S-1 Annual Performance Report on Actual Operations

BOI report form for annual performance of actual operations of footwear, leather goods tannery enterprise

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Section 4, Tule VI of the Implementing Rules and Regulations

LCS-CSD-FORM-MR-FIA
Updated as of 11 January 2017

ANNUAL EXPORT PERFORMANCE REPORT
OF FOREIGN EXPORT ENTERPRISES
For the year ended ____________________
SEC Registration No.______________
BOI Registration No. ______________
CDC Registration No. ______________
CEZA Registration No. _____________

PEZA Registration No. __________
SBF Registration No. ___________
ZCSEZA Registration No. _______
Others: ________________________

Note: If the Annual Report is executed by an authorized representative, a board resolution evidencing
such authority must be submitted.

Name of the Enterprise
Name of the Chief
Executive Officer/President
Name of Authorized
Representative
Office Address
Plant Location
Telephone Number
Email Address
Authorized Product/
Activity
Equity Investments
Foreign
Local

: _________________________________________
: _________________________________________
: _________________________________________
: _________________________________________
: _________________________________________
: _________________________________________
: _________________________________________
: _________________________________________
: _________________________________________
: _________________________________________
Volume
US Dollars

Value
Philippine Peso

Total Sales
Domestic Sales
Export Sales
Export Ratio
_____________
Date

__________________________
Signature over Printed Name
__________________________
Position

Republic of the Philippines
City of ________________
Subscribed and sworn to before me, this _____ day of ______ , _________________
exhibited to me his/her ___________ ID, numbered ________, issued on ____________ in
______________.
Notary Public