Business Permit Application

NEW BUSINESS PERMIT APPLICATION

APPLICATION SECTION

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APPLICATION TYPE

MODE OF PAYMENT

DATE OF APPLICATION

TYPE OF OWNERSHIP

DTI (REGISTRATION #)

SEC (REGISTRATION #)

CDA (REGISTRATION #)

TIN #

DATE OF DTI REGISTRATION

DATE OF SEC REGISTRATION

DATE OF CDA REGISTRATION

AMENDMENT

REFERENCE NO.

ARE YOU ENJOYING TAX INCENTIVE FROM ANY GOVERNMENT ENTITY?

Yes No

if no, please specify the entity

NAME OF TAXPAYER / REGISTRANT

LAST NAME

FIRST NAME

MIDDLE NAME

BUSINESS NAME

TRADE NAME/FRANCHISE

BUSINESS ADDRESS INFORMATION

HOUSE #

BUILDING NAME

UNIT #

STREET

BARANGAY

SUBDIVISION/SITIO/PUROK

MUNICIPALITY

PROVINCE

POSTAL CODE

EMAIL ADDRESS

TELEPHONE NO.

MOBILE NO.

OWNER'S ADDRESS

HOUSE #

BUILDING NAME

UNIT #

STREET

BARANGAY

SUBDIVISION

MUNICIPALITY

PROVINCE

POSTAL CODE

EMAIL ADDRESSS

TELEPHONE NO.

MOBILE NO.

IN CASE OF EMERGENCY CONTACT PERSON

TELEPHONE/MOBILE NO.

EMAIL ADDRESSS

BUSINESS INFORMATION

BUSINESS AREA (in sq. meters)

TOTAL NO. OF EMPLOYEES IN ESTABLISHMENT

NO. OF EMPLOYEES RESIDING WITHIN LGU

BUSINESS CATEGORY

BUSINESS PLACE

LESSOR'S FULL NAME

LESSOR'S FULL ADDRESS

LESSOR'S CONTACT NO.

LESSOR'S EMAIL ADDRESS

MONTHLY RENTAL

BUSINESS ACTIVITY

LINE OF BUSINESS NO. OF UNITS CAPITALIZATION
(for New Business) GROSS SALES/RECEIPTS (for renewal)

ESSENTIAL NON-ESSENTIAL

{{ activity.line_of_business }} {{ activity.units }} {{ activity.capitalization|number:2 }} {{ activity.essential|number:2 }} {{ activity.non_essential|number:2 }}

REQUIREMENTS

REQUIREMENT DATE ISSUED VERIFICATION/REMARKS BY: (OFFICE/AGENCY STAFF)

{{ requirement.name }} APPROVED

LINE OF BUSINESS	NO. OF UNITS	CAPITALIZATION (for New Business)	GROSS SALES/RECEIPTS (for renewal)
ESSENTIAL	NON-ESSENTIAL
{{ activity.line_of_business }}	{{ activity.units }}	{{ activity.capitalization\|number:2 }}	{{ activity.essential\|number:2 }}	{{ activity.non_essential\|number:2 }}

	REQUIREMENT	DATE ISSUED	VERIFICATION/REMARKS BY: (OFFICE/AGENCY STAFF)
	{{ requirement.name }}			APPROVED

SELECT REQUIREMENTS

NAME

{{ requirement.name }}

BUSINESS ACTIVITY

CODE

LINE OF BUSINESS

NO. OF UNITS

CAPITALIZATION

ESSENTIAL

NON-ESSENTIAL

# NAME BUSINESS NAME BUSINESS TRADE NAME

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Mobile #:	+63900000000
Email:	example@email.com
Website:	www.puratarlac.gov.ph
Address:	#000 Street, Barangay

#	NAME	BUSINESS NAME	BUSINESS TRADE NAME
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APPLICATION SECTION

NAME OF TAXPAYER / REGISTRANT

BUSINESS ADDRESS INFORMATION

OWNER'S ADDRESS

BUSINESS INFORMATION

BUSINESS ACTIVITY

REQUIREMENTS

SELECT REQUIREMENTS

BUSINESS ACTIVITY

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