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Application for Registration
AFAB application form for registration
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APPLICATION FOR REGISTRATION
TYPE OF APPLICATION
___ New FAB Enterprise
___ New Project
___ Expansion Project
___ Amendment of Business Activity
Republic of the Philippines
Office of the President
THE AUTHORITY OF THE FREEPORT AREA OF BATAAN
The Freeport Area of Bataan
FOR AFAB USE ONLY
Application No.
Date filed
Application Fee:
O.R. no.
Instructions: Please accomplish this form by providing the required information on appropriate spaces. Do not leave any blank space, indicate “N/A” if not
applicable and attach additional sheet/s as Annexes if necessary. Only complete set of documents will be accepted for processing.
COMPANY PROFILE
1. Name of Company: Please write the company’s full name legibly.
2. Name of Proposed FAB Enterprise: Please write the proposed FAB Enterprise’s full name legibly.
3. Office Address: Write or type the company’s full address. Place one letter on each box. Leave one box blank between names.
No. / Building
Street & Barangay
City / Town
Province
Zip Code
4. Office Contact Information: Write or type your company’s full contact details.
Telephone No.
Fax Number
Telephone No.
E-mail Address
5. Nature of Business: Please check what applies.
Division of Existing
Corporation
Division of New Corporation
as one of its Business
New Corporation as its
Sole Business
Proposed Corporation
Partnership
Single Proprietorship
Others (Please Specify): ____________________________________
6. Name of Authorized Representative: Write or type the full name in the given sequence. Place one letter on each box. Leave one box blank between names
LAST
FIRST
MIDDLE
7. Contact Information of Authorized Representative: Write or type authorized representative’s full contact details.
Telephone No.
Cellphone No.
E-Mail Address
8. SEC Registration/Articles of Incorporation
Year Registered
Primary Purpose (per Articles of Incorporation/Partnership)
SEC Registration No.
Authorized Capitalization:
Subscribed Capital
Paid-Up Capital
AFAB-07-0501_FM_Application for Registration
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9. Shareholders of Intended FAB Enterprise
Name
Nationality
% Ownership
Amount of Share
10. Description and location of current / previously undertaken projects similar to that proposed at FAB:
PROJECT DATA DESCRIPTION
General Project Description
Concept of business operation;
Facilities to be setup;
Product lines / services with description & uses highlighting unique or distinguishing features;
Market study highlighting the target market & indicating whether new, expansion or transfer of operations, stating reasons for transfer
List of clients & suppliers with contact information; and,
Environmental impact statement for environmentally-critical projects or those to be located in environmentally critical areas.
Technical Data
For Telecommunications and Information Technology Related Projects: Systems /Schematic Diagram/network configuration Diagram (Shows local network
in FAB plus connectivity to total Network outside FAB, attach separate sheet if necessary)
Technology Transferred, if applicable; (Highlight new production technology or state-of-the art machinery/equipment to be used if any)
(Attach Process Flow Chart)
Environmental Soundness
Raw materials the proposed project will consume/be used during operations:
Raw material/s
Solid Waste
(Description & Estimated Volume/Day)
Volume/Month
Liquid Waste
(Description & Amount/Day)
Source
Cost
Gaseous Emissions
(Source (e.g. furnace boilers, etc.)
Brief Description of Waste Disposal System and Planned Treatment process:
List of Machinery/Telecommunication/Electronic/Computer/ and
other Equipment/Devices to be used (with machinery layout) and
Antennas to be installed (including technical specifications):
No. of
units
Total Cost
Origin
Mode of Shipment Air/Sea/Land
Space Requirements
Intended location in FAB:
Land Area
Status of Facility
Power (KWH/mo.)
Building Floor Area
Others:
Lease Existing Yes No
Construct new facility Yes No
Sub-leased
Yes No
Buy Land
Yes No
Power and Other Utility Requirements:
Water (cu.m./mo.)
Telephone (lines)
Others (please specify)
AFAB-07-0501_FM_Application for Registration
Page 3 of 4
List of Support/Infrastructure Services required within the FAB
Timetable of the Project
1.
2.
3.
4.
5.
