5/28/2018 New Boa Bacc Form

1/3

Professional Regulation CommissionManila

APPLICATION FOR ACCREDITATION OF INDIVIDUAL CPA/

FIRM / PARTNERSHIP OF CPAs IN THE PRACTICE OF

PUBLIC ACCOUNTANCY

1. Name of Individual CPA/Firm/Partnership:10.

2. Full Name of Sole Practitioner/Partners

CPA Certif icateNumber

Position in theFirm/Partnership

10.

3. SEC Certificate of Registration No.:10. (if a registered partnership)

4. Complete Address of Principal Office:

10.

5. Tel. No. Fax No.

6. Website of principal office

7. Website of branches

8. E-mail address

9. Branches/Sub-Offices, if any:

10.

10. Full Name of Staff members CPACertificateNumber

APEC RegistryNumber

Position inFirm/Partnership

11. Full Name of Principal, if any CPA CertificateNumber

Position in theFirm/Partnership

10.

12. Correspondent Relationship with Foreign CPA/Accounting Firm, if any:10.

Name of Foreign FirmName of Foreign

CountryNature and Extent of

Relationship

Reg. No. ___________

BACC Form No. 02

Rev. 03/07-25-08

5/28/2018 New Boa Bacc Form

2/3

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 ) s.s.City of _______________ )

Personally appeared before me ________________________________________________ with his/herCommunity 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 voluntaryact 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 attachplantilla of partner and staff members.

Reg. No. ___________

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

5/28/2018 New Boa Bacc Form

3/3