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Application for Business Permit

AFAB application form for business permit

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APPLICATION FOR BUSINESS PERMIT
Republic of the Philippines
Office of the President
THE AUTHORITY OF THE FREEPORT AREA OF BATAAN

TO BE FILLED OUT ONLY BY AFAB PERSONNEL

Application No.
Date filed:
Application Fee:
O.R. no.

Instructions: Please accomplish this form by providing the required information on appropriate spaces. Do not leave any blank space, indicate “N/A” if not applicable and
attach additional sheet/s as Annexes if necessary. Only complete set of documents will be accepted for processing.

I. BASIC INFORMATION
1. Name of Applicant: Write or type your full name in the ff. sequence: LAST NAME, FIRST NAME, MIDDLE NAME. Place one letter on each box. Leave one box blank between names
LAST
Staple here

FIRST

|

Staple a recent
ID picture (Taken within
the last 6 months)
1.5 in X 2 in
(passport size)

MIDDLE

2. Address: Write or type your full address. Place one letter on each box. Leave one box blank between names.
No. & Street

Please print your name
at the back of the photo.

Barangay
City / Town

Staple here

Province

|

Zip Code

3. Contact Information: Write or type your full contact details.
Cellphone No.

Telephone No.

E-Mail Address
4. Sex: Male / Female

5. Civil Status:

6. Nationality:

7. Name of Business: Please write the business’ full name legibly.

8. Location of Business: Write or type the full business address. Place one letter on each box. Leave one box blank between names.

9. T.I.N. (Tax Identification Number)

No. & Street

Barangay

10. Amount Capital: (in
Philippine Peso)

City / Town
Province

Zip Code

11. Kind of Ownership: (Please check one)
Corporation
Sole Proprietorship
Partnership

Others (Please specify):
_______________
_______________

12. Nature of Business: (Please check one)
Canteen / Eatery
Variety Stores / Dry Goods

Others (Please specify)
_______________
_______________

Sari-Sari Store

I affirm that:
(1) All the information supplied in this application form, and all submitted documents are true, complete, and accurate;
(2) I will abide by the rules and policies set by the Authority of the Freeport Area of Bataan (AFAB).
I am aware that any or all the information furnished in this application may be checked against the original documents and that withholding information or giving
false information, as well as violations on my part of any of the AFAB’s policies, rules and regulations will disqualify me from approval of application/will be a basis
for revocation of certificate, if approved. I also understand that no results for my application may be released until all requirements are satisfied.
Furthermore, I understand that all information I provide in this form and submitted documents may be used by the Authority for research and background
check, and I consent to such with the assurance that my personal details will be kept secure.
_________________________
Date

________________________________
Signature over Printed Name

AFAB-07-05-07_FM_Application for Business Permit

Page 2 of 2
If application is to be processed by an authorized personnel, please fill out the following section. Otherwise, leave it blank.
13. Name of Authorized Personnel:

14. Valid I.D. Presented:

15. Signature:

____________________________________________________________
(Surname)
(First Name)
(M.I.)

ID Presented: ______________________
ID Number: ______________________

Please attach Letter of Authority, designating the person named above as the authorized personnel, signed by the applicant.
Do NOT write anything after this part.TO BE FILLED OUT ONLY BY AFAB PERSONNEL
II. REQUIRED DOCUMENTS AND CLEARANCES
Documentary Requirements Submitted:
DTI or SEC Registration
(DTI Registration for single proprietorship, SEC Registration for
partnership or corporations.)

BIR Registration Certificate

Clearances:
Clearance from AFAB Corporate Planning Department
_____________________________________
Clearance from AFAB Infrastructure & Maintenance Division
_____________________________________

Barangay Business Clearance

(From the barangay where the business is located)

Locational Clearance & Zoning Compliance Certificate
(From the Corporate Planning Department)

FAB Police Clearance Certificate

(From the Public Safety & Security Department)

Valid Government Issued I.D. of Applicant

Government ID Presented: ________________________
Government ID Number:
________________________

Others: _______________________________________
________________________________________
________________________________________
Note: AFAB reserves the absolute right to require other documents that it may
deem necessary to complete its evaluation of the application.

Received this ______ day of ________________ 20__.

Clearance from AFAB Environmental & Utilities Division
_____________________________________
Clearance from AFAB Finance Department
_____________________________________
Clearance from AFAB Residents Division
_____________________________________
Clearance from AFAB Medical Officer
_____________________________________

Clearance from TRANSCO
_____________________________________
Clearance from AFAB Police
_____________________________________
Recommending Approval:

Processed and Evaluated by:
___________________________

KARL M.N. ZAPANTA
Department Manager

If you have any questions or inquiries, please feel free to contact the Registration Division at (047) 935-4004 loc. 8115 or (02) 236-5010 loc. 8115

AFAB-07-05-07_FM_Application for Business Permit
 
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