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(To be filled-up by the BIR) DLN: Application for …

(To be filled -up by the BIR)DLN:Fill in all appropriate white spaces. Mark all appropriate boxes with an X . Part ITaxpayer Information1 Taxpayer Type Single ProprietorshipEstate2 Registering OfficeHead Office3 Date of Registration ProfessionalTrustBranch Office 4 Taxpayer Identification Code6 SexMale (For taxpayers with existing TIN(To be filled up by BIR)Female or applying for a branch)7 Taxpayer's Name8 Citizenship9 Date of Birth/ Organization Date(Estates/ Trusts) ( MM / DD / YYYY )Last Name First Name Middle Name 10 Residence Address (Please indicate complete address)11 Zip Code12 Telephone Number13 Business Address (Please indicate complete address)14 Zip Code15 Municipality Code16 Telepho

(To be filled-up by the BIR) DLN: Fill in all appropriate white spaces. Mark all appropriate boxes with an “X”. Part I Taxpayer Information 1 Taxpayer Type Single Proprietorship Estate 2 Registering Office Head Office 3 Date of Registration

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