RA8502 Application Form for Enterprise

RA8502 Application Form for Enterprise Page 1 of 3 Form R. A. 8502-1 (For Jewelry Enterprise) Application No.

APPLICATION FOR ACCREDITATION Under Jewelry Industry Development Act of 1998 (R.A. 8502)

(Please check or fill up blank spaces)

New : ______Micro jewelry enterprise (

Accreditation valid : ______Medium scale jewelry enterprise (P15M-100M)* until __ Large scale jewelry enterprise (>P100M)*

A. BASIC INFORMATION Name of Firm: Office Address: Factory/Plant Address: Tel. No. Fax No. Contact Person / Position: Year Established DTI/SEC/CDA Reg. No.: Date: BIR Reg. No. Date: BOC Customs Intelligence and Investigation Service (CIIS) Reg. No.: Date: Legal Personality: ____Single Proprietorship ____Partnership ___Corporation ___Others (Cooperative, etc.)

Principal Officers: President: Vice President: Treasurer: Secretary:

Equity Profile: Name Nationality Capitalization (Php)

B. PROJECT COST AND SOURCES OF FINANCING (To be filled up by New Applicant) Project Cost (Php) Building ______Machinery and Equipment ______Installation and other Cost ______Financial Charges ______Working Capital ______Others (Please Specify) ______Total Project Cost ______

Sources of Financing Amount (Php) Equity: Local ______Foreign ______Loans ______Others ______Other Financing ______

C. LABOR GENERATION RA8502 Application Form for Enterprise Page 2 of 3 Labor No. of Employment Direct Indirect Administrative

D. REGISTRATION UNDER OTHER LAWS (BOI, PEZA, EDA, etc.) Law: ______Law: ______Registration No.: ______Registration No.: ______Date Registered: ______Date Registered: ______

E. ACTIVITIES IN THE MANUFACTURE OF JEWELRY UNDER R.A. 8502 Activity: Annual Capacity: Manufacturing Process:

F. SALES PERFORMANCE FOR THE PAST THREE (3) YEARS (To be filled up by Existing Jewelry Enterprises) Domestic Export Total Year Peso Equivalent Quantity Value (Php) Quantity Quantity Value (Php) (Php)

G. ARE THERE ACTIVITIES OTHER THAN JEWELRY MANUFACTURING? No ______Yes ______If Yes, please indicate below

Activity Ave. Annual Sales (Php)

I hereby certify that the above information are true and correct and that relevant documents shall be made available to verify the same, if necessary.

______Signature over printed name

______Position

Subscribed and sworn to before me this ______day of ______, 20______with the affiant exhibiting to me his/her Residence Certificate No. ______dated ______, issued at ______.

NOTARY PUBLIC Doc No. Page No. Book No. Series of RA8502 Application Form for Enterprise Page 3 of 3

ANNUAL BUSINESS ______to ______Month Year Month Year

A. RAW MATERIALS, SUPPLIES AND EQUIPMENT PROPOSED FOR ACQUISITION RAW MATERIALS / SUPPLIES Description Quantity Amount Php

Subtotal Php US$

IMPORTED

Subtotal US$

MACHINERY, EQUIPMENT, TOOLS, AND SPARE PARTS Description Quantity Amount Php

Subtotal Php US$

IMPORTED

Subtotal US$ TOTAL LOCAL Php TOTAL IMPORTED US$

PORT/S OF ENTRY: (Please attach additional sheet, if necessary)

B. PROJECTED PRODUCTION AND SALES Activity Quantity Value A. Total Production In house Php Subcontracted Php B. Domestic Sales Php C. Export Sales US$ D. Countries of Destination:

Submitted by:

______Signature over printed name

______Position