Republic of the Philippines

City of Caloocan
Office of the City Mayor
BUSINESS PERMITS & LICENSING OFFICE
Tel. No.: 288-88-11 Local 2248 / 2217

BIN: _________________ Brgy. No.: ____________ Date: _________________

Name of Taxpayer/Owner: _______________________________________________________________________
Address: _____________________________________________________________________________________
Kind of Organization: Single Proprietorship FoundationCooperative
Partnership Contact Person ___________________________________________
Corporation Position _____________________ Contact No. _________________

Business Name / Trade Name: ____________________________________________________________________

Business Address: _____________________________________________________________________________
Telephone No.: ________________________________________________________________________________
No. of Years of Operation: ______________
Line/s of Business:
Manufacturer / Producer Kind/s of Products ______________________________
Wholesaler Kind/s of Merchandise ______________________________
Service / Contractor Kind/s of Service/s ______________________________
Retailer Kind/s of Merchandise ______________________________
Lessor Residential / Commercial ______________________________
Printing & Publication Specify: ______________________________
Food Establishment Franchise? ___________ Carinderia? ___________ Rest.? ___________
Amusement & Recreational Specify: ______________________________
Warehouse Kind/s of Merchandise ______________________________
Address (Main Office): ______________________________
Garage / Terminal Type of Vehicles ______________________________
No. of Vehicles ______________________________
Container Yard No. of Container Vans ______________________ 20 footer
______________________ 40 footer
Estimated Area of Business: ___________ No. of Employees: _________ No. of Delivery Vehicles: ________
Type of Vehicle/s Used: _______ Date Business Started: _________ Daily Gross Sales As Declared: P___________
Estimated Daily Gross Sales: P____________
Address of Warehouse (if any): ___________________________________________________________________
If Place of Business is Owned:
Name of Owner: ________________________________________________________________________
Acquisition Cost: _________________________ Tax Declaration No.: ________________________
Amount Paid: ___________________ Latest OR No.: _______________ Date: ________________
If Place of Business is Rented:
Name of Owner: ________________________________________ Floor Area: __________________
Rent Per Month: ___________________________ Rent Started: _______________________________
Mayor’s Permit No.: _________________ Amount Paid: ___________________ OR No.: _______________
Remarks: _____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

(Team Leader) ________________________________ ________________________________

Signature Over Printed Name Signature Over Printed Name
License Officer License Officer