Republic of the Philippines

For BIR BCS/ Department of Finance

Use Only Item: Bureau of Internal Revenue

BIR Form No.

Annual Income Tax Return
1700 Individuals Earning Purely Compensation Income
(Including Non-Business/Non-Profession Income)
January 2018 (ENCS) Enter all required information in CAPITAL LETTERS using BLACK ink. Mark applicable boxes
Page 1
with an “X”. Three (3) copies must be filed: two (2) copies for BIR and one copy for the taxpayer. 1700 01/18ENCS P1
1 For the Year (YYYY) 2 Amended Return? Yes No 3 Alphanumeric Tax Code (ATC) I I 0 1 1
Part I – Background Information on Taxpayer/Filer
4 Taxpayer Identification Number (TIN) 5 RDO Code 6 Taxpayer Type
- - - 0 0 0 0 0 Employee
(Regular Rates)
NRANETB*
(25%)
7 Taxpayer’s Name (Last Name, First Name, Middle Name)

8 Registered Address (Indicate complete address. If the registered address is different from the current address, go to the RDO to update registered address by using BIR Form No. 1905)

8A ZIP Code
9 Date of Birth (MM/DD/YYYY) 10 Email Address

11 Citizenship 12 Claiming Foreign Tax Credits? 13 Foreign Tax Number, if applicable

Yes No
14 Contact Number (Landline/Cellphone No.) 15 Civil Status
Single Married Legally Separated Widow/er

16 If married, spouse has income? Yes No 17 Filing Status Joint Filing Separate Filing

Part II – Background Information on Spouse

18 Spouse’s TIN 19 RDO Code 20 Taxpayer Type
- - - 0 0 0 0 0 Employee
(Regular Rates)
NRANETB*
(25%)
21 Spouse’s Name (Last Name, First Name, Middle Name)

22 Contact Number 23 Citizenship

24 Claiming Foreign Tax Credits? Yes No 25 Foreign Tax Number
(if applicable)

Part III – Total Tax Payable (DO NOT enter Centavos; 49 Centavos or Less drop down; 50 or more round up)
Particulars A) Taxpayer/Filer B) Spouse
26 Tax Due (Either from Part V.A Item 47A/B OR Part V.B 53A/B)
27 Less: Total Tax Credits/Payments (From Part V.C Item 58A/B)
28 Net Tax Payable/(Overpayment) (Item 26 Less Item 27) (From Part V Item 59A/B)
29 Less: Portion of Tax Payable Allowed for 2nd Installment to be paid on or before October 15
(50% or less of Item 26) (applicable only to employee subject to regular IT rates)
30 Amount of Tax Payable/(Overpayment) (Item 28 Less Item 29)
Add: Penalties 31 Surcharge
32 Interest
33 Compromise
34 Total Penalties (Sum of Items 31 to 33)
35 Total Amount Payable/(Overpayment) (Sum of Items 30 and 34)
36 Aggregate Amount Payable/(Overpayment) (Sum of Items 35A and 35B)
I declare under the penalties of perjury that this return, and all its attachments, have been made in good faith, verified by me, and to the best of my knowledge and belief, are true and correct,
pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof. Further, I give my consent to the processing of my information as
contemplated under the **Data Privacy Act of 2012 (R.A. No. 10173) for legitimate and lawful purposes. (If signed by an Authorized Representative, indicate TIN and attach authorization letter)

37 Number of Attachments

Printed Name and Signature of Taxpayer/Authorized Representative

Part IV - Details of Payment
Particulars Drawee Bank/Agency Number Date (MM/DD/YYYY) Amount
38 Cash/Bank Debit Memo

39 Check

40 Tax Debit Memo

41 Others (specify below)

Machine Validation/Revenue Official Receipt Details [if not filed with an Authorized Agent Bank (AAB)] Stamp of Receiving Office/AAB and Date of Receipt
(RO’s Signature/Bank Teller’s Initial)

NOTE: * Non-Resident Alien Not Engaged in Trade or Business

** The BIR Data Privacy Policy is in the BIR website (www.bir.gov.ph)
 BIR Form No.

1700 Annual Income Tax Return

Individuals Earning Purely Compensation Income
January 2018 (ENCS) (Including Non-Business/Non-Profession Income)
Page 2 1700 01/18ENCS P2
TIN Taxpayer’s Last Name
0 0 0 0 0
Part V – Computation of Tax
If subject to graduated rates, fill in items 42 to 47; if subject to 25%, fill in items 48 to 53 ( DO NOT enter Centavos; 49 Centavos or Less drop down; 50 or more round up)
Part V.A – Subject to Graduated Rates A) Taxpayer/Filer B) Spouse
42 Gross Compensation Income (From Schedule 1 Item 5Ac/5Bc)
43 Less: Non-Taxable / Exempt Compensation
44 Gross Taxable Compensation Income (Item 42 Less Item 43)

45 Add: Other Taxable Non-Business/Non-Profession Income (specify) ____________________

46 Total Taxable Income (Sum of Items 44 and 45)

47 Tax Due [Item 46 x Applicable Income Tax Rate (refer to tax table below)] (To Part III Item 26)
Part V.B – Subject to 25% Flat Rate for NRANETB
48 Gross Compensation Income (From Schedule 1 Item 5Ad/5Bd)

