Application for Business Permit

DEED OF UNDERTAKING/WAIVER

NEWRENEWALADDITIONAL

QUARTERLYSEMI-ANNUALYANNUALY

BUSINESS TRADE NAME TEL. NO.

MAYOR’S PERMIT NO.

DATE

BUSINESS ADDRESS

NAME OF TAXPAYER

ADDRESS OF TAXPAYERS HOUSE NO. STREET NAME BARANGAY CITY/MUNICIPALITY

NAME OF PRESIDENT / CEO / MANAGER

COMMUNITY TAX CERTIFICATE NO.:

SSS NO.:

DATE ISSUED:

CITY GOVERNMENT OF VALENZUELA

TIN NO.:

PLACE ISSUED:

(INDIVIDUAL OR CORPORATE)

IF TRANSFER OF OWNERSHIPFROM WHOM ACQUIRED:

DELIVERY TRUCKS/VANS/VEHICLES

NO. OF UNITS

STORAGE OF FLAMMABLES ESTIMATED AREA USED IN BUSINESS

NO. OF GALLONS:

NAME OF OWNER:

ADDRESS:

KIND OF OWNERSHIP % OF ALIEN CAP INVESTMENT

LOCATIONAL CLEARANCE NO.:

SEC. REG. NO.:

DATE OF ISSUE:

DATE OF ISSUE:

CERTIFICATE OF OCCUPANCY NO:

BOI REG. NO.:

DTI REG. NO.: DATE OF ISSUE:

DATE OF ISSUE:

DATE OF ISSUE:

DATE OF ISSUE:

TO BE FILLED UP BY PROCESSOR/ASSESSOR

TO BE FILLED UP BY NEW APPLICANT ONLY

IF PLACE OF BUSINESS IS RENTED / NOT OWNED

CDA REG. NO.:

ENDORSEMENTS:OFFICE DATE ENDORSED DATE RELEASED OFFICE DATE ENDORSED DATE RELEASED

ENGINEERING DEPARTMENT/BUILDING OFFICAL

POLICE DEPARTMENT

HEALTH DEPARTMENT

FIRE/ELECTRICAL DEPARTMENT

SINGLE PROPRIETORSHIP PARTNERSHIP CORPORATION

RENT PER MONTH:

ADMINISTRATOR: (If name of owner is not available)

RENT START: (Month/Year)

CODE LINE OF BUSINESS/ACTIVITIES GROSS SALES/RECEIPTS CAPITAL INVESTMENTSUBSCRIBED PAID-UP

TOTAL NO. OFEMPLOYEES/WORKERS

TOTAL NO. OFEMPLOYEES/WORKERS FROMVALENZUELA

SURNAME FIRST NAME MIDDLE INITIAL TEL. NO.

HOUSE NO. STREET NAME BARANGAY

Form VC BPO1

Republic of the Philippines

Metropolitan Manila

APPROVED BY:

CHIEF - BPLO

CITY MAYOR

SIGNATURE OF APPLICANT/REPRESENTATIVE

POSITION/TITLE

1.2.3.

REQUIREMENTS:RENEWAL:

Barangay Clearance (2011)Community Tax Certificate (Cedula) 2011Previous permit and application

1.2.3.

NEW BUSINESS:Barangay Clearance Community Tax Certificate (Cedula)Sketch of Business LocationAll other requirements required by law, ordinance and rules are subject to Pos-Audit process.

YTATAXPAYER’S COPY

I, , of legal age, Filipino and a resident of Valenzuela City, after having duly sworn to in accordance with law, avers that:

As an applicant for a business permit/license for the City of Valenzuela and as a law abiding citizen and taxpayer thereof, I undertake to comply with all therequirements for the issuance of a business permit and license as required by law or City Ordinance. I further undertake to allow any duly authorized inspectors of the City Government to conduct ocular inspection of my establishment to ensure faithful compliance to any regulatory measures and post inspection requirements and in case of violation or non-compliance thereof it will result in the closure of the business establishment without need of notice, Executive Order and revocation of my business permit. I executed this undertaking and waiver to attest to the truth and veracity of the foregoing based on personal knowledge and for all legal intents and purposes.

