<p> RA8502 Application Form for Enterprise Page 1 of 3 Form R. A. 8502-1 (For Jewelry Enterprise) Application No.</p><p>APPLICATION FOR ACCREDITATION Under Jewelry Industry Development Act of 1998 (R.A. 8502)</p><p>(Please check or fill up blank spaces)</p><p>New : ______Micro jewelry enterprise (<P1,500,000)* Renewal : ______Small scale jewelry enterprise (P1.5M-15M)*</p><p>Accreditation valid : ______Medium scale jewelry enterprise (P15M-100M)* until __ Large scale jewelry enterprise (>P100M)*</p><p>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.)</p><p>Principal Officers: President: Vice President: Treasurer: Secretary:</p><p>Equity Profile: Name Nationality Capitalization (Php)</p><p>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 ______</p><p>Sources of Financing Amount (Php) Equity: Local ______Foreign ______Loans ______Others ______Other Financing ______</p><p>C. LABOR GENERATION RA8502 Application Form for Enterprise Page 2 of 3 Labor No. of Employment Direct Indirect Administrative</p><p>D. REGISTRATION UNDER OTHER LAWS (BOI, PEZA, EDA, etc.) Law: ______Law: ______Registration No.: ______Registration No.: ______Date Registered: ______Date Registered: ______</p><p>E. ACTIVITIES IN THE MANUFACTURE OF JEWELRY UNDER R.A. 8502 Activity: Annual Capacity: Manufacturing Process:</p><p>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)</p><p>G. ARE THERE ACTIVITIES OTHER THAN JEWELRY MANUFACTURING? No ______Yes ______If Yes, please indicate below</p><p>Activity Ave. Annual Sales (Php)</p><p>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.</p><p>______Signature over printed name</p><p>______Position</p><p>Subscribed and sworn to before me this ______day of ______, 20______with the affiant exhibiting to me his/her Residence Certificate No. ______dated ______, issued at ______.</p><p>NOTARY PUBLIC Doc No. Page No. Book No. Series of RA8502 Application Form for Enterprise Page 3 of 3</p><p>ANNUAL BUSINESS ______to ______Month Year Month Year</p><p>A. RAW MATERIALS, SUPPLIES AND EQUIPMENT PROPOSED FOR ACQUISITION RAW MATERIALS / SUPPLIES Description Quantity Amount Php</p><p>LOCAL</p><p>Subtotal Php US$</p><p>IMPORTED</p><p>Subtotal US$</p><p>MACHINERY, EQUIPMENT, TOOLS, AND SPARE PARTS Description Quantity Amount Php</p><p>LOCAL</p><p>Subtotal Php US$</p><p>IMPORTED</p><p>Subtotal US$ TOTAL LOCAL Php TOTAL IMPORTED US$</p><p>PORT/S OF ENTRY: (Please attach additional sheet, if necessary)</p><p>B. PROJECTED PRODUCTION AND SALES Activity Quantity Value A. Total Production In house Php Subcontracted Php B. Domestic Sales Php C. Export Sales US$ D. Countries of Destination:</p><p>Submitted by:</p><p>______Signature over printed name</p><p>______Position</p>