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Bataan Sworn Atp

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79 views

Bataan Sworn Atp

Uploaded by

pomperadachow
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Annex “B”

Taxpayer-user’s Sworn Statement

SWORN STATEMENT

RICARDO PENA
I, Filipino, of legal age designated
as of RPM Printing Press , with business address at
GAHAK KAWIT CAVITE , do hereby certify the following:

1. That, ----same as above--- with business address at ______


GAHAK KAWIT CAVITE is a duly registered entity under the laws of the Philippines;

2. That the receipts or sales/commercial invoices to be issued by the abovementioned


entity shall only come from the receipts or invoices covered by and reflected in the
attached BIR-registered “Printer’s Certificate of Delivery of Receipts and Invoices”;

3. That the above-mentioned entity shall not issue a receipt or sales/commercial invoice
unless he has received his copy of the duly stamped “Registered”
of Delivery of Receipts or Sales/Commercial Invoice;

4. That the aforementioned receipts or sales/commercial invoices are serially numbered


and conformed to the requirements of Sections 237, 238, and 113 (for VAT taxpayer) of
the National Internal Revenue Code of 1997, as amended; and

5. That in case of violations of Sections 237, 238, and 113 (for VAT-registered taxpayers)
of the National Internal Revenue Code of 1997, the above-mentioned business would
voluntarily pay or comply with the sanctions provided under existing laws, rules and
regulations.

I declare, under the penalties of perjury, that the foregoing attestations are true and
correct to the best of my knowledge and belief.

RICARDO PENA

(Name and Signature of


Taxpayer/Authorized Representative)
OWNER
Position :
TIN : 251374918
Address : GAHAK KAWIT CAVITE
PRINTER’S CERTIFICATE OF DELIVERY OF RECEIPTS AND/OR INVOICE
I, RICARDO C. PENA , Proprietor or Duly-Authorized Representative of RPM PRINTING PRESS
a Single Proprietor duly registered and existing under the laws of the Philippines with principal office at ,
162 Miranda Subd. Gahak, Kawit, Cavite, h ereafter referred as “the Printer”, hereby certifies the following:

1. That ____________________engaged my/our services to print his/its Receipts/Invoices, details of which are as
follows:

Required Data Printer’s Details Taxpayer’s Details


TIN 251-374-918-000 010-754-890-00000
Name Ricardo C. Pena BATAAN CASA ROTISSEUR CORPORATION

Registered Address 162 Miranda Subd., Gahak, Kawit, Cavite GF SM CITY BATAAN LERMA ST. IBAYO 2100

2100 CITY OF BALANGA (CAPITAL) BATAAN PHILIPPINES

Home RDO 54B 020

(A) Category of Document Invoice Official Receipt Others (specify) ________________

(B) Details of Receipts/Invoices covered by this delivery:


Doc Kind of OR/Invoic Categor ATP No. of No. of Sets No. of Copies Inclusive Serial Place where the Invoice
Type Number Booklets per Booklet Per set Numbers /Receipts will be used
020AU2024000
NON-VAT SERVICE INVOICE BOUND 20 50 2 000001 001000
0003786

(C) Mode of delivery ___________ Partial Delivery _______ Full Delivery

(D) Size of Receipts/Invoice

(E) Details of Delivery: : _____ Bound______ Looseleaf_____


___
Total No. of Booklets/Looseleaf to be Printed :
Less: No. of Booklets/Looseleaf delivered
Previous Delivery : ________
This/Current Delivery : ______ _______ _____
_
Outstanding Balance :
=============== ===============

020
2. That upon issuance of the authority to print (ATP) by the BIR-RDO No. _______________on
___________________
MAY 30 ,2024 020AU20240000003786
under OCN/ATP No. _____________________________, the aforesaid receipts and
invoices were printed. Photocopy of aforementioned ATP is hereto attached.

3. That copies of the aforementioned receipts/invoices have been delivered to the above-named taxpayer;

4. That no other copies of aforementioned receipts/invoices have been printed or reproduced except the copies delivered
to the taxpayer as mentioned in the preceding statement; and
5. That the ‘printer’ shall not print or reproduce nor shall it permit its machines or facilities to be used to print or
reproduce extra or additional copies of the receipts/invoices above-described.

same as above
This certification is issued to____________________________________ in compliance with BIR Regulations
No.___ and for all legal intents and purposes this may serve.

Done this _________ day of __________________ at Cavite.

I declare under the penalties of perjury that this certificate 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.

Name of Printer Ricardo C. Pena


Address 162 Miranda Subd., Gahak, Kawit, Cavite
TIN 251-374-918-000

By: RICARDO PENA


___________________________________________
Signature Over Printed Name
Authorized Representative

Note: The PCD shall cover receipts and invoices embodied in just one ATP

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