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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? (
Owners 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:

Lessors Name:
Lessors Complete Address:
No.
Street
E-mail address:
Lessors Date of Birth:

Last Name

First Name

Subd.

Middle Name

Brgy.
Tel. No.
Lessors 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:
Treasurers 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:

_________________