49 Less: Non-Taxable/Exempt Compensation (please specify) _________________________________

50 Gross Taxable Compensation Income (Item 48 Less Item 49)

51 Add: Other Taxable Income (please specify) _____________________________________________

52 Total Taxable Income (Sum of Items 50 and 51)

53 Tax Due (Item 52 x 25% Flat Rate) (To Part III Item 26)
Part V.C - Tax Credits/Payments (attach proof)
54 Tax Withheld per BIR Form No. 2316, if applicable (From Schedule 1 Item 5Ae/5Be)

55 Tax Paid in Return Previously Filed, if this is an Amended Return

56 Foreign Tax Credits, if applicable

57 Other Tax Credits/Payments (specify) _______________________________________

58 Total Tax Credits/Payments (Sum of Items 54 to 57) (To Part III Item 27)

59 Net Tax Payable/(Overpayment) (Either Item 47 OR Item 53 Less Item 58) (To Part III Item 28)

Part VI - Schedule
Schedule 1 – Gross Compensation Income and Tax Withheld (Attach Additional Sheet/s, if necessary)
Gross Compensation Income and Tax Withheld (On Items 1, 2, 3 and 4, enter the required information for each of your employer/s and mark (X) whether the information is for the Taxpayer or the Spouse (should be separate item nos.
even if both have the same employer). On Item 5A, enter the Total Gross Compensation and Total Tax Withheld for the Taxpayer and on Item 5B, for the Spouse. (DO NOT enter Centavos; 49 Centavos or Less drop down; 50 or more round up)
a. Name of Employer

Taxpayer
1 Spouse
b. Employer’s TIN

Taxpayer
2 Spouse
b. Employer’s TIN

Taxpayer
3 Spouse
b. Employer’s TIN

Taxpayer
4 Spouse
b. Employer’s TIN

Continuation of Schedule 1 (Enter the amount of compensation and tax c. Compensation Income Subject d. Compensation Income
e. Tax Withheld
withheld corresponding to the above employer ) to Regular/Graduated Rates Subject to 25% Flat Rate

5A Gross Compensation Income and Total Tax Withheld for

TAXPAYER (To Part V Items 42A/48A and 54A)
5B Gross Compensation Income and Total Tax Withheld for
SPOUSE (To Part V Items 42B/48B and 54B)
TABLE 1 – Tax Rates (effective January 1, 2018 to December 31, 2022) TABLE 2 – Tax Rates (effective January 1, 2023 and onwards)
If Taxable Income is: Tax Due is: If Taxable Income is: Tax Due is:
Not over P 250,000 0% Not over P 250,000 0%
Over P 250,000 but not over P 400,000 20% of the excess over P 250,000 Over P 250,000 but not over P 400,000 15% of the excess over P 250,000
Over P 400,000 but not over P 800,000 P 30,000 + 25% of the excess over P 400,000 Over P 400,000 but not over P 800,000 P 22,500 + 20% of the excess over P 400,000
Over P 800,000 but not over P 2,000,000 P 130,000 + 30% of the excess over P 800,000 Over P 800,000 but not over P 2,000,000 P 102,500 + 25% of the excess over P 800,000
Over P 2,000,000 but not over P 8,000,000 P 490,000 + 32% of the excess over P 2,000,000 Over P 2,000,000 but not over P 8,000,000 P 402,500 + 30% of the excess over P 2,000,000
Over P 8,000,000 P 2,410,000 + 35% of the excess over P 8,000,000 Over P 8,000,000 P 2,202,500 + 35% of the excess over P 8,000,000
 PMRF
PHILHEALTH MEMBER REGISTRATION FORM
UHC v.1 January 2020

REMINDERS:
PHILHEALTH IDENTIFICATION NUMBER (PIN)
1. Your PhilHealth Identification Number (PIN) is your unique and permanent
PURPOSE:
number.
2. Always use your PIN in all transactions with PhilHealth. REGISTRATION UPDATING/AMENDMENT
3. For Updating/Amendment check the appropriate box and provide details to Preferred KonSulTa Provider
be accomplished and submit corresponding supporting documents.
4. Please read instructions at the back before filling-out this form.

I. PERSONAL DETAILS
NAME NO
MIDDLE MONONYM
LAST NAME FIRST NAME EXTENSION MIDDLE NAME NA ME
(Jr./Sr./III)
(Check i f app li cable onl y)

MEMBER
MOTHER’s
MAIDEN NAME
SPOUSE
(If Married)

DATE OF BIRTH PLACE OF BIRTH (City/Municipality/Province/Country)

(Please indicate country if born outside the Philippines) PHILSYS ID NUMBER (Optional)

m m d d y y y y
SEX CIVIL STATUS CITIZENSHIP TAX PAYE R IDE NTIFICATION NUMBER (TIN) (Optional)
Male Single Annulled FILIPINO FOREIGN NATIONAL
Female Married Widow/er
Legally Separated
DUAL CITIZEN

