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Request For Certificate of Tax Exemption 2023

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Republic of the Philippines

Department of Finance
BUREAU OF INTERNAL REVENUE
Revenue District Office No. 083
Talisay City, Cebu

REQUEST FOR CERTIFICATE OF TAX EXEMPTION


FOR SCHOLARSHIP & JOB/LIVELIHOOD PROGRAMS

Name : ________________________________________________________________
Address : ________________________________________________________________
Purpose : ________________________________________________________________

Attached are the following requirements: (Pls. check the box)

Any valid government issued ID with photocopy


(must be readable, untampered and contains consistent information with the documents presented upon application)
Bisan unsa nga ID nga gi-issue sa gobyerno basta naay picture, address ug pirma (example: National ID,
Voter’s ID, UMID, Driver’s License, Senior Citizen ID, Philippine Postal ID, Passport, etc.)
(*For Scholarship: Kinahanglan ang ID sa Amahan ug Inahan sa estudyante)
Cert. of Low Income/No Income signed by the Barangay Chairman of the place where the
applicant resides (state years of residence and source of income if any) with attached O.R. for
certification fee and doc stamp.
*Barangay Certificate of Indigency ang kuhaon kung indigent
*For Scholarship: Ang ginikanan (Amahan ug Inahan) ang pahimuan ug certification, dili ang estudyante
Duly notarized Affidavit of Low Income/No Income indicating the following:
 Source of income and gross income for the previous year
 Name & date of birth of the child (for scholarship)
 Purpose of the request of tax exemption certificate and the name of the requesting party
 For scholarship: indicate the specific name of school or scholarship program applied
Proof of Payment sa Certification fee (P100) ug Documentary Stamp (P30.00)

Additional Requirements:
Kung ang ginikanan/applicant kay: Mag-submit og:
OFW Certification o Contrata gikan sa ilang employer sa ilang kita sa
gawas sa nasud
Previously Employed/Locally employed Certificate of Employment gikan sa last employer (must indicate position,
period of service, monthly salary and other pay/bonuses (if any)
Single Parent Solo Parent ID
Biyudo/Biyuda NSO/PSA Death Certificate sa asawa/bana
Narehistro sa laing RDO Mag-fill out og BIR Form No. 1905 para magpa-transfer to
RDO#83
Mag-file through a representative Special Power of Attorney ug government issued ID sa applicant ug
iyang authorized representative

Requested by:
__________________________________
Signature Over Printed Name of Applicant
Client Steps:
1) Inig balik sa BIR kahuman makompleto ang requirements nga nakabutang sa ibabaw:
Muadto sa ARTA Desk BIR RDO No. 083 ug pangayo og priority number para sa TIN Verifier (Counter 11).
2) Proceed sa Cashier (Counter 6) para magbayad sa Certification Fee (P100.00) ug Documentary Stamps
(P30.00)
*Pwede sad magbayad sa Authorized Agent Banks or online thru Gcash or Paymaya.
3) Inig kahuman og bayad, muadto sa Administrative Section para magpahimo og Certificate of Tax Exemption.

Note: *Dili pwede ang guardian mu-apply para sa mga ginikanan sa estudyante.
*Ma-avail lang kini sa RDO nga naay jurisdiction sa the residence sa ginikanan or kung asa naregister ang ginikanan.
*Kung ang usa or duha ka ginikanan/applicant kay nangempleyo o naay negosyo, dili na angay mukuha pa og Certificate of Tax
Exemption. Hinuon, ipresentar ra ang 2316 o 1701 sa requesting school/agency/institution.

Referred to the Chief, Client Support Section, BIR RDO# 83, for appropriate action.

TIN of Applicant__________________ Type of Registration___________________ RDO Code ________


To be filled out by BIR

Verified by: Verified by:

TIN Verifier (Client Support Section) Officer-of-the-Day / PACD

Remarks: No Income Low Income Others __________________

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