(To be filled up by BIR) DLN: [NOTE: This form shall be used in RDOs with eTIS-1 only]

BIR Form No.

Republic
Republic of the Philippines
Philippines  Application for
Department
Department of Finance
Bureau of Internal Revenue
Revenue
Registration Information
Update/Correction/Cancellation
1905
Novemb
November
er 2014
2014 (ENCS)
(ENCS)
Fill in applicable spaces. Mark all appropriate boxes with an "X".
Part I TAXPAYER INFORMATION
1 Taxpayer Identification  2 RDO 0 4 4  3 Contact
0 0 8 4 5 6 2 4 1 0 0 0 0 0
Number (TIN) Code Number  
4 Taxpayer's Name (If Individual 
 )
 ) (Last Name) (First Name) (Middle Name)   (S
(Suffix) (Nickname)

(If Non-Individual , Registered Name)

PROBEGROUP PHILIPPINES INC.
PART II REASON/DETAILS OF REGISTRATION INFORMATION UPDATE/CORRECTION
5 Replacement/Cancell ation of:
FORM/S REASON/DETAILS
 A  Ce
 C ertificate of Registration (COR) Lost/Damaged Correction/Change/Update of
B  Authority to Print (ATP)
(ATP) Receipts/Invoices
Receipts/Invoices Closure of
of a business
business Registration
Registration Information
Information
C  Tax
 Tax Cle
Clear
aran
ance
ce Cert
Certif
ific
icat
ate
e fo
for Tax
Tax Liab
Liabil
ilit
itie
ies
s (TC
(TCL1
L1)) Chan
Change
ge of accr
accred
edit
ite
ed pri
prin
nter
ter as
as (please proceed to number 6 for
D Taxpayer Identification Number (TIN) Card requested by the taxpayer   applicable change in registration
E Tax Clearance Certificate for Transfer of Property/ies  Others (please specify) information)
(TCL2)/Certificate Authorizing Registration (CAR)
F   Others (please specify)

6 Correction/Chang e/Update of Registrati on Informati on

 A. CHANGE IN REGISTERED
REGISTERED NAME/TRADE
NAME/TRADE NAME
 Re
 Registered Name Trade Name
 New Registered
Name/Trade Name
(Old RDO) (New RDO)
B. CHANGE IN REGISTERED ADDRESS
Transfer within same RDO Transfer to another RDO From To

Lot#/Blk#/Phase/House#/Unit/Room/Floor/Bldg.#/Sub Street  Building Name/Street

Name/Street Name/Subdivision/Village Zone Province

Municipality/City/District  Barangay  ZIP Code

C. CHANGE IN ACCOUNTING PERIOD (Applicable to Non-Individual) (MM/DD/YYYY)
X From Calendar Period to Fiscal Period Start Date of New Period
From Fiscal Period to Calendar Period
From One Fiscal Period to Another Fiscal Period Start Date of Old Period

D. CHANGE/ADD REGISTERED ACTIVITY/LINE OF BUSINESS

New Registered Activity/ Effective Date of Change
Line of Business (MM/DD/YYYY)

E. CHANGE/ADD
CHANGE/ADD FACILITY TYPE/DETAILS
TYPE/DETAILS (attach additional sheet, if necessary)
 Additional/New
 Additional/New Facility
Facility Facility Type*
Facility Type* PP - Place
Place of Produ
Producti
ction
on BT - Bus
Bus Te
Termi
rminal
Facility Code (pls check applicable facility type) SP - Sto
Storage
rage Plac
Place
e RP - Real
Real Prop
Proper
erty
ty for 
for 
PP SP W H SR GG BT RP Others (specify) WH - W arehouse Lease with No
F SR - Showroom Sales Activity
F GG - Garage

 Address of Facility
Facility

Lot#/Blk#/Phase/House#/Unit/Room/Floor/Bldg.#/Sub Street Building Name/Street Name/Subdivision/Village Zone Province

Municipality/City/District Barangay ZIP Code

F. CHANGE/ADD
CHANGE/ADD INCENTIVE DETAILS/REGIS
DETAILS/REGISTRATION
TRATION
Investment Promotion Agency Number of Years
Legal Basis Start Date (MM/DD/YYYY)
Incentives Granted End Date (MM/DD/YYYY)

Registration/Accreditation No. Registered Activity

Effectivity Date From To Tax Regime
(MM/DD/YYYY)  Activity Start Date
Date (MM/DD/YYYY)
Date Issued (MM/DD/YYYY)  Activity End Date (MM/DD/YYYY)

G. CHANGE/ADD
CHANGE/ADD TAX TYPE DETAILS/SUSPEND
DETAILS/SUSPEND TAX TYPE/RE-REGISTER
TYPE/RE-REGISTER TAX TYPE
Suspend/Cancelled Form Type ATC Effect iv
ive Da
Date of
of Re-r eg
egister/Added/ Form Type  ATC Effective Date
Tax Type/s (to be filled-up by BIR) Change (MM/DD/YYYY) New Tax Type/s (to be filled-up by BIR) (MM/DD/YYYY)

H. CHANGE/UPDATE OF CONTACT TYPE

Phone Number Mobile Number Fax Number    Email Address (required)

I. CHANGE/UPDATE
CHANGE/UPDATE OF
OF CONTACT
CONTACT PERSON/AUTHOR
PERSON/AUTHORIZED
IZED REPRESENTA
REPRESENTATIVE
TIVE
(Last Name) (First Name) (Middle Name)   (Suffix)