II. ADDRESS and CONTACT DETAILS

PERMANENT HOME ADDRESS Hom e Phone Number
Unit/Room No./Floor Building Name Lot/Block/Phase/House Number Street Name

(COUN TRY C OD E + AR EA CODE + TEL EPHONE NUM BER)

Subdivision Baranga y Municipality/City Province/Sta te/Country (If abroad) ZIP Code
Mobile Number (Required)

MAILING ADDRESS SAME AS ABOVE

Unit/Room No./Floor Building Name Lot/Block/Phase/House Number Street Name Bus iness (Direct Line)

Subdivision Baranga y Municipality/City Province/Sta te/Country (If abroad) ZIP Code E-mail Address (Required for OFW)

III. DECLARATION OF DEPENDENTS (Use additional form if necess ary )

DATE OF NO Chec k if
NA ME MIDDLE MONONYM
BIRT H with
LAST NAME FIRST NAME EXTENSION
(Jr./Sr./III)
MIDDLE NAME RELATIONSHIP
(mm-dd-yyyy)
CITIZENSHIP NA ME Per manent
Disa bility
(Check i f app li cable onl y)

IV. MEMBER TYPE

DIRECT CONTRIBUTOR INDIRECT CONTRIBUTOR
Employed Private Kasambahay Family Driver
Listahanan LGU-sponsored
Employed Government Migrant Worker
4Ps/MCCT NGA-sponsored
Professional Practitioner Land-Based Sea-Based
Senior Citizen Private-sponsored
Self-Earning Individual Lifetime Member
Filipinos with Dual Citizenship / Living Abroad PAMANA Person with Disability
Individual
KIA/KIPO PWD ID No. ______________
Sole Proprietor Foreign National
Group Enrollment Scheme PRA SRRV No. _____________________ Bangsamoro/Normalization
____________________ ACR I-Card No. _____________________
For PhilHealth Use only:
PROFESSION: (Except Employed, Lifetime Members and MONTHLY INCOME: PROOF OF INCOME: Point of Service (POS) Financially Incapable
Sea-based Migrant Worker)
Financially Incapable

This form ma y be reproduce d and is not f or sale Continue at the bac k

 HQP-PFF-039
(V08, 11/2020)
FOR Pag-IBIG Fund USE ONLY

MEMBER’S DATA FORM Pag-IBIG MID NUMBER

(MDF) REGISTRATION TRACKING NUMBER

INSTRUCTIONS
1. Accomplish this form in one (1) copy only. If registration is thru online, the form 6. Indicate the full name of your FATHER and MOTHER as they appear in your birth certificate.
should be printed back to back on a single sheet of paper. 7. On the “OCCUPATION” portion, indicate your job, profession, or type of work to earn a living.
2. Type or print all entries in BLOCK or CAPITAL LETTERS. 8. On the “HEIRS” portion, the provision on the Laws on Succession, under the New Civil Code,
3. All fields marked with asterisk (*) are mandatory. shall be observed.
4. On the “OCCUPATIONAL STATUS” portion, if not employed or purpose is 9. For any subsequent change of information, please secure and accomplish Member’s Change
pre-employment, select “UNEMPLOYED/NOT YET EMPLOYED”. of Information Form (MCIF, HQP-PFF-049) and submit to any Pag-IBIG Branch nearest you.
5. The “NAME EXTENSION” shall refer to JR., II, III and the like.

*OCCUPATIONAL STATUS  EMPLOYED  UNEMPLOYED/NOT YET EMPLOYED

 CHECK THIS BOX IF FIRST TIME JOB SEEKER
*MEMBERSHIP CATEGORY
MANDATORY VOLUNTARY
 EMPLOYED (PRIVATE)  SELF-EMPLOYED  EMPLOYED (FOREIGN GOVERNMENT)  MEMBER OF COOPERATIVE/
 EMPLOYED (GOVERNMENT)  PROFESSIONAL/BUSSINESS OWNER  BARANGAY OFFICIAL/EMPLOYEE TRADE UNION
 EMPLOYED PRIVATE HOUSEHOLD  JOB ORDER PERSONNEL  NON-WORKING SPOUSE  OVERSEAS FILIPINO IMMIGRANT
 OVERSEAS FILIPINO  OTHER EARNING GROUP (OEGs)  MEMBER OF RELIGIOUS GROUP  OTHERS, Please specify
WORKER (OFW)  PENSIONER/INVESTOR/LESSOR __________________________
PERSONAL DETAILS

NAME NAME EXTENSION NO MIDDLE NAME

LAST NAME FIRST NAME MIDDLE NAME
(e.g. Jr., II) (check if applicable only)

*MEMBER 

FATHER 

*MOTHER (Maiden Name) 

*SPOUSE (If Married) 

MEMBER’S NAME AS APPEARING IN
THE BIRTH CERTIFICATE 
*DATE OF BIRTH *MARITAL STATUS TAXPAYER IDENTIFICATION NUMBER (TIN)
 Single/Unmarried  Widow/er  Annulled
m m d d y y y y  Married  Legally Separated
*PLACE OF BIRTH (City/Municipality/Province/Country) *CITIZENSHIP SSS/GSIS NUMBER
(Please indicate country if born outside the Philippines)

EMPLOYEE NUMBER
*SEX HEIGHT WEIGHT PROMINENT DISTINGUISHING FACIAL FEATURES
 Male (Ex. Moles, Scars, etc.)
 Female ______ (cm) ______ (kg) For AFP/PNP Employee, Serial/Badge No.

