BLPD Form OB1

Revised 2011

Republic of the Philippines

Office of the City Mayor

BUSINESS LICENSE AND PERMITS DIVISION

UNIFIED FORM
Application Form for Business Permit
Tax Year ___________
New

Amendment:
From Single to Partnership

Renewal

Mode of Payment:
Annually

From Single to Corporation

Additional

RECEIVED

DATE & TIME:

Bl-Annually

From Partnership to Single

Transfer:
Ownership

CONTROL No:

Quarterly

BY:

From Partnership to Corporation

SURRENDER
From Corporation to Single

DATE & TIME:

Location
From Corporation to Partnership

BY:

Date of Application:

DTI Registration No.:

Reference No.:

SEC Registration No.:

Type of Business:

CDA Registration No.:

PhilHealth No.:

CTC No.

Single

Corporation

Partnership
No.:
Issued On:
Issued at:

Cooperative

Pag-ibig No.:
SSS No.:
TIN:

NAME OF TAXPAYER:
Last Name:

First Name:

Middle Name:

Business Name:
Trade Name/Franchise:
Name of President/Treasurer of Corporation:
Last Name:
First Name:

Middle Name:

Business address

Owners Address

House No./Bldg. Name

Street:
Barangay:
Subdivision:
City/Municipality:
Tel. No.
E-mail Address:
Property Index Number (PIN):

House No./Bldg. Name:

Street:
Barangay:
Subdivision:
City/Municipality:
Tel No.:
E-mail Address:
No. of Delivery Vans:

Business Area (in Sq. m.)

If Place of Business is Rented;

House No./Bldg.Name:
Street:
Barangay:
Tel. No.
In case of Emergency
BUSINESS
ACTIVITY
Code

Lessors name:
First Name:

Last Name:
Lessors Address

# of Employees Residing in
LGU:

No. of Employees:

Monthly Rental:
Middle Name:

Subdivision:
City/Municipality:
Province:
E-mail Address:
Contact Person/Tel no./ Mobile Phone No./E-mail address:
No. of
Units

Capitalization (for New

Business)

Line of
Business

Gross Sales/Receipts (for Renewal)

Essential

Non-essential

SUBSCRIBED AND SWORN to before me this _______day of ______________,20____________in

the City of Tacloban.
Doc. No. _______________
Page No: _______________
Book No:_______________
Series of 20_____________
_____________________________________________
____________________________________________
Administering Officer
Representative

2x2
Recent ID picture

CTO

BLPD Form OB1

Revised 2011

MAP SKETCH

INSPECTION REPORT:
BUSINESS ACTIVITIES:
No. of Units:

TAXABLE ITEMS:

Main: _______________________________________________
___________________________________
_______________________________
________________________________________________ ___________________________________
_______________________________
________________________________________________ ___________________________________
________________________________
________________________________________________ ___________________________________
________________________________
________________________________________________ ___________________________________
_______________________________
________________________________________________ ___________________________________
________________________________
________________________________________________ ___________________________________
________________________________
________________________________________________ ___________________________________
________________________________
Others: ________________________________________________ ___________________________________
_______________________________
________________________________________________ ___________________________________
_______________________________
________________________________________________ ___________________________________
_______________________________
________________________________________________
___________________________________ ________________________________
________________________________________________ ___________________________________
_______________________________
________________________________________________ ___________________________________
_______________________________
________________________________________________ ___________________________________
________________________________
________________________________________________ ___________________________________
________________________________

No. of Employees:

__________________ _____
___________________________________

Signboard (in sq. m.):

Single Faced:
____________________
_________________________________________
Double Faced: ___________________
_________________________________________
Bldg./Space/Lot Rental: P___________________ /month
_________________________________________
Vehicles used in Business:
Peddling
Delivery
Gross weight of:
4,500kgs. Or more
____________
_____________
Below 4,500 kgs.
____________
_____________
Motorized tricycle
____________
_____________
Motorcycle
____________
_____________
Others: caretelas
____________
_____________
Pedicabs
____________
_____________

Area used in Business (in sq. m.):

For Eatery Establishment:
No. of Tables :
No of Chairs:
Total seating capacity:

For Boarding House:

No. of Beds:
Total No. of Boarders:

___________________________
___________________________

Estimated Capitalization:

Inspection conducted by:

______________________________________
BLPD Inspector
Conform:
Date of Inspection: ______________________

________________________________________
Owner/Representatives

Oath of Undertaking:
I undertake to comply with the other regulatory requirement and deficiencies
within 30 days from release of the business permit.

__________________________________________________
Signature of Applicant over printed name

FOR INQUIRIES, PLEASE CONTACT:

BLPD PERSONNEL at #325-7023 or Visit at http://www.blpd.tacloban.gov.ph