Application Form BIR 1916

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Republika ng Pilipinas TAX PRACTITIONER’S APPLICATION BIR Form No.

Kagawaran ng Pananalapi
Kawanihan ng Rentas Internas
FOR ACCREDITATION
(INDIVIDUAL)
1916
January 2000

1. TAXPAYER IDENTIFICATION NUMBER 2. PRIVILEGE TAX RECEIPT NUMBER 3. DATE OF APPLICATION

268 744 860 000 4733180 10012019


(MM/DD/YYYY)
4. NAME 5. CITIZENSHIP
RODEL RYAN L. YANA FILIPINO
6. BUSINESS ADDRESS 7. TELEPHONE NUMBER
STA. CRUZ, CALAPE, BOHOL 09222036670
8. FAX NUMBER
NONE
9. EDUCATIONAL ATTAINMENT
EDUCATIONAL NAME OF DEGREE/UNITS DATE GRADUATED
COURSE SCHOOL / COLLEGE / UNIVERSITY RECEIVED OR LAST ATTENDED

COLLEGE HOLY NAME UNIVERSITY BACHELOR OF SCIENCE


IN ACCOUNTANCY 10/14/20077

POST GRADUATE N/A

MASTERS N/A
10. EXAMINATIONS TAKEN/PASSED CERTIFICATE/ROLL NUMBER DATE PLACE
X BOARD 0123949 06/13/2008 MANILA
BAR

OTHERS (Specify) _________________

11. PROFESSIONAL PRACTICE


INCLUSIVE DATES NATURE OF PRACTICE PLACE OF PRACTICE
FROM TO

JULY 2016 PRESENT PUBLIC PRACTICE CALAPE, BOHOL


JULY 2013 JUNE 2016 ACCOUNTING ASSISTANT - D.B. EBOJO & ASSOCIATES TAGBILARAN CITY, BOHOL

JUNE 2010 JULY 2011 FINANCE EXECUTIVE - INTER HORIZON CORPORATION PTE. LTD. SINGAPORE
(ATTACH SEPARATE SHEET IF NECESSARY)
12. SEMINARS OR TRAINING IN TAXATION
TITLE NO. OF HOURS PERIOD COVERED CONDUCTED BY
TAXATION FOR SMALL BUSINESSES - BIR REGISTRATION
AND BIR FORMS 1.5 05/07/2019 ACCELERA

ESTATE AND DONOR'S TAX - PART 3 1.5 05/07/2019 ACCELERA

ESTATE AND DONOR'S TAX - PART 2 1.5 05/07/2019 ACCELERA


13. MEMBERSHIP IN PROFESSIONAL ORGANIZATION

PHILIPPINE INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS (PICPA)

14. CHARACTER REFERENCES:


NAME ADDRESS

MAYOR NELSON N. YU STA. CRUZ, CALAPE, BOHOL

ARCH. GERMADELO T. CINCHES UBUJAN, TAGBILARAN CITY, BOHOL

DWIGHT B. EBOJO, CPA POBLACION, DAUIS, BOHOL


15. Have you been convicted of any crime? If yes, what crime?
Yes X No

I DECLARE, UNDER THE PENALTIES OF PERJURY, THAT THIS APPLICATION STAMP OF BIR RECEIVING OFFICE
HAS BEEN MADE IN GOOD FAITH, VERIFIED BY ME, AND TO THE BEST OF MY AND DATE OF RECEIPT
KNOWLEDGE AND BELIEF, IS TRUE AND CORRECT, PURSUANT TO THE PROVISIONS
OF THE NATIONAL INTERNAL REVENUE CODE OF 1997, AND THE REGULATIONS
ISSUED UNDER AUTHORITY THEREOF.

10/01/2019
_______________
RODEL RYAN L. YANA
_______________________________________
DATE SIGNATURE OF APPLICANT
OVER PRINTED NAME
ATTACHMENTS : (SEE BACK PAGE)
ATTACHMENTS REQUIRED :
A. DOCUMENTARY EVIDENCE SUPPORTING ACADEMIC QUALIFICATION
B. CERTIFICATE OF REGISTRATION AND CURRENT LICENSE WITH PRC, SUPREME COURT OR OTHER REGULATORY BODIES
C. CERTIFICATE OF MEMBERSHIP WITH THE PERTINENT PROFESSIONAL ORGANIZATION
D. CERTIFICATE OF GOOD MORAL CHARACTER ISSUED BY 2 DISINTERESTED PERSONS, WHO ARE EITHER
MEMBER OF THE BAR OR CPA IN GOOD STANDING

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