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MEMBERSHIP

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Statement of Account

M E M B E R S H I P

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Note: AMENDED PICPA BY-LAWS

ARTICLE V - MEMBERSHIP

SECTION 3. It shall be the duty of every CPA, qualified under Section of this Article, to submit his/her curriculum vitae which shall include his permanent residence and place of office, as the basis for the issuance of a Certificate of Membership ina form prescribed by the National Board of Directors.

SECTION 7. A CPA shall be a member of the Chapter of the province or city where his residence or place of business is located.

*CPA / PRC REG. No.:

*PRC Reg. Date:

Last Name

First Name

Birth Date

Middle Name

Sex

*Civil Status:

Company
Position
Company Address
Tel. No.
Fax No.
Email

Home Address:
Tel. No.
Fax No.
Email
Preferred Mailing Address

College
Year Graduated
Address
Post Graduate
Year Graduated
Address

Region
Chapter
Sector
Type of Member

0111-NORTHERN	0112-WESTERN	0113-EASTERN	0114-SOUTHERN
Caloocan City	Mandaluyong City	Marikina City	Las Piñas City
Malabon City	Manila	Pasig City	Makati City
Navotas	San Juan	Quezon City	Muntinlupa City
Valenzuela City		Rizal	Parañaque City
			Pasay City
			Taguig