CDA form
Content
REPUBLIC OF THE PHILIPPINES
BATANGAS CITY
BUSINESS PERMITS AND LICENSING OFFICE
Application Form for Business
TAX YEAR ________
Instructions
1.
2.
3.
Provide accurate information and print legibly to avoid delays. Incomplete application form will be returned to the applicant.
Ensure all documents attached to this application form are complete and properly filled out.
For corporation, only responsible person (President, Chief Accountant and Corporate Secretary) should sign the form.
In case of Liaison Officer or any authorized representative, please kindly present an authorization letter signed by the
identified responsible person of the corporation .
Business Permit No._____________________(for renewal)
Business Plate No.
Date of Application
Business Type
Single Proprietorship
Partnership
Corporation
New
Renewal
Registration No.
DTI
Quarterly
Date of Registration
Date of Expiry
Registration No.
Date of Registration
Date of Expiry
Registration No.
Date of Registration
Date of Expiry
SEC
Business Classification (micro, small, etc.)
Mode of Payment
Annually
Bi-Annually
CDA
Name of Registrant
For Single Proprietorship
Last Name
First Name
Date of Birth:
Trade Name:
Middle Name
Suffix Name
TIN:
Doing Business As (DBA):
Franchise:
Name of Registrant
For Partnership
Last Name
First Name
Middle Name
Suffix Name
Date of Birth
TIN
For Corporation/Cooperative
Complete Business Name:
Name of CORPORATION/COOPERATIVE:
Name of Registrant:
Address:
Tel. No./E-mail address:
Are you enjoying tax incentive from any government entity? (
Owner’s Address:
House No./Bldg. No.
Building Name
) Yes
TIN:
( ) No
Please specify the entity: ______________________________
Complete Business Address:
House No./Bldg. No.
Building Name
Unit No.
Street
Barangay
Unit No.
Street
Barangay
Subdivision
City/Municipality
Province
Postal Code
Residential Line
Mobile No.
E-mail address
Business Area (in sqm.)
Subdivision
Office Landline
Fax Number
E-mail address
In case of emergency, contact person/Tel.No./Mobile No.:
Total No. of Employees in Establishment
Total No. of Employees Residing in Batangas City
Male:
Female:
In case Place of Business is rented, complete this section:
Lessor’s Name:
Lessor’s Complete Address:
No.
Street
E-mail address:
Lessor’s Date of Birth:
Last Name
First Name
Subd.
Middle Name
Brgy.
Tel. No.
Lessor’s TIN:
City
Monthly Rental
Province
Branch
Business Activity
No. of Units
Line of Business
Capitalization
(for New Business)
Gross/Sales Receipts
(for Renewal)
I DECLARE UNDER PENALTY OF PERJURY that the foregoing information are true based on my personal knowledge and authentic records.
SIGNATURE OF APPLICANT OVER PRINTED NAME
POSITION/TITLE
For City Assessors:
VERIFICATION OF DOCUMENTS
Description
Barangay Business Clearance
Market Clearance (for Market Stall Holders only)
Cert. of Envtl. Permit to Operate/City Environmental Cert.
Veterinary Clearance and Certification
Sanitary Permit/Health Certificate
Fire Safety Inspection Certificate
Others, please specify:
Office/Agency
Barangay
Office of the City Market Administrator
City Environment and Natural Resources Office
Verified by:
Remarks
Office of the City Veterinary and Agricultural Services
City Health Office
Batangas City Fire Station
Application checked by: BPLO
ASSESSMENT:
Treasurer’s Office
Business Tax and Fees Division
Latest Payment
___
___
___
For the BATANGAS CITY FIRE STATION:
APPLICATION NO.: R4A-B_______________
(To be filled up by applicant/owner)
Name of Applicant/Owner:
Name of Business:
Total Floor Area:
Address of Establishment:
DATE:
_______
Contact No.:
_______
Signature of Applicant/Owner
Compliance Checklist for Assessment of Fire Safety Inspection Certificate (FSIC) for BUSINESS:
(To be checked/filled up by the Customer Relations Officer)
ASSESSMENT:
Occupancy Permit (if applicable)
Previous Fire Safety Inspection Certificate (FSIC) (if applicable)
Photocopy of Fire Insurance Policy (if applicable)
Fire Code Realty Tax:
Fire Code Premium Tax:
Fire Code Sales Tax:
Fire Safety Inspection Fee:
Storage Clearance Fee:
Fire Code Admin Fine:
Others:
Total:
Certified by:
Customer Relations Officer
Time and Date Received:
_________________
BATANGAS CITY
BUSINESS PERMITS AND LICENSING OFFICE
Application Form for Business
TAX YEAR ________
Instructions
1.