COMMON REFERENCE NUMBER (CRN) FREQUENCY OF MEMBERSHIP SAVINGS (MS)

(If Available) PAYMENT (If payment of MS is not thru payroll deduction) For DepEd Employee, Division Code-Station Code
 Monthly  Semi-Annually
 Quarterly  Annually
ADDRESS AND CONTACT DETAILS
*PERMANENT HOME ADDRESS (Indicate country code if abroad)
Unit/Room No., Floor Building Name Lot No., Block No., Phase No. House No Street Name COUNTRY + AREA CODE TELEPHONE NUMBER
Home
Subdivision Barangay Municipality/City Province/State/Country (if abroad) ZIP Code
Cell Phone

*PRESENT HOME ADDRESS

Unit/Room No., Floor Building Name Lot No., Block No., Phase No. House No Street Name Business (Direct Line)

Subdivision Barangay Municipality/City Province/State/Country (if abroad) ZIP Code Business (Trunk Line) Local

Email Address
*PREFERRED MAILING ADDRESS
 Present Home Address  Permanent Home Address  Employer/Business Address
THIS FORM MAY BE REPRODUCED. NOT FOR SALE.
 HQP-PFF-039
(V08, 11/2020)

PRESENT EMPLOYMENT DETAILS (If with more than one (1) employer, use separate sheet and follow format below)
*OCCUPATION EMPLOYMENT STATUS TYPE OF WORK (For OFW only)
(Pls. specify country of assignment)
 Permanent/Regular  Contractual  Part-time/
 Casual  Project-based Temporary
 Land-based __________________________
 Sea-based __________________________
*EMPLOYER/BUSINESS NAME MONTHLY INCOME
Basic
+
*EMPLOYER/BUSINESS ADDRESS Allowances/Others
Unit/Room No., Floor Building Name Lot No., Block No., Phase No. House No. =
Total Mo. Income
Street Name Subdivision Barangay OFFICE ASSIGNMENT
 Head Office  Branch ____________
Municipality/City Province State/Country (If abroad) ZIP Code DATE EMPLOYED (Month, Year)

PREVIOUS EMPLOYMENT FROM DATE OF Pag-IBIG Fund MEMBERSHIP (Use another sheet if necessary)
EMPLOYER/BUSINESS NAME OFFICE ASSIGNMENT
 Head Office  Branch ____________
EMPLOYER/BUSINESS ADDRESS FROM TO

m m y y y y m m y y y y
EMPLOYER/BUSINESS NAME OFFICE ASSIGNMENT
 Head Office  Branch ____________
EMPLOYER/BUSINESS ADDRESS FROM TO

m m y y y y m m y y y y
EMPLOYER/BUSINESS NAME OFFICE ASSIGNMENT
 Head Office  Branch ____________
EMPLOYER/BUSINESS ADDRESS FROM TO

m m y y y y m m y y y y

HEIRS (In case of death, Fund benefits shall be divided among the member’s heirs in accordance with the Rules of Succession under the New Civil Code, as amended) (Use another sheet if necessary)

NAME NO MIDDLE NAME

LAST NAME FIRST NAME MIDDLE NAME RELATIONSHIP DATE OF BIRTH
EXTENSION (Check only if applicable)


m m d d y y y y


m m d d y y y y


m m d d y y y y


m m d d y y y y

CERTIFICATION
I hereby certify that the information given, and all statements made herein are true and correct. Likewise, I hereby authorize Pag-IBIG Fund to collect
record, organize, update/modify, consult, use, consolidate, block, erase or destruct my personal data as part of my information. I hereby affirm my
right to: (a) be informed; (b) object to processing; (c) access; (d) rectify, suspend or withdraw my personal data; (e) damages; and (f) data portability
pursuant to the provision of R.A. No. 10173 (Data Privacy Act of 2012).

______________________________________ _________________
SIGNATURE OF INFORMANT DATE

FOR Pag-IBIG FUND USE ONLY

RECEIVED BY DATE

_________________________________ ________________________ ____________________

Signature over Printed Name Designation/Position Branch/Unit

DISCLAIMER
Membership registration with the Fund does not automatically qualify a Pag-IBIG member to avail of the Fund’s various loan programs. A Pag-IBIG
member must satisfy the eligibility requirements and comply with the documentary requirements, which is subject to verification and approval.

