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12-1 ETF REgistration Statement
SEC registration statement for the issuer of securities/mutual fund companies/public companies
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: FINANCING COMPANY – BRANCH OFFICE
INFORMATION SHEET OF THE PROPOSED
□
□
I.
□
□
BRANCH
AGENCY
EXTENSION
UNIT
Corporate Profile:
1. Name of Corporation
:
2. Date of Incorporation
:
3. Certificate of Authority No./
Date of Approval
:
4. Principal Office Address
:
5. Contact Number
:
6. Type of Financing Company
Activity to be undertaken by branch:
7. Other business activities
to be undertaken
:
8. Officer of Branch1:
Name
Address
:
Position
:
Birth date
:
Birth Place
:
T. I. N.
:
Specimen Signature
1
:
:
Include Branch Manager, Administrative Officer, Cashier. Attach additional sheet if needed.
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FINANCING COMPANY – BRANCH OFFICE
Officer of Branch
Name
:
Address
:
Position
:
Birth date
:
Birth Place
:
T. I. N.
:
Specimen Signature
:
Officer of Branch
Name
:
Address
:
Position
:
Birth date
:
Birth Place
:
T. I. N.
:
Specimen Signature
:
9. Capital Structure of Head Office:
Class of
Shares
No. of Shares
Par/Stated
Value
(PhP)
Aggregate
Value/Amount
(PhP)
Authorized Capital
Stock
Subscribed Capital
Stock
Paid-up Capital
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FINANCING COMPANY – BRANCH OFFICE
10. Directors and Officers
Name
Citizenship
11. Assigned Capital of the Branch
Residence
Position
P
12. Address of the Proposed Branch
13. Other Branches with Certificates of Authority (CA)*
CA No.
Address
Classification
Assigned
Capital
* Attach additional sheet if needed.
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FINANCING COMPANY – BRANCH OFFICE
II.
Branch’s Plan of Operation
14. Economic profile of the locality where said branch is to be established (i.e., population,
estimated growth rate, employment and business activities/establishments, sources of income
in the locality)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
15. Existing Financing Companies in the Area
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
16. Describe the branch’s:
a. Financial resources (capability to handle assigned capital and expanded resources)
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
b. Management competence
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
c.
Competitive strengths and weaknesses
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
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FINANCING COMPANY – BRANCH OFFICE
17. Branch’s marketing program (i.e., target market, market plan, promotion, distribution)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
18. Branch’s credit and collection policies
Type of Loan
Minimum/Maximum
Loan Value
(PhP)
Rate of
Interest
Term of Loan
Mode of
Payment
I hereby certify that all information set forth in the above report is true and correct to the best of my
knowledge and belief.
Signature of the President over Printed Name
REPUBLIC OF THE PHILIPPINES)
IN THE CITY OF
) S.S.
SUBSCRIBED AND SWORN TO before me this ____ day of ______________, _____ the
above affiant exhibiting to me his/her Tax Identification Number ___________ issued at
____________________ on ____________________.
NOTARY PUBLIC
Doc. No. __________
Page No. __________
Book No. __________
Series of __________
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