SEC. FORM NO. F104 For Representative Olfkwol a Foreign Corporation APPLICATION OF A FOREIGN CORPORATION TO ESTABLISH A REPRESENTATIVE OFFICE IN THE PHILIPPINES (Name of Corporation) hereby applies for a license to transact business in the Philippines as a representative office under the name under Section 125 of Batas Pambansa Blg, 68 and Foreign Investments Act of 1991 (RA 7042, as amended), and submits the following statements and accompanying documents: 1. The applicant is a corporation forms and organized under the laws of HEE enn cere reece ee eee rece foetal term of intends to operate a non-stock non-profit enterprise in the Philippines. 2. The location of its principal or home office isa (Gakdress i Tading street number of principal olfice of foreign corporation) - SE with (Nameot Resident Agent) (Nationality) residence or office address at is its resident agent in the Philippines, authorized to accept summons and legal processes in all legal proceedings and, all notices affecting the corporation. 4. The corporation shall hold office in and operate in pesily place in the Phalppines) 5. The purpose(s) of said corporation which it intends to pursue in the transaction of its business in the Philippines is/are (lease use auiional Shoot necessary)nN The names and addresses of the present directors and officers of the corporation are as follows: NAME ADDRESS The authorized capital. stock ~— of _~—sthe_-—corporation is roughly equivalent to P and the aggregate number of shares which the corporation has_— authority to. issue is (ionized by classes series any) The outstanding capital stock ofthe corporation is. and the aggregate number of shares which the corporation has issued is Beene (ieomized by clases & series, i any) all of Which are of a par value of The amount actually paid in the treasury of the foreign corporation is That we hereby authorize the Securities and Exchange Commission and the Bangko Sentral ng Pilipinas to examine and verify the deposit in the leased alienate aa el ee said corporation in the (Name of Banky amount of which is equivalent to (P_______) at the current rate of exchange, representing the actual remittance of the applicant. This authority is valid and inspection of said deposit may be made even after the issuance of the license of the company. That we undertake to change our corporate name as herein provided, or as amended thereafter, immediately upon receipt of notice or directive from the Commission that another corporation, partnership or person has acquired a prior right to the use of that name or that the name has been declared misleading, deceptive, confusingly, similar to a registered name, or contrary to public morals, good custom or public policyDone this day of /201__at (Cignatare roo the resident aga) SUBSCRIBED AND SWORN TO before me, this day of __, 200___ affiant exhibiting to me his/her Government issued IDs. issued at on NOTARY PUBLIC No. No. Hisk No, Series 200