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    Professional Regulation Commission

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    Rudy Danvince Tolentino Bernardo
    This document is an application for a Professional Identification Card (PIC) renewal for Excellency De Guzman, a Certified Public Accountant. It contains personal information like name, address, license details. The applicant declares that the information provided is true and correct, and acknowledges legal consequences for false statements. For those who did not meet Continuing Professional Development requirements, there is an undertaking to submit the remaining credits for the next renewal. Real estate practitioners cannot avail this undertaking and must submit proof of all credits prior to renewal.

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    © All Rights Reserved
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    Professional Regulation Commission

    Uploaded by

    Rudy Danvince Tolentino Bernardo
    29 views1 page
    This document is an application for a Professional Identification Card (PIC) renewal for Excellency De Guzman, a Certified Public Accountant. It contains personal information like name, address, license details. The applicant declares that the information provided is true and correct, and acknowledges legal consequences for false statements. For those who did not meet Continuing Professional Development requirements, there is an undertaking to submit the remaining credits for the next renewal. Real estate practitioners cannot avail this undertaking and must submit proof of all credits prior to renewal.

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    This document is an application for a Professional Identification Card (PIC) renewal for Excellency De Guzman, a Certified Public Accountant. It contains personal information like name, address, license details. The applicant declares that the information provided is true and correct, and acknowledges legal consequences for false statements. For those who did not meet Continuing Professional Development requirements, there is an undertaking to submit the remaining credits for the next renewal. Real estate practitioners cannot avail this undertaking and must submit proof of all credits prior to renewal.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    29 views1 page

    Professional Regulation Commission

    Uploaded by

    Rudy Danvince Tolentino Bernardo
    This document is an application for a Professional Identification Card (PIC) renewal for Excellency De Guzman, a Certified Public Accountant. It contains personal information like name, address, license details. The applicant declares that the information provided is true and correct, and acknowledges legal consequences for false statements. For those who did not meet Continuing Professional Development requirements, there is an undertaking to submit the remaining credits for the next renewal. Real estate practitioners cannot avail this undertaking and must submit proof of all credits prior to renewal.

    Copyright:

    © All Rights Reserved
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    of 1

    TIME RECEIVED:

    TIME RELEASED:

    Professional Regulation Commission

    APPLICATION FOR PROFESSIONAL IDENTIFICATION CARD (PIC)

    NOT FOR SALE (REPRODUCTION IS ALLOWED)

    APPOINTMENT DATE: June 14, 2019 (AM) - Robinsons Place Santiago | OR: - | Amount: PHP -
    REFERENCE NO: REW5H7PABBB5
    NAME: OBRA, EXCELLENCY DE GUZMAN

    CITIZENSHIP: FILIPINO BIRTHDATE: May 02, 1991

    PERMANENT MAILING ADDRESS: OBRA ST. P-6 RIZAL SANTIAGO CITY


    TEL. NO. / CP NO.: 09064479436 EMAIL ADDRESS: obraexcellency02@gmail.com
    SCHOOL GRADUATED: NORTHEASTERN COLLEGE DATE GRADUATED: April 08, 2011
    REGISTRATION DATE: October 28, 2011 EXPIRATION DATE: May 02, 2022
    PROFESSION: CERTIFIED PUBLIC ACCOUNTANT LICENSE NO.: 0140486

    DECLARATION AND ATTESTATION

    I am aware and I give my consent to the collection of the data required by this application form and
    the taking of my photograph, and if applicable, the taking of my fingerprints.

    I further attest that all particulars and supporting documents provided by me are correct and
    complete. I am aware that any false statement or fraudulent document will lead to the rejection of my
    application or to the cancellation of my PIC already issued, and may also render me liable under applicable
    administrative and criminal laws.

    SIGNATURE OF LICENSEE

    UNDERTAKING

    (To be filled up by professionals, except for Real Estate Practitioners, who failed to comply with the
    required CPD Credit Units for the renewal of Professional Identification Card)

    For this compliance period, I am submitting CPD units of the total required CPD Credit units. I
    hereby undertake to submit the balance of CPD credit units in addition to the required CPD units (or a
    total of units) for the next renewal of my PIC. I understand that in the event I fail to comply, my PIC will
    not be renewed.

    SIGNATURE OF LICENSEE

    NOTE:
    1) ALL REAL ESTATE PRACTITIONERS CANNOT AVAIL THE UNDERTAKING AND HAVE TO
    PROVIDE PROOF OF COMPLIANCE WITH CPD PRIOR TO RENEWAL OF PIC PURSUANT TO
    SECTION 17, ARTICLE III OF REPUBLIC ACT NO. 9646 OR THE REAL ESTATE SERVICE ACT
    OF THE PHILIPPINES AND BOARD RESOLUTION NO. 49, S. 2015.
    2) REPRESENTATIVE OF THE PROFESSIONAL APPLYING FOR ISSUANCE OF PROFESSIONAL
    IDENTIFICATION CARD (PIC) MUST SUBMIT:
    a) THE PRESCRIBED AUTHORIZATION LETTER AND PHOTOCOPY OF PROFESSIONAL
    IDENTIFICATION CARD (PIC) OF THE REPRESENTATIVE AND EXPIRED PIC OF THE
    PRFESSIONAL; OR
    b) SPECIAL POWER OF ATTORNEY (SPA) AND PHOTOCOPY OF ANY VALID GOVERNMENT
    ISSUED IDENTIFICATION CARD (ID) OF THE REPRESENTATIVE AND THE PROFESSIONAL
    3) STRICTLY FOLLOW THE APPOINTMENT DATE ON RENEWAL OF PROFESSIONAL
    IDENTIFICATION CARD (PIC).

    REG-03
    Rev. 02
    September 15, 2017
    Page 1 of 1

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