Republic of the Philippines BTRCP Form No.

16A
Department of Trade and Industry 2008 Edition
(Please read instruction/
requirements at the back
BUSINESS NAME APPLICATION FORM before filling-up the
FOR SOLE PROPRIETOR application form)
NEW RENEWAL
(PLEASE TICK THE APPROPRIATE BUTTON FOR REGISTRATION OF BUSINESS NAME UNDER ACT 3883, AS AMENDED)
A. Business Details
1. Type of Business Main 2. For Renewal Only
Branch _____________________ _______________________ Previous Certificate No. ___________
(Indicate Date of Registration and Certificate No. of Main Office)
Franchise/Dealership______________________________________ Date of Registration ___________
(Indicate Name of Franchisor/Dealer)
st
1 -
3. Proposed Business Name(s) nd
2 -
(in order of priority) rd
3 -
4. Tax Identification Number 5. E-mail Address
B. Business Address and Phone Numbers
6. House/Building No. 7. Street 8. Barangay 9. Town/City

10. Province 11. Zip Code

12. Phone Numbers 13. Are you the original owner of the business? Yes No
Landline ____________
If No, acquired thru Transfer Assignment Bulk Sales
Mobile ____________
14. I would like to receive /subscribe to simple messaging service (SMS) Business Name _____________________________________
notification and I understand that applicable fee will be deducted from my Certificate No. _____________________________________
mobile credit per SMS I receive or send. Yes No Date of Registration ___________________________________
C. Employee Count and Capitalization
15. No. of Employees _____ Male _____ With Disability 16. Capitalization
_____ Female _____ With Disability (in Philippine Peso)
D. Owner s Details
17. First Name 18. Middle Name 19. Last Name 20. Suffix (e.g. Jr, Sr, I, II)

21. Sex 22. Do you consider yourself as Person With 23. Date of Birth 24. Civil Status 25. Citizenship
Male Female Disability (PWD)? Yes No
E. Owner s Address and Phone Numbers
26. House/Building No. 27. Street 28. Barangay 29. Town/City

30. Province 31. Zip Code

32. Phone Numbers 33. Have you ever been convicted of any crime involving
Landline _______________ moral turpitude? Yes No
Mobile _______________
F. Business Activity(ies) and Product(s)/Service(s)
34. Business Activity Exporter Importer Wholesale 35. Product Handled/Service Rendered
Retailer Manufacturer/Producer Service
UNDERTAKING
I hereby declare that all information supplied in this application are true and correct to the best of my belief and knowledge, and further declare
that any false or misleading information supplied, or production of materially false or misleading document to support the application shall be a
ground for the appropriate criminal, civil and or administrative action against me.
Further, I hereby commit to abide by the following:
1. Change and/or cancel the registered business name in the event that there is already another person, firm or entity lawfully using an
identical or confusingly similar name;
2. Comply with the provisions of Act 3883, as amended and its implementing rules and regulations and other related laws and rules; and
3. Recognize and accept the authority and power of the Department of Trade and Industry or any of its designated representatives or
agents to check and monitor compliance to my business establishment with various trade and industry laws and its implementing rules
and regulations, and violations of the same shall be likewise a ground for the cancellation of my Certificate of Business Name
Registration.

_________________________________ ______________________________
(Signature Over Printed Name) Date
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
For DTI Use Only
TRN/PBN Date of Registration Certificate No. Processed By Office OR Number Date Paid

