(To be filled up by BIR) DLN:
Republic of the Philippines
Department of Finance
One-Time Abatement for Micro Taxpayers
Bureau of lnternal Revenue Application Form
Fill in all
Remarks: Reviewed by
l_l Comnlete as to documentary requirements
!otners Assistant Revenue Distric{ Ofiicer
(Signature Over Printed Name)
Stamp of Receiving
Offi@ and Dated
Receipt (Revenue
Approved by: Offi@fs Signaturc)
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Revenue Revenue District fficer
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website (\,\ l/i,r/.bir. gov. ph)