GUIDE IN ACCOMPLISHING MEMBER’S DATA FORM (MDF)
FRONT
Submit MDF in one (1) copy and observe the following:
 Mandatory Coverage
1 Pag-IBIG Membership ID (MID) Number - a unique 12-
digit number series assigned to a registered member. To
be accomplished by Pag-IBIG Fund.
2 Registration Tracking Number (RTN) - refers to
system-generated number issued after completion of
online registration.
3 Instructions - refers to quick guide in accomplishing the
MDF.
4 Occupational Status - check the appropriate box to
indicate working status of a person either employed,
unemployed or not yet employed (for first time job
seeker).
5 Membership Category - check the appropriate box to
indicate type of membership coverage as defined under
R.A. 9679.
ANNEX A
BACK
a. Employed (Private) - any person in service of a
private employer and who receives compensation
for such services rendered, may or may not be
registered yet with the Social Security System
(SSS); will also include the following:
- Employees of foreign-based employers with an
administrative agreement with the Fund
b. Employed (Government) - any person in service of
any of the government offices that are coverable by
the GSIS; will also include the following:
- Uniformed personnel of the Armed Forces of the
Philippines, Philippine National Police, Bureau of
Fire Protection, Bureau of Jail Management and
Penology
- Members of the Judiciary and Constitutional
Commissions
c. Overseas Filipino Worker (OFW) - any person
working for a foreign-based employer, whether
deployed or for deployment abroad, or a
combination of local and overseas deployment,
whether based on land or at sea.
d. Self-employed (SE) - any person not over sixty
(60) years old, who is practicing his/her profession,
or engaged in any trade, business or occupation,
with monthly average income/ earnings of at least
P1,000 and is not under an employer-employee
relationship.
Professional/Business Owner - refers to
individual that earns income through conducting
profitable operations from a trade or business that
he operates directly.
Job Order Personnel - refers to hired workers for
a piece of work or intermittent job of short duration
not exceeding six (6) months and is paid on a daily
or hourly basis and has no employee-employer
relationship.
Other Earning Group (OEGs) - this refers to small
scale units engaged in the production of goods and
services with the primary objective of generating
employment and income to the person concerned
in order to earn a living.
- Public Utility Transport Driver
- Market Vendor
- Farmer
- Fisher Folk
- Others (Other similar self-employed individuals)
 Voluntary Coverage
a. Employed (Foreign Government) - refers to
employee of foreign government
(embassies/consulates) or international
organizations without an administrative agreement
with the Fund.
b. Barangay Official/Employee - refers to any
person in authority in their jurisdictions, or who may
be designated by law or ordinance and charged
with the maintenance of public order, protection
and security of life and property, or the
maintenance of a desirable and balanced
environment, or who comes to the aid of persons in
authority.
c. Non-Working Spouse - refers to a spouse who
devotes full time to managing the household and
family affairs.
d. Member of Religious Group - refers to individual,
head or leader of any organization in the exercise
of religious belief.
e. Pensioner - any person receiving old-age or
permanent total disability pension or any person
who has received the lump sum excluding one
receiving survivorship pension benefits; or
Investor - the owner of investor securities or
investor share where investor securities or shares
mean shares of stock issued by a Real Estate
Investment Trust (REIT) or derivatives thereof; or
Lessor - shall include the owner or administrator or
agent of the owner of the residential unit.
f. Member of Cooperative - a member of an
autonomous and duly registered association of
persons, with a common bond of interest, who have
voluntarily joined together to achieve their social,
economic, and cultural needs and aspirations by
making equitable contributions to the capital
required, patronizing their products and services
and accepting a fair share of the risks and benefits
of the undertaking in accordance with the
universally accepted cooperative principles; or
Member of Trade Union - a member of an
organization whose membership consists of
workers and union leaders, united to protect and
promote their common interest.
g. Overseas Filipino Immigrant - refers to a person
of Filipino origin who lives out of the Philippines as
citizen or as permanent resident of a different
country.
6 Member’s Name - this portion shall be accomplished in
the following order:
 Last Name - refers to the family name or surname.
 First Name - refers to the given name.
 Name Extension - refers to Jr., II, III and the like.
 Middle Name - refers to registrant’s mother’s maiden
last name or for married women, refers to father’s last
name.
 No Middle Name - this portion shall be checked if
informant is not using a middle name, such as the
Chinese.
7 Father’s Name Please refer to item
no. 6 in accomplishing
8 Mother’s Name (Maiden Name) Last Name, First
Name, Name
9 Spouse’ Name Extension, and Middle
Name
10 Member’s Name as Appearing in the Birth Certificate
- indicate Member’s name based on Birth Certificate.
11 Date of Birth - indicate date of birth in the following
format: mm/dd/yyyy
Example: If born on January 14, 1980, please write 01
14 1980.
12 Place of Birth - indicate the City/Municipality/
Province/Country where the registrant was born. Specify
only the country if born outside the Philippines.
13 Sex - check the appropriate box.
14 Height - indicate height in centimeters (cm).
Conversion: 1 foot = 30.48 cm
1 inch = 2.54 cm
Example: 5’3” = 160.02 cm
15 Weight - indicate weight in kilograms (kg).
Conversion: 1 pound (lb) = 0.4536 kilogram
Example: 120 lbs = 54.43 kg
16 Common Reference Number (CRN) - indicate if
available.
17 Marital Status - check the appropriate box.
18 Citizenship - indicate your nationality.
19 Prominent Distinguishing Facial Features - indicate
your distinguishing features that can be found on the
face such as “mole under the right eye” or “mole or birth
mark on the left cheek/forehead”.
20 Frequency of Membership Savings (MS) Payment -
check appropriate box if payment of MS is not thru
payroll deduction.
21 Taxpayer Identification Number (TIN) - indicate your
9-digit TIN issued by the Bureau of Internal Revenue
(BIR).
22 SSS/GSIS Number - for private employees, indicate
your 10-digit Social Security Number, and for
government employees, indicate your 11-digit Business
Partner Number.
23 Employee Number - refers to your company ID number.
 For AFP/PNP Employee, indicate Serial/Badge No.
 For DepEd Employee, aside from Employee Number,
indicate Division Code-Station Code
24 Permanent Home Address - indicate the address of
your permanent residence.
25 Present Home Address - indicate the address where
you currently reside, and the state/country only if present
address is outside the Philippines.
26 Preferred Mailing Address - check the appropriate box
to indicate your chosen address to receive mail.
27 Contact Numbers - indicate the country and area code
only if outside Metro Manila or based abroad.
28 Occupation - indicate your job, profession, or type of
work to earn a living.
For Other Working Group (OWG)/Informal Sector, select
from the following:
- Public Utility Transport Driver
- Market Vendor
- Farmer
- Fisher Folk
- Others (Other workers in the informal sector)
29 Employment Status - check the appropriate box.
30 Employer/Business Name - indicate complete
Employer/Business Name appearing in the registration
certificate or employment contract (applicable for
Formally Employed, OFW and Self-employed
Professional/Business Owner).
31 Employer/Business Address - indicate complete
Employer/Business Address appearing in the
registration certificate or employment contract
(applicable for Formally Employed, OFW and Self-
employed Professional/Business Owner).
32 Type of Work - check the appropriate box (applicable
for OFW only).
33 Monthly Income - indicate your income or earning per
month.
34 Office Assignment - check the appropriate box to
indicate whether assigned to Head Office or a particular
Branch.
35 Date Employed - indicate inclusive date of employment
under current employer.
36 Previous Employment From Date of Pag-IBIG
Membership - indicate details of your previous
employment.
37 Heirs - indicate your legal heir/s in accordance with the
Laws of Succession, as provided in the New Civil Code
of the Philippines, as amended.
38 Certification - affix your signature and indicate the date
when the MDF was accomplished.
39 Acknowledgement - to be accomplished by Pag-IBIG
Fund.
 APPLICATION FOR REGISTRATION AS
BARANGAY MICRO BUSINESS ENTERPRISE (BMBE)

