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2 Company/Consortium

NEDA application form for consulting dervices (for corporation, partnership, and sole proprietorship)

Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Form 2 – Application Form for Consulting Services (For corporation, partnership, and sole proprietorship)
Republic of the Philippines
National Economic and Development Authority
Application for Accreditation/Registration

I ________________________ of legal age, with postal address at ________________________
___________________, after having been duly sworn in accordance with the law, hereby depose and say:
1.

That I am the ____________________________ of ______________________________
_____________________ duly authorized to make this statement, as evidenced by the attached
written authority from the proprietor/governing board of the firm;

2.

That I hereby present the following information for Accreditation/Registration for Consulting
Services with the National Economic and Development Authority.

A. GENERAL INFORMATION

1. Name of Firm/Individual
a. Main Office Address
b. Phone Number
c. Fax Number

: ______________________________________________
:Street#: _____________ Street Name: ________________
Postal Code:_________ City/Region: ________________
: _________________ d. Email Address ____________
:__________________ e. Telex Number ____________

2. Type of Firm (Please Check)
[ ] Sole Proprietorship
[ ] Partnership

[ ] Corporation
[ ] Others

3. Person managing the affairs of the firm
a. Name
: _____________________________________________
b. Designation
: _____________________________________________
c. Phone Number
: _____________________________________________
d. Specimen Signature
: _____________________________________________
4. For purpose of submission of bids, quotations, offers or proposals, updates and
verification of Registration Records:
a. Person Authorized to Sign : _____________________________________________
b. Designation
: _____________________________________________
c. Phone Number
: _____________________________________________
d. Specimen Signature
: _____________________________________________
5. For purpose of contract signing or acceptance of Purchase Order/Job Order:
a. Person Authorized to Sign : _____________________________________________
b. Designation
: _____________________________________________
c. Phone Number
: _____________________________________________
d. Specimen Signature
: _____________________________________________

B. LEGAL ASPECT

1. Registration/Licenses
Registration/
License #

Place of
Registration

Date of Reg.
(mm/dd/yy)

Expiration Date
(mm/dd/yy)

DTI Business Name
Registration
SEC (if partnership or
corporation)
Certificate
Mayor’s
Permit/Municipal
License
BIR VAT Registration
Certificate

2. Ownership
NAME(S) of Owner/Stockholders/Partners

Tax ID Number (TIN)

3. Extent of Filipino ownership of the firm’s assets: _______%

C. TECHNICAL ASPECT (Please prepare in a separate sheet the list of contracts for
professional or consulting services entered into for the last two (2) years stating the name of
client, title/nature of consulting service and inclusive period)
D. FINANCIAL ASPECT (all amounts in Philippine Pesos)
Current Year-1

Current Year-2

Total Current Assets
Total Current Liabilities
AFFIDAVIT
I hereby certify that all information provided herein, including the annexes and enclosures
thereto, are true and correct, and I hold myself liable, criminally or civilly, for any misrepresentation or
false statement made herein.
I have hereunto affixed my signature this ____ day of _________, 200___ at

_______________________ , Philippines.
__________________
Affiant

Republic of the Philippines
PROVINCE/CITY OF

)
) S.S.

SUBSCRIBED AND SWORN TO before me this _____ day of ___________, 20__ at
___________________, affiant exhibited to me his/her Community Tax Certificate No.
___________ issued at ________________on _____________________.

NOTARY PUBLIC
 
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