Affidavit Spa

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Dolores Mejia is applying to become a tax practitioner/agent with the Bureau of Internal Revenue (BIR). She is submitting affidavits and undertakings as part of the application requirements.

Dolores Mejia is applying as a Tax Practitioner/agent with the Bureau of Internal Revenue (BIR).

The affidavit states that Dolores Mejia has not been charged with or convicted of a crime involving moral turpitude, and has not been found guilty of any offenses under the Tax Code or aiding such offenses.

Republic of the Philippines)

CITY OF ILIGHAN
)S.S.

UNDERTAKING

I DOLORES MEJIA DOLORES , of legal age, single, Filipino, and a


resident of Purok #1 Kiwalan, Iligan City after been duly sworn to in
accordance with law, do hereby depose and say:
1. That I am applying as Tax Practitioner/agent with the Bureau of
Internal Revenue (BIR)
2. That I hereby undertake to preserve the working papers within
the period prescribed under section 235 of the NIRC of 1997, as
amended, and making them available to the Bureaus authorized
representative/s when required to do so;
3. That I am executing this affidavit to attest the truthfulness of the
foregoing statements and for the purpose of complying one of
the requirements as tax practitioner/agent.
IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of
___________ 2016, at ILIGAN City.

DOLORES M. SEBLERO

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


2015, Iligan City, affiant exhibiting to me her SSS No. 08-09379194.

DOC. No. ______


Page No._______
Book No._______
Series of 2016

Republic of the Philippines)

CITY OF ILIGAN

)S.S.

AFFIDAVIT
I, DOLORES MEJIA SEBLERO, of legal age, single, Filipino, and a
resident of Purok #1 Kiwalan, Iligan City, after having been duly sworn to
in accordance with law, do hereby depose and say:
1. Tha I am applying as Tax Practitioner/agent with the Bureau of
Internal (BIR);
2. That I have not been charged with and convicted by final
judgment of a crime involving moral turpitude;
3. That I have not been found guilty of any act or omission
penalized under the Tax Code, or found guilty of aiding or
abetting or causing the commission of any such offences by
another;
4. That I am executing this affidavit to attest the truthfulness of the

foregoing statements and for the purpose of complying one of


the requirements as Tax practitioner/agent.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of


________ 2016, affiant exhibiting to me her SSS No. 08-0937919-4.

DOLORES MEJIA SEBLERO


Affiant

SUBSCRIBED AND SWORN TO before me this___ day of _________, 2016,


Iligan City, affiant
Exhibiting to me her SSS No. 08-0937919-4.

Doc No.

_____

Page No. _____


Book No. _____
Series of 2016

SPECIAL POWER OF ATTORNEY


Know All Men by these Presents:
That I, Lucille C. Omandam , Filipino of legal age, married and
with postal address at Zamora St. Poblacion , Iligan City, Lanao del Norte
do hereby authorized Dolores M. Seblero likewise of legal age, Filipino with
postal address at Purok #1 Kiwalan, Iligan City, Lanao del Norte, to
represent in my behalf with the office of Bureau of Internal Revenue-BIR
relative to my business registered.
Hereby Giving and Granting unto said Attorney-in-Fact full power
and authority to do ans perform requisite or necessary to carry into effect
the authority fully to the intent and purpose as we might or could lawfully
do if personally present and hereby RATIFYING and CONFORMING said
Attorney-in-fact shall have lawfully done by virtue of these presents.
IN WITNESS WHEREOF, I have hereunto affixed my signature this __ day of
__________2016,
Iligan City.

LUCILLE C.

DOLORES M. SEBLERO

OMANDAM
Attorney-in-Fact

Principal

Signed in the presence of:


________________________

________________________

At the locality mentioned, this _____ day of _____________ personally


appeared before me:
LUCILLE C. OMANDAM __________________________________
DOLORES M. SEBLERO

__________________________________

Known to me and to me known to be the same persons who


executed the foregoing instruments and acknowledge that
the same is their free act and voluntary deed.
IN WITNESS WHEREOF, I have hereunto affixed my signature and
notarial seal on the date and place above written.

DOC. No. _________


Page No. _________
Book No. _________
Series of 2016

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