Refining License

SRA application form for refining license

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Date:
SUGAR REGULATORY ADMINISTRATION
Sugar Center Building
North Avenue, Diliman
Quezon City 1101 Philippines
Gentlemen:
Pursuant to Sugar Order No. 4, dated 17 September 1992, Series of 1992-1993, I HEREBY
APPLY for the issuance of license to manufacture refined sugar for the Crop Year
For this purpose, I hereby set forth the following information:
1. Refinery Name:
2. President:
3. Refinery Address:
Fax Number:
Telephone Number:
4. Metro Manila Office Address:
Fax Number:
Telephone Number:
5. We are owners/not owners (circle one) of the sugar refinery we operate. (If not owners,
submit documents pertinent to right or authority from owner to operate sugar refinery).
a. MOA/Contract of Lease
b. Surety/Cash Bond
6. Enclosed herewith are latest copies of each of the sugar refinery's business papers:
Number and Date
a. Mayor's Permit (Refinery site)
b. DTI Registration
c. SEC Registration
( Enclosed latest copy of Articles of Incorporation)
d. CDA Registration for Cooperative
e. Tax Payer Identification Number (TIN)
f. Email Address
I HEREBY CERTIFY to the correctness of above information and I AGREE to have same
examined and verified by SRA whenever necessary and to submit reports regularly.
Further, I HEREBY AGREE that SRA may cause the suspension, cancellation or revocation of
the REFINING LICENSE or the imposition of a fine, or both, for non-observance or violation
of the conditions imposed by SRA Sugar Order No. 4 dated 17 September 1992, Series of
1992-1993 and pertinent SRA rules and regulations.

President
( Signature over Printed Name)
SUBSCRIBED AND SWORN to before me this
day of
affiant exhibited to me his/her Community Tax Certificate No.
at
Doc. No.
Page No.
Book No.
Series of

issued on

REFINING LICENSE QUESTIONNAIRE
CROP YEAR 2018-2019
A.- Production (2017-2018)
1. Total Raw Melted
1.1
Average Pol
1.2
Average Color

M.T.

2.

Melting Rate

ICUMSA

3.
4.

Refined Sugar Manufactured, Gross
Refined Sugar Manufactured, Net
4.1
Average Pol
4.2
Average Color
Average Refined Sugar Output
Rated Capacity (RAW)
Total Molasses Produced
Total available Operating Time

LKg/Day
LKg./Day

5.
6.
7.
8.

9. Total Actual Operating Time
10. Start of Operation

ICUMSA
LKg.
LKg./Day
M.T.
Hrs.
Hrs.

11. End of Operation
LKg.

12. End-of-Year Sugar Stock
B. Production Estimates (2018-2019)
1. Projected Raw Sugar Available for Melting
Mili Share
1.1
1.2

2.

3.

Outside Local Raw
Imported Raw
1.3
Projected Refined Sugar Production
2.1
Premium Grade
2.2
Bottlers Grade
2.3
Standard Grade
Projected Refining Period
3.1
3.2

LKg.
Lkg.
LKg.
Lkg.
Lkg.
Lkg.
Lkg.
Lkg.

Start
End

C. Technical Information
1. Work Force
1.1
Permanent
1.2

Seasonal

2. Warehouse Capacity
Main Refined Sugar Warehouse
2.1
2.2
Subsidiary Warehouse
3. Power and Energy
Bagasse Consumed
3.1
Bunker Oil Consumed
3.2
4.

5.
6.
7.
8.

3.3
Outside Power Purchased
Pollution Abatement Facilities for Refineries
4.1
Type or Method
4.2
Rated Capacity
Refinery Superintendent
Factory Manager
Chief Chemist/Head, QA
Pollution Control Manager

LKg.
Lkg.
Tons
Li
Kw

Li/Day

Prepared by: Mill Company
Resident Manager
Date

FM-REG-LMD-006 Rev.00
Effectivity Date:March 12, 2015

UNDERTAKING

KNOW ALL MEN BY THESE PRESENTS:

(Name of Company/Corporation/Cooperative)

with office address and principal place of business at

hereby undertakes to faithfully abide and comply with all the Sugar Orders/ Circulars/
Rules and Regulations and other issuances of the Sugar Regulatory Administration; to allow
SRA authorized representative/s to inspect my/our warehouse/s anytime of the day; and
that I/We shall be held administratively liable for any violation thereof. This is without
prejudice to criminal or civil liability, if any, under existing laws.
Furthermore, SRA may, for just cause suspend/ cancel/ revoke/ terminate at anytime
my/our license or impose a fine, or both, for violation of pertinent SRA rules and
regulations.
day of

IN WITNESS WHEREOF, I have hereunto set my hand this
, Philippines.
, at

(Name of Company/ Corporation /Cooperative)

By:
(Name/Signature /Position)
(Signature over Printed Name or person duly authorized for this purpose)

SUBSCRIBED AND SWORN to before me this
day of
exhibited to me his/her Community Tax Certificate No.
at

; affiant
issued on

Doc. No.
Page No.
Book No.
Series of

FM-REG-LMD-004 Rev.00
Effectivity Date:March 12, 2015