BACC Form No. 02 Rev.

03/07-25-08

Reg. No. ___________

Professional Regulation Commission

Manila

APPLICATION FOR ACCREDITATION OF INDIVIDUAL CPA/ FIRM / PARTNERSHIP OF CPAs IN THE PRACTICE OF PUBLIC ACCOUNTANCY
1. 10. 2. 10. Name of Individual CPA/Firm/Partnership:

Full Name of Sole Practitioner /Partners

CPA Certificate Number

Position in the Firm/Partnership

3. 10. 4. 10. 5. 6. 7. 8. 9. 10.

SEC Certificate of Registration No.: (if a registered partnership) Complete Address of Principal Office:

Tel. No. Website of principal office Website of branches E-mail address Branches/Sub-Offices, if any:

Fax No.

10.

Full Name of Staff members

CPA Certificate Number

APEC Registry Number

Position in Firm/Partnership

11. 10.

Full Name of Principal, if any

CPA Certificate Number

Position in the Firm/Partnership

12. 10.

Correspondent Relationship with Foreign CPA/Accounting Firm, if any: Name of Foreign Name of Foreign Firm Country

Nature and Extent of Relationship

BACC Form No. 02 Rev. 03/07-25-08

Reg. No. ___________

13.

Changes in the Firm/Partnership from Last Registration:

14.

Internal Quality Review Procedures

I hereby certify that the foregoing entries/information are true and correct

Date

Place

Managing Partner Sole Practitioner

ACKNOWLEDGMENT

Republic of the Philippines ) City of _______________ )

s.s.

Personally appeared before me ________________________________________________ with his/her Community Certificate No. ___________________issued at ______________________________ on _________________________ known to me and to me known to be the same person who execute the foregoing instrument and acknowledge the same to be his/her free voluntary act and deed.

NOTARY PUBLIC Doc. No. Page No. Book No. Series of Doc. No. Page No. Book No. Series of

Note:

Use additional sheet where necessary which must be certified as true and correct or attach plantilla of partner and staff members.