JURIDICAL ENTITY APPLICATION FOR REGULAR LICENSE

(To be filled out by FEO Personnel only)

LICENSE CONTROL No.: - - -

TYPE OF LICENSE: LRR LCR
Company Type: ☐ Business ☐ Display Shop ☐ Security Agency ☐ Embassy
☐ LGU ☐ Manufacturer ☐ Dealer ☐ Repair Shop
☐ GOCC ☐ Gun Club ☐ Others _____________________
Day Month Year
(To be filled out by Applicant completely and legibly)
DATE: / /
JURIDICAL ENTITY INFORMATION
Company Name:

Company Last Name

Representative: First Name
Middle Name
Position:
Company Address:
Unit No./Bldg:
Street/Brgy:
City/Municipality:
Region: Postal Code:

Mobile No.: + 6 3 Telephone No.:

Email Address:
Business Permit No.: Expiry: / /
Sec Reg. No.: Expiry: / /
DTI Reg. No.: Expiry: / /
LTO No.: Expiry: / /
TIN No.: - -
Type of Business: Single Partnership Corporation
Business Classification: Local
Local Multinational/International
Bonded Firearms Local Corporation
Last Name
Custodian:
First Name
Middle Name
Mobile No.: + 6 3 Telephone No.: ( )

CERTIFICATION AND UNDERTAKING

We hereby certify that, pursuant to the provisions of Republic Act 10591, all
statements provided herein are true and correct. Further, we certify that we have not been 2” X 2”
convicted of any crime involving moral turpitude, nor havewe been convicted or currently an I.D. Photo of
accused in a pending criminal case for a crime that is punishable with a penalty of more than Company Representative
two (2) years. Any misdeclaration/falsity stated in this application shall be a basis for the
(White Background)
cancellation of this license and the revocation of the registration/s of the firearm/s and its/their
eventual confiscation without prejudice to the filing of criminal and/or civil case against us. Original Photo Only
No Photocopy
No Scanned
______________________________
Signature above printed name of Owner/ Representative Signature above printed name of Bonded Firearm Custodian

SUBSCRIBED AND SWORN to before me this _______ day of _______ 20____

applicant exhibited to me his/her competent evidence of identity issued by
_______________________, bearing ID No. ______________ on ____________ 20_____.

Doc. No.:________
Page No.:________
Book No.: _______
Series of 20______

_____________________________________ RIGHT THUMBMARK

NOTARY PUBLIC (Roll thumbprint from left to right)