Position TIN
  page 2 - BIR Form No. 1905 
J. CHANGE/UPDATE OF STOCKHOLDERS/MEMBERS/PARTNERS
(Last Name, First Name, Middle Name, Suffix, if Individual/Registered Name, if non-individual) TIN 

 7 Closure of Business/Cancellat ion of Registration

 A. CANCELLATION OF TIN
Death As a result of merger/consolidation
Multiple/Identical TIN Others (please specify)
Failure to start/commence business (For Non-Individual)
Permanent closure of a branch Effective Date of Cancellation
Dissolution of corporation/par tnership (MM/DD/YYYY)

B. DE-REGISTER/CESSATION OF REGISTRATION
Permanent closur e of business (head office) of an individual Effective Date of Cessation
  Others (please specify) (MM/DD/YYYY)

8 Update of Books of Accounts

Type Volume Date Registered Date Issued
Books Registered Quantity Permit Number 
(Manual or Loose) From To (MM/DD/YYYY) (MM/DD/YYYY)

9 Other Update/Correction (please specify details) For Taxpayer For BIR Use

Effective Date of Change

(MM/DD/YYYY)  Approved by:
REVENUE DISTRICT OFFICER Date
(Signature over Printed Name)
10 Declaration Stamp of Receiving Office
I declare, under the penalties of perjury, that this application has been made in good faith, verified by me, and Date of Receipt 
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.

Taxpayer/Authorized Representative Title/Position of Signatory

(Signature over Printed Name)

Documentary Requirements:
REPLACEMENT/CANCELLATION G. Change/Add Tax Type Details 
A. Certificate of Registration  - Original Certificate of Registration
1. Original Copy of Old Certificate of Registration, for replacement I. Change/Update of Contact Person/Au thorized Representative 
2. Affidavit of Loss, if lost - Authorization or Certification issued by Officer enumerated under Section 52 (A)
3. Proof of payment of Certification Fee and Documentary Stamp Tax - to be of the Tax Code (President or representative and Treasurer or Assistant
submitted before the issuance of the new Certificate of Registration Treasurer of the Corporation)
B . Au th o r ity to Prin t (A TP) Rec eip ts an d In v o ic es J . Ch an g e/Up d ate o f Sto c k h o ld er s /M em b er s /Partn er s  
1 . Ori gi na l A ut ho ri ty t o P ri nt Pr im ary a nd Se co nd ary R ece ip ts /I nvo ic es - Am en de d Ar ti cl es of In co rp or at io n/ Co op er at io n/ Pa rt ne rs hi p
2. New Application Form (BIR Form No. 1906), if applicable
C. Tax Clearance Certificate For Tax Liabilities (TCL1)  CLOSURE OF BUSINESS/CANCELLATION OF REGISTRATION
1. Affidavit of Loss, if lost A. Cancellation of TIN 
2. Proo f of p ayment of Ce rt ifi cati on Fe e an d Do cum entary Stam p Tax - to b e INDIVIDUAL
submitted before the issuance of the new Tax Clearance Certificate 1. Death Certificate
D. TIN Card  2. Estate Tax Return
1. Affidavit of Loss, if lost 3. Proof of payment of existing liabilities, if any
2. Old TIN Card (if replacement is due to damaged card) Additional requirements for taxpayers engaged in trade or  
3. Marriage Certificate (for change of family name) business or exercise of Profession
4. SEC Certificate (for change of Corporate Name) 4. Existing BIR Certificate of Registration (for surrender)
5. Inventory list of unused primary and secondary receipts/invoices
CORRECTION/CHANGE/UPDATE OF REGISTRATION INFORMATION 6. Unused primary and secondary receipts/invoices for cancellation
A. Change in Registered Name/Trade Name  NON-INDIVIDUAL
1. Amended SEC Registration/ DTI Certificate 1. Notice of Dissolution of Business
2. Original Certificate of Registration 2. Dissolution Papers (board resolution, bankruptcy declaration)
 B. Change in Registered Ad dress  3. Inventory list of unused primary and secondary receipts/invoices
1. Original Certificate of Registration 4. Unused primary and secondary receipts/invoices for cancellation
2. Invento ry l ist of unused p rincipa l an d suppl eme ntary receipt s/i nvoices 5. Existing BIR Ce rti fi cate of Regi strati on
3. U nused primary and supplementary receipts/invoices for stamping 6. P roof of payment of existing liabilities
4. Latest DTI Certificate/ SEC Registration 7. SEC issued Certificate of the Filing of the Articles of Merger/Consolidation,
5. Sketch of place of production (if taxpayer is subject to Excise Tax) if applicable
6. Duly signed Transfer Commitment Form (unnotarized) 8. Affidavit of "No Operation" together w/ returns filed, "No Operation"
See Annexes C & F, RMO No. 40-2004 duly indicated (for failure to commence business)
C. Ch an g e in A c c o u n tin g Perio d B . Ces s atio n o f Reg is tratio n (fo r In d iv id u al & No n -in d iv id u al w i th b u s in es s )  
1. BIR written approval of the change 1. Letter request for cessation of registration
2. Photocopy of short period return filed 2. Existing BIR Certificate of Registration (for surrender)
D. Change/Add Registered Ac tivity/Line of Business  3. Inventory list of unused primary and secondary receipts/invoices
- Original Certificate of Registration 4. Unused primary and secondary receipts/invoices for cancellation
E. Change/Add Facility Type/Details  5. Same requirements as in Cancellation of TIN, if applicable
 - Appropriate Application for Registration and requirements therein
F. Change/Add Incentive Details/Registration  Update of Books of Accounts
- Certificate of Accreditation/Registration from Investment Promotion Agency - Photocopy of the first page of the previously approved books