BMBE Form 01
Date Application Filed :___________
Application No._________________

New Renewal ________________________________________

Certificate No. ___________ Name of Business Enterprise
Date Registered: __________ (DTI Business Name/ SEC Registered Name)
DTI Business Name /SEC Registration No/CDA Registration No._____________

Name of Owner (if Sole Proprietor)

Male Female
(Last Name) (First Name) (Middle Name)

Business _____ (House/Bldg. No.) ______________________________ (Bldg. Name) Telephone No.

Address ___________ (Unit No.) ____________________________ (Street) Mobile No.
_________________ (Barangay) ________________ (Subdivision) Fax No
_______________ (City/Municipality) ______________ (Province) Email
Branches (if any) _______________________________________________
Type of Business Organization
Single Proprietorship Partnership Corporation Cooperative
Association Others_______________________
Status of Business
New Existing
Principal Business Activity
Production Processing Manufacturing Trading
Services (Excluding those rendered by anyone who is Others______________
duly licensed by the government after having passed a
government licensure examination in connection with the
exercise of one’s profession)
Product Lines/Services
Other Businesses if any
 Yes No If yes, how many? ____________________________________
Total Assets (To the nearest Thousand Pesos excluding the value of the land on
which the business entity’s office, plant and equipment are located) Php
Total Number of Employees No. of Males: No. of Females:
Regular: Irregular/Part-time:
UNDERTAKING

I/We hereby declare, for purposes of Section 5 of RA 9178, that all information, including the business enterprise’s asset
size, supplied in this application which shall be the basis of assessing my eligibility for registering as BMBE are true and
correct to the best of my belief and knowledge. Any false or misleading information supplied, and/or production of
materially false or misleading document to support this application shall be ground for disapproval of BMBE
application/revocation of BMBE Certificate of Authority as well as ground for criminal, civil and/or administrative action
against our enterprise. I affirm under the penalties of perjury, that this declaration has been made in good faith.

I/We undertake to advise the Department of Trade and Industry through the Negosyo Center of any change in the status of
its ownership structure and shall surrender the original copy of the BMBE Certificate of Authority for notation of the
transfer.

