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    Application Form: Professional Regulation Commission

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    Nica09_forever
    - The document is an application form for the Certified Public Accountant examination to be taken on October 5, 6, and 12, 2019 in Manila. - The applicant, James Eandriane Lacson, is a repeat exam taker who previously took the exam in May 2019 and received a rating of 60.00 but failed the exam. - Lacson graduated from the Philippine School of Business Administration-Manila with a Bachelor of Science in Accountancy degree in March 2019.

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    Application Form: Professional Regulation Commission

    Uploaded by

    Nica09_forever
    64 views1 page
    - The document is an application form for the Certified Public Accountant examination to be taken on October 5, 6, and 12, 2019 in Manila. - The applicant, James Eandriane Lacson, is a repeat exam taker who previously took the exam in May 2019 and received a rating of 60.00 but failed the exam. - Lacson graduated from the Philippine School of Business Administration-Manila with a Bachelor of Science in Accountancy degree in March 2019.

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    prc.pdf

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    - The document is an application form for the Certified Public Accountant examination to be taken on October 5, 6, and 12, 2019 in Manila. - The applicant, James Eandriane Lacson, is a repeat exam taker who previously took the exam in May 2019 and received a rating of 60.00 but failed the exam. - Lacson graduated from the Philippine School of Business Administration-Manila with a Bachelor of Science in Accountancy degree in March 2019.

    Copyright:

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

    Application Form: Professional Regulation Commission

    Uploaded by

    Nica09_forever
    - The document is an application form for the Certified Public Accountant examination to be taken on October 5, 6, and 12, 2019 in Manila. - The applicant, James Eandriane Lacson, is a repeat exam taker who previously took the exam in May 2019 and received a rating of 60.00 but failed the exam. - Lacson graduated from the Philippine School of Business Administration-Manila with a Bachelor of Science in Accountancy degree in March 2019.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    APPOINTMENT DATE: Aug 15, 2019 (01:00 PM TO 02:00 PM) - Robinsons Place Manila

    Professional Regulation Commission

    APPLICATION FORM

    NOT FOR SALE (REPRODUCTION IS ALLOWED)


    REFERENCE NO: EXYEHIM1M9PP
    Application No.
    OR: - | AMOUNT: PHP -
    -
    First Timer
    Name of Examination CERTIFIED PUBLIC ACCOUNTANT
    _________________________________
    X Repeater
    Conditioned Date of Examination October 5, 6 & 12, 2019
    _________________________________
    Absent
    Place of Examination Manila
    _________________________________
    ________________
    08/07/2019
    Date(mm/dd/yy)
    NOTICE: All supporting documents shall become part of the records of the Commission. All applications must be filed
    PERSONALLY by the applicant.

    PART I-PERSONAL INFORMATION


    SUR NAME GIVEN NAME/S MIDDLE NAME
    LACSON JAMES EANDRIANE CAFINO
    Maiden Surname (for married female only)

    Permanent Mailing Address (House no., Street, Village/Subd., Brgy., Town, Prov./City)
    7799 ST. PAUL ST., SAN ANTONIO VILLAGE MAKATI CITY
    Gender Citizenship Contact numbers (Landline & Mobile) E-mail Address
    X Male Female X Filipino Others______ 09065578358 [email protected]
    Civil Status Date of Birth(mm/dd/yy) Place of Birth (City/Town,Prov) RURBAN Code(Town/City,Prov)
    X Single Married Widow/er 10/10/1995 ZAMBOANGUITA, NEGROS ORIENTAL 074625
    Spouse’s name & Citizenship Father’s Name & Citizenship Mother’s Name & Citizenship
    ALAN EBON LACSON / FILIPINO JULITA CAFINO LACSON / FILIPINO
    HAVE YOU EVER BEEN CHARGED AND CONVICTED BY FINAL JUDGEMENT BY ANY COURT OF JUSTICE/MILITARY TRIBUNAL OR
    ADMINISTRATIVE BODY? X No Yes (If yes, attach hereto a copy of the decision)
    PART II – EDUCATIONAL INFORMATION
    Name of School Address/Location of School PRC School code
    PHILIPPINE SCHOOL OF BUSINESS ADMINISTRATION-MANILA 826 R. PAPA STREET, SAMPALOC, MANILA 0599
    Degree/Course Obtained PRC COURSE Code Date Graduated (mm/dd/yy) PRC Board Code
    BACHELOR OF SCIENCE IN ACCOUNTANCY 5136 03/30/2019 0100
    Date Graduated PRC SCHOOL
    Other Higher Educational Attainment Name of School Address/Location of School CODE
    (mm/dd/yy)

    PART III – PREVIOUS PRC LICENSURE EXAMINATION/S TAKEN (Last Three Exams)
    Place of Date Taken Result of Examination (pls check)
    Name of Examination Rating Exam No. Verified by
    Examination (mm/yy) Passed Failed Cond.
    CERTIFIED PUBLIC ACCOUNTANT - 05/2019 60.00 X

    Review School/Center: Self-Review School-Based Review Others (specify name) __________________________


    STATUS CODES (refer at the back) 1.) Examination Type (EXcode) 2.) Number of Times Taken 1

    I HEREBY CERTIFY that the information and/or ACTION TAKEN BY THE APPLICATION PROCESSOR
    statements in this application including the supporting ISSUANCE of the FOLOWING FORMS
    documents submitted in support thereof are all true and
    correct to my own knowledge, and that I am fully aware that NOTICE OF ADMISSION PERMANENT EXAMINATION &
    (NOA) REGISTRATION RECORD CARD (PERRC)
    any false information or statement in this application or in its
    attachments shall render me liable for criminal prosecution REMARKS ______________________________________________
    and/or administrative sanction. ______________________________________________________________________________

    PROCESSOR_____________________________ Date ___________


    RIGHT THUMBMARK _______________________ ____________________________________________________________
    Signature of Applicant ACTION TAKEN BY LEGAL OFFICER (if applicable)
    _______________________ REMARKS ______________________________________________
    Date Accomplished ______________________________________________________________________________

    LEGAL OFFICER __________________________ Date ___________


    Subscribed and sworn to before me this __________day of ____________________________________________________________
    _________20____at__________. Affiant applicant exhibited ACTION TAKEN BY THE BOARD
    to me his / her Community Tax Certificate No. APPROVED DISAPPROVED CONDITIONAL
    15417560
    ________________________issued at MANILA CITY HALL
    _______________
    REMARKS ______________________________________________
    on _____________.
    04/01/2019 ______________________________________________________________________________
    DOCUMENTARY STAMP

    CHAIRMAN/ MEMBER ______________________ Date __________


    ____________________________________________________________
    ACTION TAKEN BY THE CASHIER
    _______________________________
    PRC ADMINISTERING OFFICER AMOUNT PAID ____________
    - OFFICIAL RECEIPT NO. _____________
    -
    PRC - CASHIER
    CASHIER _________________________________ -
    Date __________
    ____________________________________________________________
    ACTION TAKEN BY THE ISSUING OFFICER
    Administration of Oath Is Free REMARKS _______________________________________________
    (Office Order No. 2009-377 & 2009-379 ______________________________________________________________________________
    both dated September 3, 2009)
    ISSUING OFFICER ________________________ Date __________

    IMPORTANT: FAILURE TO SUBMIT THIS APPLICATION FORM WITH THE REQUIRED DOCUMENTS SHALL MEAN APP-01
    NON-INCLUSION IN THE LIST OF EXAMINEES IN THE ROOM ASSIGNMENT AND FORFEITURE OF EXAMINATION FEES Rev. 00
    February 25, 2015
    Page 1 of 1

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