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Application for Certificate of Tax Exemption

The Regional Director Bureau of Internal Revenue Revenue Region No, ______ Attn. : Chief, Legal Division Thru ______________ Revenue District Officer Sir : Pursuant to Revenue Regulation 20-2001, we respectfully submit the following requirements for the issuance of a Certificate of Tax Exemption to____ ______________________________ Cooperative, to wit: 1. 2. 3. 4. 5. Certified true copy of Articles of Cooperation and By-Laws. Certified true copy of Certificate of Registration / Confirmation issued by CDA. Original copy of Certificate of Good Standing from the CDA. Latest financial statements duly audited by an independent CPA Certification under oath by the Chairperson / General Manager a. The cooperative is transacting business with members only with both members and non-members. b. Amount of accumulated general reserve fund and undivided net savings. c. At least 25% of the net surplus is retained to members in the form of interest on capital and a patronage refund. d. List of members and the share contribution of each member. Please acknowledge receipt thereof. Very truly yours, __________________ Chairman of the Board/Manager

Attachment to the application for CTE


Republic of the Philippines } Province of _________________ ) s.s. City/Municipality of __________ ) AFFIDAVIT I, _____________________ of legal age and with postal address at __________________________ after having been duly sworn to in accordance with law do hereby depose and say : 1. 2. 3. That I am the duly elected chairman of the __________ .; That as chairman I am aware of the operations of the above cooperation ; That the cooperative is transacting business

with members only with both members and non-members 4. That the accumulated general reserve fund and net savings of the cooperation as of ________ is ________ . 5. That at least 25% of the net surplus is retained to members in the form of interest on capital and/or patronage fund. 6. That attached hereto is a list of members and their corresponding share capital contribution to the cooperative. 7. That I am executing this affidavit to prove to the veracity of the above statements.

In witness whereof, I have hereunto set my hand this ____ day of ___________ at _________________ , Philippines. __________________ Affiant SUBSCRIBED AND SWORN TO before me this ___ day of __________ at ____________ , Philippines, affiant exhibiting to me his / her CTC No. ______ issued at _________ on ______________ . NOTARY PUBLIC

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