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Sworn Annex A

This sworn statement certifies that [Company Name] is engaged in [line of business] and complies with Bureau of Internal Revenue conditions for [Type of Machine/Name of Software]. The authorized representative declares the essential features of the machine/software and undertakes legal sanctions if found in violation. The statement was sworn before a notary public.

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6K views1 page

Sworn Annex A

This sworn statement certifies that [Company Name] is engaged in [line of business] and complies with Bureau of Internal Revenue conditions for [Type of Machine/Name of Software]. The authorized representative declares the essential features of the machine/software and undertakes legal sanctions if found in violation. The statement was sworn before a notary public.

Uploaded by

rhianne_lhen5824
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Annex “A”

SWORN STATEMENT

I, (Name of Authorized Representative), (Nationality), of legal age designated as


(Position) of (Registered Name of Company/Corporation), with business address
located at _____________________________________, do hereby certify the following:

• THAT the company is engaged in, (line of


business) and existing under (business name), with
TIN__________________.

• THAT the (Type of Machine/Name of Software)


conform to the conditions/specification requirements set by the Bureau
of Internal Revenue;

• THAT the (Type of Machine/Name of


Software) has the following essential features;

•
•
•
(Attach additional sheet if necessary)

• THAT in the event that the foregoing be


discovered to be in violation of existing rules and regulations, I hereby
undertake to face any legal sanctions and pay corresponding penalties
thereof as provided for under the National Internal Revenue Code of
1997;

I HEREBY DECLARE UNDER PENALTIES OF PERJURY THAT THE FOREGOING


ATTESTATIONS ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.

Name and Signature of


Affiant/Authorized
Representative
TIN: ___________________________

SUBSCRIBED and sworn to before me, in the City/Municipality of


____________________________, this day of __________, 20___ by ____________________
with Residence Certificate No. _______ issued at _____________ on, ______________
20___.

Notary Public

Doc. No. _______


Page No. _______
Book No. _______
Series of _______

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