2.
3.
Provide accurate information and print legibly to avoid delays. Incomplete application form will be returned to the applicant.
Ensure all documents attached to this application form are complete and properly filled out.
For corporation, only responsible person (President, Chief Accountant and Corporate Secretary) should sign the form.
In case of Liaison Officer or any authorized representative, please kindly present an authorization letter signed by the
identified responsible person of the corporation .
Business Permit No._____________________(for renewal)
Business Plate No.
Date of Application
Business Type
Single Proprietorship
Partnership
Corporation
New
Renewal
Registration No.
DTI
Quarterly
Date of Registration
Date of Expiry
Registration No.
Date of Registration
Date of Expiry
Registration No.
Date of Registration
Date of Expiry
SEC
Business Classification (micro, small, etc.)
Mode of Payment
Annually
Bi-Annually
CDA
Name of Registrant
For Single Proprietorship
Last Name
First Name
Date of Birth:
Trade Name:
Middle Name
Suffix Name
TIN:
Doing Business As (DBA):
Franchise:
Name of Registrant
For Partnership
Last Name
First Name
Middle Name
Suffix Name
Date of Birth
TIN
For Corporation/Cooperative
Complete Business Name:
Name of CORPORATION/COOPERATIVE:
Name of Registrant:
Address:
Tel. No./E-mail address:
Are you enjoying tax incentive from any government entity? (
Owner’s Address:
House No./Bldg. No.
Building Name
) Yes
TIN:
( ) No
Please specify the entity: ______________________________
Complete Business Address:
House No./Bldg. No.
Building Name
Unit No.
Street
Barangay
Unit No.
Street
Barangay
Subdivision
City/Municipality
Province
Postal Code
Residential Line
Mobile No.
E-mail address
Business Area (in sqm.)
Subdivision
Office Landline
Fax Number
E-mail address
In case of emergency, contact person/Tel.No./Mobile No.:
Total No. of Employees in Establishment
Total No. of Employees Residing in Batangas City
Male:
Female:
In case Place of Business is rented, complete this section:
Lessor’s Name:
Lessor’s Complete Address:
No.
Street
E-mail address:
Lessor’s Date of Birth:
Last Name
First Name
Subd.
Middle Name
Brgy.
Tel. No.
Lessor’s TIN:
City
Monthly Rental
Province
Branch
Business Activity
No. of Units
Line of Business
Capitalization
(for New Business)
Gross/Sales Receipts
(for Renewal)
I DECLARE UNDER PENALTY OF PERJURY that the foregoing information are true based on my personal knowledge and authentic records.
SIGNATURE OF APPLICANT OVER PRINTED NAME
POSITION/TITLE
For City Assessors:
VERIFICATION OF DOCUMENTS
Description
Barangay Business Clearance
Market Clearance (for Market Stall Holders only)
Cert. of Envtl. Permit to Operate/City Environmental Cert.
Veterinary Clearance and Certification
Sanitary Permit/Health Certificate
Fire Safety Inspection Certificate
Others, please specify:
Office/Agency
Barangay
Office of the City Market Administrator
City Environment and Natural Resources Office
Verified by:
Remarks
Office of the City Veterinary and Agricultural Services
City Health Office
Batangas City Fire Station
Application checked by: BPLO
ASSESSMENT:
Treasurer’s Office
Business Tax and Fees Division
Latest Payment
___
___
___
For the BATANGAS CITY FIRE STATION:
APPLICATION NO.: R4A-B_______________
(To be filled up by applicant/owner)
Name of Applicant/Owner:
Name of Business:
Total Floor Area:
Address of Establishment:
DATE:
_______
Contact No.:
_______
Signature of Applicant/Owner
Compliance Checklist for Assessment of Fire Safety Inspection Certificate (FSIC) for BUSINESS:
(To be checked/filled up by the Customer Relations Officer)
ASSESSMENT:
Occupancy Permit (if applicable)
Previous Fire Safety Inspection Certificate (FSIC) (if applicable)
Photocopy of Fire Insurance Policy (if applicable)
Fire Code Realty Tax:
Fire Code Premium Tax:
Fire Code Sales Tax:
Fire Safety Inspection Fee:
Storage Clearance Fee:
Fire Code Admin Fine:
Others:
Total:
Certified by:
Customer Relations Officer
Time and Date Received:
_________________