Approved Business Name

 GENERAL INSTRUCTIONS IN ACCOMPLISHING AND SUBMITTING APPLICATION AND REQUIREMENTS
Accomplish the application form by typing/printing (upper case/capital letter); completely and clearly. All required
fields/information are printed in italics. For online application form, these are marked with red asterisk (*).
Do not abbreviate the information, in business name, business and owner s address and name of owner in the Certificate
of Business Name Registration.
Only the owner of the business is authorized to sign the application form.
Submit the following (where applicable), together with the application form to the proper DTI Office, where the business is
located.
A. Business Details
1. Type of Business. Tick the appropriate button for your business. If Branch, indicate the Date of Registration and
Certificate Number of main office. If Franchise or Dealership, indicate the name of the Franchisor. A Consent Certificate
in lieu of the Franchise/Dealership Agreement is required to be submitted.
2. For Renewal Only. Indicate the previous Certificate Number and Date of Registration.
3. Proposed Business Name. Indicate in order of priority. Business Name (BN) should be reflective of the nature of
business and must have prefix, infix , and/or suffix (e.g. Alberto s Garment Manufacturing, Marita s Carinderia). Use of
dominant or generic (e.g. Automotive Enterprise, you must add a prefix ) business names are not allowed.
4. Tax Identification Numbe (TIN). A required information to be able to transact with any government office per E.O. 98.
5. E-mail Address. A required information for online applications only.
B. Business Address and Phone Numbers
6. House/Building No. Includes building name and floor number, Lot, Block and Phase numbers, and Subdivision name,
among others. These information will be printed in the Certificate of BN Registration.
7. Street, 8. Barangay and 9. Town/City and 10. Province. These information will be printed in the Certificate of BN
Registration.
11. Zip Code. Check the Philippine Postal Service Web site for proper Zip Code
12. Phone Numbers. Either landline or mobile numbers with area code. Required information for online applications only.
13. Method of Acquisition. If business is acquired through Transfer, Assignment or Bulk Sales, indicate BN, Certificate
Number, and Date of Registration of previous owner. Submit the following: (1)Affidavit of Vendor stating that at the time
of sale, he had no creditors, or if there are creditor(s) a copy of notice to them regarding the sale; (2) Deed of Sale,
Assignment or Transfer; (3) Inventory of properties sold, assigned or transferred; (4) Original Certificate of Business Name
Registration of Vendor for cancellation.
14. Subscription to simple messaging service (SMS). Updates the subscriber the status of applications, DTI advisory,
among others. A corresponding fee will be deducted from your mobile credit per SMS received or sent.
C. Employee Count and Capitalization
15. No. of Employees. Indicate number of employees, male/female employees with disability.
16. Capitalization. Indicate a more realistic capitalization.
D. Owner s Details
17. First Name, 18. Middle Name, 19. Last Name, 20 Suffix (if applicable). Indicate correct entries as these would appear in
the Certificate of BN Registration.
21. Sex. indicate Male or Female.
22. Person With Disability. Indicate if applicable, for statistics purposes.
23. Civil Status. Indicate if Married, Single, or Widowed.
24. Date of Birth. Owner must be of majority age (at least 18 years old)
25. Citizenship. Owner must be a Filipino Citizen. Proof of citizenship (photocopy) such as PRC ID, voter s ID, passport is
required. For Naturalized Filipinos, submit photocopies of Naturalization Certificate and Oath of Allegiance or ID card
(original to be presented for comparison) issued by the Bureau of Immigration and Deportation (BID). If Filipino citizenship
is Acquired by Election, submit photocopy of Affidavit of Election or ID Card issued (original to be presented for
comparison) by BID.
Foreign Nationals are subject to Foreign Investment Act and must submit the following: (1) Certified True Copy (CTC) of
the current year s Permit to Engage in Retail Business under R.A. 1180 from the concerned Local Government Unit (Alien
Retailer only); (2) Photocopy of Alien Certificate of Registration (ACR); (3) Accomplished DTI Form No. 17 under R.A.
7042; (4) Current written appointment of Filipino resident agent; (5) clearance from other involved agencies such as
Department of Science and Technology, Philippine National Police (PNP), etc.
E. Owner s Address and Phone Numbers
26. House/Building No. This information include building name and floor number, Lot, Phase and Block numbers, and
Subdivision, among others. This information will be printed in the Certificate of BN Registration.
27. Street, 28. Barangay, 29. Town/City and 30. Province. These information will be printed in the Certificate of BN
Registration.
31. Zip Code. Check the Philippine Postal Service Web site for proper Zip Code.
32. Phone Numbers. Either landline or mobile numbers with area code. Required information for online applications only.
33. Conviction of any crime involving moral turpitude. Indicate Yes or No, for records purpose only.
34. Business Activity. Include applicable business activities and identify only one (1) main activity.
35. Product/Service. Include applicable product/service as long as they are allied. Identify only one (1) main product/service.

ADDITIONAL DOCUMENTS MAY BE REQUIRED ON A CASE TO CASE BASIS DEPENDING ON ACTUAL EXAMINATION AND
PROCESSING OF THE APPLICATION.
APPLICABLE FEES
BN Application Fee (New/Renewal) - Php 300.00 Documentary Stamp Tax - Php 15.00
Bulk Sales Php 55.00 Surcharge for Renewal (beyond 90 days after expiration) - Php 100.00