Building construction/renovation
Importation of machinery/equipment
Installation of machinery/equipment
Hiring/Training of Personnel
Start of Operations
Manpower Requirements
1st year
3rd year
5th year
Financial Data
1st year
3rd year
5th year
Cumulative Investment / Project Cost
1st year
3rd year
5th year
During Construction (Cumulative)
During Operation:
Regular (Cumulative Totals)
Contractual (Cumulative Totals)
Total Employment during Operation
Projected Foreign Gross Revenues (Export services
including constructive exports within FAB and to other similar
ecozones)
Projected Domestic Gross Revenues (Revenues outside
FAB and other similar ecozones)
Cumulative Tax Provision
(5% of Gross Income Earned)
Land
Land Improvements
Buildings
Plant Machinery & Equipment
Communication and Electronic Equipment
Transportation Equipment
Office Equipment
Furniture and Fixtures
Other assets
Sub-Total
Working Capital
TOTAL INVESTMENT / PROJECT COST
Sources of Funds (Total Investment for the 1st year only)
Percentage (%)
Amount
From Equity
From Loans: (Attach certification/proof of funding on loan obtained)
Bank Loans
Advances from parent Company (if any)
TOTAL SOURCES OF FUNDS
Projected Rate of Return on Investment (ROI)
Projected Payback Period
SUPPORTING DOCUMENTS AS INTEGRAL PART OF APPLICATION
Letter of intent accompanied by this Form
Board Resolution of duly authorized representative / signatory
Certified true copy of Business Registration (Securities and Exchange Commission (SEC) Papers, License to transact Business in the Philippines, DTI
Registration)
Resume of Stockholders & Key Management Officers
Proposed site development plan to include perspective drawings, timetable and cost.
Proof of Financial Capability (any or all of the following):
Latest audited financial Statements of enterprise (or parent/management company if applicable) stamped “Received ” by the Bureau of Internal Revenue
Latest income tax return of enterprise (or parent/management company if applicable)
Verifiable Bank Certification of deposits or approved loan or credit line; if equity financing is less than total project cost
Formalities (licenses, permits, etc..) with National Telecommunications Commission (NTC) and franchises from Congress, if applicable
Brochures
Others, Pls. specify____________________________________________
Note: AFAB reserves the absolute right to require other documents that it may deem necessary to complete its evaluation of the application of the prospective
locator.
AFAB-07-0501_FM_Application for Registration
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APPLICANT'S ADDITIONAL UNDERTAKINGS
In addition to above performance commitments, the applicant also commits to undertake the ff.:
1. To support the goals of transforming the FAB into a modern and world-class metropolis;
2. To help promote the FAB as an investment and tourist destination;
3. To comply with all the rules and regulations on importation/exportation promulgated by government authorities concerned;
4. To establish a separate entity that will exclusively engage in the proposed business activities at the FAB, if so required by AFAB;
5. To submit such periodic reports and other information on its activities in the FAB as may be required by AFAB.
6. To hire, as much as practicable, employees and workers from peripheral areas of the FAB through Labor Center of AFAB, and to abide by existing labor
policies, rules and regulations pursuant to the Labor Code of the Philippines;
7. That pursuant to the provisions of Section 3 and Section 14 of Republic Act No. 3019 [Anti-Graft Act], the applicant-enterprise has not given or promised to give
and will not give any gift to any officer or employee of the Authority of Freeport Area of Bataan in connection with the filing and processing of this application.
8. To adhere to zoning regulations, building and environmental standards prescribed by the authorities concerned; and
9. To comply with the terms and conditions of the lease agreement with AFAB.
Done in the city province of _______________________________this _________ day of_____________,20____
___________________________
(Applicant Firm)
__________________________________________
(Signature over printed name)
__________________________________________
(Position/Designation)
Republic of the Philippines}
City/Province of
}S.S.
_________________________________}
Subscribed and sworn to before me this___________ day of ___________________, 20_______in the City /Province of ____________________. Affiant exhibited to me his
Community Tax Certificate No._____________________ issued at _____________________, on_________________
Doc. No.___________
Page No.___________
Book No.___________
Series of___________
Do NOT write anything after this part. TO BE FILLED OUT ONLY BY AFAB PERSONNEL
Received from the locator applicant this _____ day of _____________, 20___.
Received and checked by:
____________________
For the AFAB - Corporate Affairs Department
Item
Terms and Conditions
Remarks
Lease Rate
Lease Term
Security Deposits (2 mos. Advance, 2 mos. deposit)
Escalation Rate (5% annual escalation)
Performance Bond (2% for Cash, 10% for Surety)
Special provisions, if any
For the AFAB - Corporate Planning Department
Item
Terms and Conditions
Remarks
Leased Premises
Leased Area
Locational Clearance and Zoning Compliance
Certificate (Please attach)
Provision for parking
Building Frontage
Condition for pre-termination
Special provisions, if any
Received by the Registration Division with complete details this _____ day of _____________, 20___.
Received and checked by:
____________________
Application Fee is Php. 3,600.00 (for non-pioneer enterprises), Php 6,000.00 (for pioneer enterprises).
Registration Fee is Php. 6,000.00
If you have any questions or inquiries, please feel free to contact the Registration Division at (047) 935-4004 loc. 8115 or (02) 236-5010 loc. 8115.
AFAB-07-0501_FM_Application for Registration
