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1F Application for Classifier's License

PhilFIDA application form for Classifier's license

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2004

Republic of the Philippines
Department of Agriculture

FIBER INDUSTRY DEVELOPMENT AUTHORITY
Region ____, ___________
Control No.
: ______
Date Applied
: ______
Date Released
: ______
License Expires on: ______
APPLICATION FOR CLASSIFIER LICENSE
(Original)
The Administrator
FIDA, Quezon City
Thru: The Fiber Regional Director
Region ___________
Madam:
I have the honor to apply for a Classifier License pursuant to PD 652 in relation to Executive
Order Nos. 709 and 116, and in accordance with the provisions of FIDA Revised Administrative Order
No. 1.:
1.

Name __________________________________________________________________________
TIN __________________________________ Civil Status ______________________________
Residence _______________________________________________________________________
Sex ___________
Age ________ Height __________ (cm)
Weight ____________ kls.
Nationality _________________________________________
Employer _____________________________ Address __________________________________;

2.

That I am applying as classifier of :
( ) Abaca
( )
( ) Buntal
( )
( ) Cabo Negro
( )
( ) Canton
( )
( ) Coir
( ) Sisal
( )
( ) Cotton

3.

(Pls. check applicable boxes)
Kapok
( ) Ramie
Kenaf
( ) Sabahon
Maguey
( ) Salago
Musa Factory
( ) Non-Abaca (MSP)
Waste
( ) Banana
Pacol
Others ____________________
Specify

That I have sufficient knowledge, skills and experience in classifying/grading fibers in accordance
with the government standards;

4.

That I am submitting the following documents to support my application;
Certificate of good moral character from the Barangay Chairman of the Barangay where
I reside;
Certificate of passing the classifier’s examination conducted by the Authority in FIDA
form.

5.

That I shall at all times comply with the rules and regulations of the Fiber Industry Development
Authority (FIDA);

6.

That I have ____ (number) dependent/s in the family.

I hereby certify under the penalty of law to the veracity of the above statements and that this
application was prepared by me.
_________________________________
Printed Name and Signature of Applicant
License/application fees _______________ (P ________) O.R. No. _________ Date Paid __________
Surcharge/penalty : __________________ (P_______ ) O.R. No. ____________ Date Paid __________
Attested by:

Verified by:

____________________________
Fiber Regional Director

_______________________________
Printed Name & Signature

fn: Application for Classifier License (Original – October 2004)
 
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