Republic of the Philippines

OFFICE OF THE CITY TREASURER

City of Puerto Princesa

NEW
RENEW
ADDITIONAL
TRANSFER
Ownership

APPLICATION FOR BUSINESS PERMIT

Form/Application No:

PIN:

Owner: Surname :

Location

BIN:

Date:

Firstname :

Middlename :

Sex :
Male
Female

Corporate Owner (If Legal Organization)

Administrator : Surname :

Firstname :

Middlename :

Sex :
Male
Female
Type :
Main
Branch

Business Tradename :

Owner Address:
House No./Bldg. No. :
Building Name :
Street :

Type of Business Organization:

Single Proprietorship

Barangay :

Business Address :

Subdivision :

House No./Bldg. No. :

Subdivision :

City/Municipality

Building Name :

City/Municipality :

Province :

Unit No. :

Province :

Tel. No. :

Street :

Tel. No. :

Email Address :

Barangay :

Email Address :

Unit No. :

Business Area (sqm) :

Rented

Number of Employees :
Male:______ Female:______
Owned

TIN No.:
Partnership

DTI No. :
Date of Registration:

Corporation

SSS No. :
Date of Registration:

Cooperative

Others:

SEC No. :
Date of Registration:

If place of business is rented, please identify the following:

Lessors: Last Name :

First Name :

Middle Name :

Address : House No./Bldg. No. :

Subdivision :

Building Name :

City/Municipality :

Unit No. :

Province :

Street :

Tel. No. :

Barangay :

Email Address :

LINE OF BUSINESS

CAPITAL INVESTMENT (for New Business)

Monthly Rental

GROSS SALES / RECEIPTS (for Renewal)

Retailer of Essential Commodities

Wholesaler of Essential Commodities
Retailer of Non - Essential Commodities
Wholesaler of Non - Essential Commodities
Retailer of Tobacco
Retailer of Liquor
Restaurant / Refreshment Parlor / Canteen etc
Hotel / Pension / Inn
Bar
Service Contractor :

Delivery Truck / Van

Weights and Measure
Personnel
REMARKS
SWORN STATEMENT OF GROSS SALES AND / OR RECEIPTS
I HEREBY CERTIFY that the gross sales and/or receipts declared above is true, correct and complete statement of the sales and/or receipts realized by the above
mentioned establishment as appearing in the Sale Book and /or Books of Account for the period from _______________________ to ________________________ 20______
___________________________________________
Signature of Applicant / Representative
SUBSCRIBED AND SWORN TO before me this ________ day of ________________________ 20___ affiant exhibiting to me his/her Community Tax Certificate No.
_________________________ issued on _________________________, 20______ in the City of Puerto Princesa.
___________________________________________
City Treasurer

Affidavit of Undertaking Under Oath

I undertake to comply with the regulatory requirement and other deficiencies within 30 days from the release of business permit.
Failure on my part to comply therewith will cause the cancellation of my Temporary Permit.
City Zoning Division Requirements

Complied

Not Complied _____________

City Tourism Office Requirements

Complied

Not Complied _____________

City Health Office Requirements

Complied

Not Complied _____________

City Engineering Office Requirements

Complied

Not Complied _____________

City Fire Marshall Requirements

Complied

Not Complied _____________

Social Security System

Complied

Not Complied _____________

_____________________________________________________
Signature of Applicant over Printed

SUBSCRIBED AND SWORN TO before me this ________ day of ________________________ 20___ affiant exhibiting to me his/her Community Tax
Certificate No. _________________________ issued on _________________________, 20______ in the City of Puerto Princesa.
Doc No. __________________
Page No. _________________
Book No. _________________
Series of _________________

Verification of Documents
Description
Barangay Clearance
Zoning Clearance
Sanitary / Health Clearance
Occupancy Permit
Fire Safety Inspection Certificate
Others, Please Specify

Office / Agency

Date Issued

Verified by (BPLO Staff)

Barangay
Zoning Division
City Health Department
Building Official
City Fire Department

Sketch Map (if applicable):

_______________________________ _______________________________
Business Taxes and Fees Division

Land Tax Division

_______________________________ _______________________________
SSS

Phil Health

_______________________________ _______________________________
Zoning
City Fire Marshall

_______________________________ _______________________________
City Tourism Officer

City Health Officer

_______________________________ _______________________________
DTI

Bay Watch

_______________________________
Market Superintendent
_______________________________
CMO Representative
Permits and Licensing Division