Applicant’s/Authorized Representative’s Signature

Over Printed Name
 S.E.C. FORM NO. F-106
For registered partnership
to have foreign equity

APPLICATION OF AN EXISTING
PARTNERSHIP TO DO BUSINESS UNDER THE
FOREIGN INVESTMENTS ACT OF 1991

___________________________________________________________
(Name of Partnership)

hereby applies for authority to do business under the Foreign

Investments Act of 1991 (RA 7042, as amended) and submits the
following statements and accompanying documents:

1. That the applicant is a partnership registered with this

Commission with SEC Reg. No. ______________________ issued on
_________________________ and intends to operate a

( ) domestic market enterprise *

( ) export market enterprise **

2. That the purpose(s) of said company is ____________________

______________________________________________________________________________________________
______________________________________________________________________________________________
_______________________________________________________________________________________
__________________________________________________________________________________________
(Please use additional sheet if necessary)

3. That the business address of the corporation is in

________________________________________________________________________
(specific address)

4. That the present capital of the applicant is

____________________________________________ (P __________________ ).

* domestic market enterprise - an enterprise which produces goods for sale, or renders services or otherwise
engages in any business in the Philippines. This requires minimum contributed capital equivalent of
US$200,000.00

** export market enterprise - an enterprise wherein a manufacturer, processor or service (including tourism)
enterprise exports sixty percent (60%) or more of its output, or wherein a trader purchases products
domestically or exports sixty percent (60%) or more of such purchases. Minimum contributed capital
required is P3,000.00

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 5. That the partnership shall have a foreign equity of
___________________________ per cent ( ________%) which shall be
undertaken through:

( ) Admission of non-Philippine national as partner

( ) Assignment of Filipino partnership interest to non-Philippine national

( ) Others _______________________________________________________

6. That the applicant or its partner(s) who are

stockholders/partners of an existing corporation/partnership in the
Philippines which is engaged in the same line of business as that of the
applicant are as follows:
NO. OF
NAME OF CORPORATION/ PERCENTAGE OF DIRECTORS/
NAME PARTNERSHIP SHAREHOLDINGS PARTNERS
______________ __________________________ ________________ ____________
______________ __________________________ ________________ ____________
______________ ___________________________ ________________ ____________
______________ __________________________ ________________ ____________
______________ __________________________ ________________ ____________
(Please use additional sheet if necessary)

7. That as an export enterprise, the applicant undertakes to

export at least 60% of its total output as indicated hereunder and
commits to submit report of such export to the Board of Investments as
required by the Implementing Rules of RA 7042 as amended:

TOTAL PROJECTED DOMESTIC EXPORT EXPORT

YEAR PRODUCTS SALES VOLUME/VALUE*** SALES SALES %
_____ _________ ______________________ __________ ________ _______
_____ _________ ______________________ __________ ________ _______
_____ _________ ______________________ __________ ________ _______
_____ _________ ______________________ __________ ________ _______
*** Please use value in case of products of different kinds and characteristics as well as to those
of the same kind but with various categories using different unit of measurement, volume in case
of products of the same kind or category using a common unit of measurement.

8. That we hereby authorize the Securities and Exchange

Commission and the Bangko Sentral ng Pilipinas to examine and verify
the deposit in the ______________________________ in the name of
(Name of the Bank)
_________________________________ of said corporation in the amount of
(Name of the Officer)

2
______________________________________________ which is equivalent to
______________________________ (P___________) at the current rate of
exchange, representing the actual remittance of the applicant. This
authority is valid and inspection of said deposit may be made even after
the issuance of the license of the company.

IN WITNESS WHEREOF, I, the authorized representative of the

applicant, hereby signed this application this ______ day of ____________,
200______ in ____________________________.

_________________________________
(Authorized Representative)
_________________________________
Position

SUBSCRIBED AND SWORN TO before me this ______ day of _________,

200___, affiant exhibiting to me his/her Community Tax Certificate No.
______________ issued at _____________________ on ____________________.

NOTARY PUBLIC

Doc. No. ____________;

Page No. ____________;
Book No. ____________;
Series of 200 ________.

NOTE:
 Only applications with complete supporting documents including proper
indorsements from appropriate government agencies shall be accepted.
 All documents executed abroad should be authenticated by the Philippine
Embassy or Consulate in the country where executed.
 Submit six (6) copies

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 V. UPDATING/AMENDMENT
Please check: FROM TO
Change/Correction of Name
(Last Name, First N ame, Name Extension (Jr./Sr./III) Middle Name)

Correction of Date of Birth

Correction of Sex

Change of Civil Status

Updating of Personal Information/Address/

Telephone Number/Mobile Number/e-mail
Address

FOR PHILHEALTH USE ONLY

Under penalty of law, I hereby attest that the information provided, including the documents I
have attached to this form, are true and accurate to the best of my knowledge. I agree and
authorize PhilHealth for the subsequent validation, verification and for other data sharing
RECEIVED BY:
purposes only under the following circumstances:

 As necessary for the proper execution of processes related to the legitimate and Full Name:
declared purpose;
 The use or disclosure is reasonably necessary, required or authorized by or under the ______________________________
law; and,
 Adequate security measures are employed to protect my information. PRO/LHIO/Branch:

_____________________________

Date & Time:

_________________________________________________ _________________
Member’s Signature over Printed Name Date Plea se affix right
______________________________
thumbmark if unable to write

INSTRUCTIONS

1. All information should be written in UPPER CASE/CAPITAL LETTERS. If the information is not applicable, write “N/A.”
2. All fields are mandatory unless indicated as optional. By affixing your signature, you certify the truthfulness and accuracy of all
information provided.
3. A properly accomplished PMRF shall be accompanied by a valid proof of identity for first time registrants, and supporting
documents to establish relationship between member and dependent/s for updating or request for amendment.
4. On the PURPOSE, check the appropriate box if for Registration or for Updating/Amendment of information.
5. Indicate preferred KonSulTa provider near the place of work or residence.
6. For PERSONAL DETAILS, all name entries should follow the format given below. Check the appropriate box if registrant has no
middle name and/or with single name (mononym).

