOBER 11, 12 & 18, 2020
_________________________________
Absent
Place of Examination Manila
_________________________________
________________
07/01/2020
Date(mm/dd/yy)
NOTICE: All supporting documents shall become part of the records of the Commission. All applications must be filed
PERSONALLY by the applicant.

PART I-PERSONAL INFORMATION


SUR NAME GIVEN NAME/S MIDDLE NAME
ARANDID ALELI MARYROSE CABIO
Maiden Surname (for married female only)

Permanent Mailing Address (House no., Street, Village/Subd., Brgy., Town, Prov./City)
519 REGIDOR ST. BRGY. STA. CATALINA MAJAYJAY, LAGUNA
Gender Citizenship Contact numbers (Landline & Mobile) E-mail Address
Male X Female X Filipino Others______ 09360973709 [email protected]
Civil Status Date of Birth(mm/dd/yy) Place of Birth (City/Town,Prov) RURBAN Code(Town/City,Prov)
X Single Married Widow/er 12/22/1996 MAJAYJAY, LAGUNA 133416
Spouse’s name & Citizenship Father’s Name & Citizenship Mother’s Name & Citizenship
ALEX M. ARANDID / FILIPINO LIEZL C. ARANDID / FILIPINO
HAVE YOU EVER BEEN CHARGED AND CONVICTED BY FINAL JUDGEMENT BY ANY COURT OF JUSTICE/MILITARY TRIBUNAL OR
ADMINISTRATIVE BODY? X No Yes (If yes, attach hereto a copy of the decision)
PART II – EDUCATIONAL INFORMATION
Name of School Address/Location of School PRC School code
MANUEL L. QUEZON UNIVERSITY 916 R. HIDALGO STREET, QUIAPO, MANILA 0553
Degree/Course Obtained PRC COURSE Code Date Graduated (mm/dd/yy) PRC Board Code
BACHELOR OF SCIENCE IN ACCOUNTANCY 5136 05/10/2019 0100
Date Graduated PRC SCHOOL
Other Higher Educational Attainment Name of School Address/Location of School CODE
(mm/dd/yy)

PART III – PREVIOUS PRC LICENSURE EXAMINATION/S TAKEN (Last Three Exams)
Place of Date Taken Result of Examination (pls check)
Name of Examination Rating Exam No. Verified by
Examination (mm/yy) Passed Failed Cond.
CERTIFIED PUBLIC ACCOUNTANT - 10/2019 71.67 X

Review School/Center: Self-Review School-Based Review Others (specify name) __________________________


STATUS CODES (refer at the back) 1.) Examination Type (EXcode) 2.) Number of Times Taken 1

I HEREBY CERTIFY that the information and/or ACTION TAKEN BY THE APPLICATION PROCESSOR
statements in this application including the supporting ISSUANCE of the FOLOWING FORMS
documents submitted in support thereof are all true and
correct to my own knowledge, and that I am fully aware that NOTICE OF ADMISSION PERMANENT EXAMINATION &
(NOA) REGISTRATION RECORD CARD (PERRC)
any false information or statement in this application or in its
attachments shall render me liable for criminal prosecution REMARKS ______________________________________________
and/or administrative sanction. ______________________________________________________________________________

PROCESSOR_____________________________ Date ___________


RIGHT THUMBMARK _______________________ ____________________________________________________________
Signature of Applicant ACTION TAKEN BY LEGAL OFFICER (if applicable)
_______________________ REMARKS ______________________________________________
Date Accomplished ______________________________________________________________________________

LEGAL OFFICER __________________________ Date ___________


Subscribed and sworn to before me this __________day of ____________________________________________________________
_________20____at__________. Affiant applicant exhibited ACTION TAKEN BY THE BOARD
to me his / her Community Tax Certificate No. APPROVED DISAPPROVED CONDITIONAL
02-027313789-1
________________________issued at SAN MIGUEL, MANILA
_______________
REMARKS ______________________________________________
on _____________.
10/24/2019 ______________________________________________________________________________
DOCUMENTARY STAMP

CHAIRMAN/ MEMBER ______________________ Date __________


____________________________________________________________
ACTION TAKEN BY THE CASHIER
_______________________________
PRC ADMINISTERING OFFICER AMOUNT PAID ____________
900 OFFICIAL RECEIPT NO. _____________
018305961462
Paymaya - Wallet Payment
CASHIER _________________________________ 07/01/2020
Date __________
____________________________________________________________
ACTION TAKEN BY THE ISSUING OFFICER
Administration of Oath Is Free REMARKS _______________________________________________
(Office Order No. 2009-377 & 2009-379 ______________________________________________________________________________
both dated September 3, 2009)
ISSUING OFFICER ________________________ Date __________

IMPORTANT: FAILURE TO SUBMIT THIS APPLICATION FORM WITH THE REQUIRED DOCUMENTS SHALL MEAN APP-01
NON-INCLUSION IN THE LIST OF EXAMINEES IN THE ROOM ASSIGNMENT AND FORFEITURE OF EXAMINATION FEES Rev. 00
February 25, 2015
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