IN WITNESS WHEREOF, I have hereunto set my hand this day of at Valenzuela City, Philippines

SHERWIN T. GATCHALIAN






DATE

BUSINESS ADDRESS

NAME OF TAXPAYER




SSS NO.:

DATE ISSUED:


TIN NO.:

PLACE ISSUED:




NO. OF UNITS


NO. OF GALLONS:

NAME OF OWNER:

ADDRESS:



SEC. REG. NO.:

DATE OF ISSUE:

DATE OF ISSUE:


BOI REG. NO.:


DATE OF ISSUE:

DATE OF ISSUE:

DATE OF ISSUE:




CDA REG. NO.:



POLICE DEPARTMENT

HEALTH DEPARTMENT



RENT PER MONTH:








Form VC BPO1


Metropolitan Manila

APPROVED BY:

CHIEF - BPLO

CITY MAYOR


POSITION/TITLE

1.2.3.



1.2.3.


YBBPLO COPY










DATE

BUSINESS ADDRESS

NAME OF TAXPAYER




SSS NO.:

DATE ISSUED:


TIN NO.:

PLACE ISSUED:




NO. OF UNITS


NO. OF GALLONS:

NAME OF OWNER:

ADDRESS:



SEC. REG. NO.:

DATE OF ISSUE:

DATE OF ISSUE:


BOI REG. NO.:


DATE OF ISSUE:

DATE OF ISSUE:

DATE OF ISSUE:




CDA REG. NO.:



POLICE DEPARTMENT

HEALTH DEPARTMENT



RENT PER MONTH:








Form VC BPO1


Metropolitan Manila

APPROVED BY:

CHIEF - BPLO

CITY MAYOR


POSITION/TITLE

1.2.3.



1.2.3.


YTTREASURER’S COPY










DATE

BUSINESS ADDRESS

NAME OF TAXPAYER




SSS NO.:

DATE ISSUED:


TIN NO.:

PLACE ISSUED:




NO. OF UNITS


NO. OF GALLONS:

NAME OF OWNER:

ADDRESS:



SEC. REG. NO.:

DATE OF ISSUE:

DATE OF ISSUE:


BOI REG. NO.:


DATE OF ISSUE:

DATE OF ISSUE:

DATE OF ISSUE:




CDA REG. NO.:



POLICE DEPARTMENT

HEALTH DEPARTMENT



RENT PER MONTH:








Form VC BPO1


Metropolitan Manila

APPROVED BY:

CHIEF - BPLO

CITY MAYOR


POSITION/TITLE

1.2.3.



1.2.3.


YEENGINEERING’S COPY










DATE

BUSINESS ADDRESS

NAME OF TAXPAYER




SSS NO.:

DATE ISSUED:


TIN NO.:

PLACE ISSUED:




NO. OF UNITS


NO. OF GALLONS:

NAME OF OWNER:

ADDRESS:



SEC. REG. NO.:

DATE OF ISSUE:

DATE OF ISSUE:


BOI REG. NO.:


DATE OF ISSUE:

DATE OF ISSUE:

DATE OF ISSUE:




CDA REG. NO.:



POLICE DEPARTMENT

HEALTH DEPARTMENT



RENT PER MONTH:








Form VC BPO1


Metropolitan Manila

APPROVED BY:

CHIEF - BPLO

CITY MAYOR


POSITION/TITLE

1.2.3.



1.2.3.


YHHEALTH OFFICE COPY










DATE

BUSINESS ADDRESS

NAME OF TAXPAYER




SSS NO.:

DATE ISSUED:


TIN NO.:

PLACE ISSUED:




NO. OF UNITS


NO. OF GALLONS:

NAME OF OWNER:

ADDRESS:



SEC. REG. NO.:

DATE OF ISSUE:

DATE OF ISSUE:


BOI REG. NO.:


DATE OF ISSUE:

DATE OF ISSUE:

DATE OF ISSUE:




CDA REG. NO.:



POLICE DEPARTMENT

HEALTH DEPARTMENT



RENT PER MONTH:








Form VC BPO1


Metropolitan Manila

APPROVED BY:

CHIEF - BPLO

CITY MAYOR


POSITION/TITLE

1.2.3.



1.2.3.


RTMFIRE DEPARTMENT COPY





Application for Business Permit

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Transcript of Application for Business Permit