Bir Sworn Statement Form – Fill Out and Use This PDF

Annex “B”

Taxpayer-user’s Sworn Statement

SWORN STATEMENT

I,

(Name of Taxpayer) ,

(Nationality)

, of

legal age

designated

as

(Position)

of

(Name of Company/Corporation)

, with

business

address at

, do hereby certify the following:

1.

That,

(Name of Company/Owner/Corporation) with business address at ______

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” Printer’s Certificate 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.

(Name and Signature of

Taxpayer/Authorized Representative)

Position :

TIN :

Address :