Bir Form 1902
Bir Form 1902
Bir Form 1902
17 Claims for Additional Exemptions/Premium Deductions for husband and wife whose aggregate family income does not exceed P250,000 per annum
Husband claims additional exemption and any premium deduction Wife claims additional exemption and any premium deduction
18 Spouse Information (Attach Waiver of Husband)
Spouse Taxpayer Identification Number Spouse Name
18A 18B
245 676 310 PARIṄAS MARRY GEMENA
Last Name First Name Middle Name
18C Spouse Employer's Taxpayer Identification Number 18D Spouse Employer's Name
DEPED/BONIFACIO MEMORIAL ELEMENTARY SCHOOL
Part III Additional Exemptions
19 Names of Qualified Dependent Child/ren (refers to a legitimate, illegitimate, or legally adopted child chiefly dependent upon & living with the taxpayer; not
more than 21 years of age, unmarried, and not gainfully employed; or regardless of age, is incapable of self-
support due to mental or physical defect).
Mark if Mentally
Last Name First Name Middle Name Date of Birth / Physically
( MM / DD / YYYY ) Incapacitated
Part IV For Employee With Two or More Employers (Multiple Employments) Within the Calendar Year
23 Type of multiple employments
Successive employments (With previous employer(s) within the calendar year)
Concurrent employments (With two or more employers at the same time within the calendar year)
[If successive, enter previous employer(s); if concurrent, enter secondary employer(s)]
Previous and Concurrent Employments During the Calendar Year
TIN Name of Employer/s
24 Declaration
I declare, under the penalties of perjury, that this form 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, and the regulations issued under authority thereof.
Attachments Complete?
EMPLOYER / AUTHORIZED AGENT Title / Position of Signatory (To be filled up by BIR)
(Signature over printed Name) Yes No
ATTACHMENTS: (Photocopy only)
For Individuals Earning Purely Compensation Income
- Birth Certificate or any valid identification card of applicant showing complete name, address, birth date and signature (Driver's license, PRC ID or passport)
- Marriage Contract, if applcable
- Waiver of husband to claim additional exemption , if applicable
- Birth Certificate/s of dependent/s, if applicable
- Employment Certificate or valid company ID with picture and signature, if available
POSSESSION OF MORE THAN ONE TAXPAYER IDENTIFICATION NUMBER (TIN) IS CRIMINALLY PUNISHABLE PURSUANT
TO THE PROVISIONS OF THE NATIONAL INTERNAL REVENUE CODE OF 1997, AS AMENDED. MCGP