Republic of the Philippines

DEPARTMENT OF TRADE AND INDUSTRY

Export Marketing Bureau
1F/2F, DTI International Building, 375 Sen. Gil Puyat Ave., Makati City 1200
(+632) 465.3300 loc. 107| (+632) 899-0111| www.dti.gov.ph/emb| exponet@dti.gov.ph

EMB-FM-EA-01
Revision No: 00 10/11/2016

APPLICATION FOR ACCREDITATION OF EXPORTERS

Please provide all required information, write N/A if not applicable.

COMPANY _________________________________________________________________

OFFICE ADDRESS _________________________________________________________________

FACTORY/PLANT ADDRESS __________________________________________________________

TELEPHONE NOS. __________________________________________________________________

FAX NOS. ___________________________ E-MAIL: _______________________________________

NAME OF CONTACT PERSON _______________________________________________

DESIGNATION OF CONTACT PERSON _______________________________________________

E-MAIL: _______________________________________

NATURE OF ACCREDITATION: NEW RENEWAL

if renewal, ACCREDITED SINCE _______

YEAR ESTABLISHED: ________

LEGAL PERSONALITY:
___ SINGLE PROPRIETORSHIP ___ CORPORATION
___ PARTNERSHIP ___ OTHERS

PRODUCT LINES: ___________________________________________________________

___________________________________________________________

PRODUCTION CAPACITY: ________________________________________________________

NUMBER OF EMPLOYEES: _____ OFFICE _____ OTHERS

_____ FACTORY _____ TOTAL

GROSS SALES (in Philippine Pesos):

YEAR DOMESTIC (%) EXPORT (%) TOTAL

(ACTUAL) (ACTUAL)
_______ ________________ _____ ______________ _____ ________________
_______ ________________ _____ ______________ _____ ________________
_______ ________________ _____ ______________ _____ ________________

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MAJOR BUSINESS ACTIVITY:
(Pls. check all applicable)

Consolidating Processing
Contracting Retailing

Distributorship Service Provider

Exporting Sub-Contracting
Importing Trading
Manufacturing Wholesale

Year Started Exporting: _________

Raw Material/s (please specify. if sourced locally/or abroad with % share)

________________________________________________________________

________________________________________________________________

________________________________________________________________

Exporting to the following countries and % share

________________________________________________________________

________________________________________________________________

________________________________________________________________

I hereby certify that the above information are true and correct and that relevant
export/commercial documents (export declaration, bill of lading/air waybill, commercial invoice,
packing list) shall be made available to verify the same.

_______________________________
(Signature of over Printed Name)

_______________________________
Position

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