CHECKLIST OF REQUIREMENTS FOR FOOD ESTABLISHMENTS

I. GENERAL REQUIREMENTS __________ Notarized Petition Form (See Attached) __________ ID Picture of Owner/General Manager/President of the Company __________ If Corporation, a copy of Registration with Securities and Exchange Commission (SEC) and Articles of Incorporation __________ If Single Proprietorship, copy of Business Name Registration with Bureau of Domestic Trade and Industry (DTI) __________ Location Plan & Flood Plan of Office and Warehouse __________ Contract of Lease of Office and Warehouse, if owned Proof of Ownership __________ List of Products

II. ADDITIONAL REQUIREMENTS A. FOR IMPORTER If Exclusive Distributor: 1 Foreign Agency Agreement duly authenticated by the Territorial Philippine Consulate 1 Certification of Status of Manufacturer issued by the Government Health Authority from the country of origin If Non-Exclusive Distributor: 1 Proforma invoice or copy of unauthenticated foreign Agency Agreement B. FOR EXPORTER : Agreement from Supplier/Manufacturer LTO of the Manufacturer Certification from supplier that the products to be distributed are all registered with BFAD C. FOR WHOLESALER Agreement from Supplier/Manufacturer LTO of Supplier/Manufacturer Certification from supplier that the products to be distributed are all registered with BFAD D. LICENSING FEES BASED ON AO 5 s. 2001 Food Distributors Importer, Exporter, Wholesaler Initial (1 year validity) P 4,000.00 Renewal (2 years validity) P 8,000.00

REPUBLIC OF THE PHILIPPINES Department of Health BUREAU OF FOOD AND DRUGS Alabang, Muntinlupa City
IN THE MATTER OF PETITION OF: _________________________________ TO OPEN A FOOD ESTABLISHMENT PARTICULARLY AS: ( ) Importer ( ) Exporter ( ) Wholesaler X________________________________X PETITION COMES NOW the undersigned petitioner unto the Bureau of Food and Drugs (BFAD), Department of Health (DOH), Alabang, City of Muntinlupa, respectfully alleges: FIRST - That the petitioner is of legal age, married/single, Filipino citizen and residing at _____________________________________________________________________________________; SECOND That he/she desires to open a food establishment, more particularly a/an ______________ of food and food products to be located at ____________________________ and shall be known as _____________________________________________________________________________; THIRD That the establishment, with a capital/investment of P_______________ is owned by _________________________with postal address at ______________________________ and with Telephone No. ___________________________________; FOURTH That the petitioner hereby agrees to change the business name or corporate name of the establishment in the event that there is a similar or same name registered with the Bureau of Food and Drugs or if it rules later that it is misleading; WHEREFORE, the petitioner respectfully prays that he/she be granted License To Operate said establishment after inspection thereof and after compliance with the requirements, rules and regulations of the Bureau of Food and Drugs: METRO MANILA, PHILIPPINES ____________________________ 20 _______. Respectfully submitted:

___________________________________________ (Signature) PRINTED NAME OF PETITIONER SUBSCRIBED AND SWORN to before me this ___________ day of ________________ 20 _______ Affiant exhibited to me his/her Residence Certificate No._____________________Issued on _____________________ at ___________________ on ____________ 20 __________.

_________________________________________ NOTARY PUBLIC

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