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REGISTRATION DATA SHEET GENERAL/BUSINESS/COMPANY RELATIONSHIP INFORMATION (FOR DOMESTIC COMPANIES ONLY) SEC NUMBER :
REGISTRATION DATA SHEET
GENERAL/BUSINESS/COMPANY RELATIONSHIP INFORMATION
(FOR DOMESTIC COMPANIES ONLY)
SEC NUMBER :
FILL UP INSTRUCTIONS - Type or print legibly. Light shaded boxes and codes are to be filled up by the SEC, including the SEC number. Check the appropriate boxes. Refer to the back of
this form for additional instructions.
COMPANY NAME
GENERAL INFORMATION
[
] DS - DOMESTIC STOCK
[
COMPANY TYPE
] - DOMESTIC NON-STOCK
[
] DP - DOMESTIC PARTNERSHIP
DATE REGISTERED :
PRINCIPAL OFFICE ADDRESS
AREA CODE
POSTAL CODE
TEL. NO
FAX. NO
BUSINESS OFFICE ADDRESS
AREA CODE
POSTAL CODE
TEL. NO
FAX. NO
BUSINESS INFORMATION
PARTNERSHIP TYPE
TYPE OF ENTERPRISE
[ ] - NO SPECIAL REGISTRATION
[
] H - FIA-HOLDING
[
] F - FINANCIAL INSTITUTION
[
] L-LIMITED
[
] - E - FIA EXPORT
[
] R - FIA REPRESENTATIVE OFF
[
] Z - PEZA-REGISTERED
[
] G-GENERAL
[
] - D DOMESTIC
[
] S - SUBIC REGISTERED
[
] B - BOI-REGISTERED
ANNUAL MEETING (For domestic companies only)
INDUSTRY CODE
TERMS OF EXISTENCE
FISCAL YEAR END(MM/DD)
[
] F - FIXED (MM/DD)
[
] V - VARIABLE
TYPE OF NON-STOCK CORPORATION
(Refer to the back of this page for the classifications).
TOTAL CONTRIBUTION
(Of domestic non-stock companies)
% OF FOREIGN MEMBERSHIP
(Of domestic non-stock companies)
.00%
COMPANY RELATIONSHIPList all companies related to registrant.(Use additional sheets, if necessary)
RELATIONSHIP TYPE
C
- DISSOLVED COMPANY (If due to consolidation)
S - PARENT COMPANY (If registrant is a subsidiary)
O - OTHERS
(RELN TYPE)
V
- DISSOLVED COMPANY (If change in company type)
A - AFFILIATE (Of the registrant)
RELN TYPE
SEC NUMBER
TIN
COMPANY NAME
POSITION
:
TIN
:
CERTIFIED CORRECT
:
DATE
:
2011/03/17 19:59:04
BIRTHDATE
:
(Signature over printed name)
DATE/TIMESTAMP:
2011/03/17 19:59:04
APPLICANT’S NAME:
[1]
Date Generated :
Thursday Mar 17, 2011 19:59:04
Transaction No. :