LAST NAME FIRST NAME NAME EXTENSION (Jr./Sr./III) MIDDLE NAME

SANTOS JUAN ANDRES III DELA CRUZ

7. Indicate registrant’s/member’s name as it appears in the birth certificate.

8. The full mother’s maiden name of registrant/member must be indicated as it appears in the birth certificate.
9. Indicate the full name of spouse if registrant/member is married.
10. Indicate the complete permanent and mailing addresses and contact numbers.
11. For updating/amendment, check the appropriate box to be updated/amended and indicate the correct data.
12. For MEMBER TYPE, check the appropriate box which best describes your current membership status.
13. For Direct Contributors, except employed, sea-based migrant workers and lifetime members, indicate the profession, monthly
income and proof of income to be submitted.
14. For Self-earning individuals, Kasambahays and Family Drivers, indicate the actual monthly income in the space provided.
15. In declaring dependents, provide the full name of the living spouse, children below 21 years old, and parents who are 60 years old
and above totally dependent to the member.
16. Dependents with disability shall be registered as principal members in accordance with Republic Act 11228 on mandatory
PhilHealth coverage for all persons with disability (PWD).
17. The registrant must affix his/her signature over printed name (or right thumbmark if unable to write) and indicate the date when the
PMRF was signed.
General Partnership

ARTICLES OF PARTNERSHIP

OF

_________________________________________________________
(Partnership Name)

KNOW ALL MEN BY THESE PRESENTS:

That we, the undersigned partners, all of legal age, residents and citizens of the
Philippines, have on this day voluntarily associated ourselves together for the purpose of
forming a general partnership under the following terms and conditions and subject to existing
and applicable laws of the Republic of the Philippines:

AND WE HEREBY CERTIFY:

ARTICLE I. Partnership Name: That the name of this partnership shall

be

and shall transact business under the said company name.

ARTICLE II. Business Purpose: That the purpose/s for which this partnership is
formed is/are:

ARTICLE III. Principal Place of Business: That the principal place of business of this
partnership shall be located at :

….
(complete address)

ARTICLE IV. Term of Existence: That this partnership shall have a term of
_________ years from and after the original recording of its Articles of Partnership by the
Securities and Exchange Commission.
 Articles of Partnership

ARTICLE V. Partners’ Circumstances: That the names, nationalities and complete

residence addresses of the partners are as follows:

Name Nationality Complete Residence Address

ARTICLE VI. Capital Contributions: That the capital of this Partnership shall be the
amount of ____________ (P_________), Philippine Currency, contributed in cash by the
partners, as follows:

Name Amount Contributed

That no transfer of interest which will reduce the ownership of Filipino citizens to less
than the required percentage of capital as provided by existing laws shall be allowed or
permitted to be recorded in the proper books of the partnership.
ARTICLE VII. Sharing Ratios: That the profits and losses of this partnership shall be
divided and distributed proportionately on the ratio of the capital contribution of each partner.

ARTICLE IX. Management: That this partnership shall be under __________, as

General Manager, who shall be in charge of the management of the affairs of the company.
He shall have the power to use the partnership name and in otherwise performing such acts as
are necessary and expedient in the management of the firm and to carry out its lawful
purposes.

ARTICLE X. Undertaking to Change Name: That the partners undertake to change

the name of this partnership, as herein provided or as amended thereafter, immediately upon
receipt of notice or directive from the Securities and Exchange Commission that another
corporation, partnership or person has acquired a prior right to the use of that name or that the
name has been declared as misleading, deceptive, confusingly similar to a registered name, or
contrary to public morals, good customs or public policy.
 Articles of Partnership

IN WITNESS WHEREOF, we have hereunto affixed our signatures this ____ day of
______, 20___, at ________.

______________________ _______________________
(name of partner) (name of partner)
TIN TIN

______________________ _______________________
(name of partner) (name of partner)
TIN TIN

(Names and Signatures of the partners and TIN)

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES)

____________________________) S.S.

BEFORE ME, a Notary Public, for and in _________________, this ____day of

_________, 20___, personally appeared the following persons:

Name TIN/ID/Passport No. Date & Place Issued

known to me and to me known to be the same persons who executed the foregoing Articles of
Partnership constituting of _____pages, including this page where the acknowledgement is
written, and they acknowledged to me that the same is their free and voluntary act and deed.

WITNESS MY HAND AND SEAL on the date and place above written.

NOTARY PUBLIC
Doc. No. ______;
Page No. ______;
Book No. ______;
series of 20 ______.