Form SRA-03A

Revised, 2016 Passport size

APPLICATION FOR LICENSE TO OPERATE AS TRADER picture 50 mm
wide X 70 mm
SUGAR REGULATORY ADMINISTRATION high (2 inches
North Avenue, Diliman, Quezon City
P.O. Box 90 U.P. Diliman wide X 2-3/4
Quezon City 1101 inches long)

Attention: REGULATION DEPARTMENT

Gentlemen:

I HEREBY APPLY for license/s for Crop Year ________ - _________ , to operate as (Please see
asterisk) and engage in Sugar/Molasses/Muscovado trading in accordance with existing laws, decrees and
implementing rules and regulations promulgated by the Sugar Regulatory Administration (SRA). For this
purpose, I HEREBY SET FORTH the following information:
(* Mark appropriate box with an X)

DOMESTIC SUGAR TRADER INTERNATIONAL SUGAR TRADER

(EXPORTER/IMPORTER)
MOLASSES TRADER INTERNATIONAL MOLASSES TRADER
(EXPORTER/IMPORTER)
MUSCOVADO TRADER MUSCOVADO TRADER/NON-PRODUCER

MUSCOVADO TRADER/PRODUCER

1. Firm/Business name:
_________________________________________________________________________

a) Type of Application New Renewal

2. Business Address: _________________________________________________________

Contact No/s. : ________________________________ Fax No. ___________________
E-mail Address : __________________________________________________________

3. Business Information:

(a) Type of Organization:

______________________________________________________________________
(Single Proprietorship, Partnership, Corporation, Cooperative)

(b) Proprietor / Managing Partner / President:

______________________________ __________________________
(Name and Position) (Nationality)

(c) Official/Authorized Representative to sign reports and other pertinent documents:

Name and Position Specimen Signature

1. ____________________________ _______________________
2. ____________________________ _______________________
3. ____________________________ _______________________

(d) Number of years in sugar / molasses / muscovado trading: ___________

(e) Area of operation/distribution outlets (specify name of province, city or municipality covered):
_____________________________________________________________

(f) Warehouse (For Sugar and Muscovado)

Number of warehouse/s: ________________________________________________

Location : ____________________________________________________________
Dimension (Per Meter- Length x Width x Height) : ____________________________
Made of (materials): ____________________________________________________

1
 Capacity : _____________________________________________________________
Please attached separate sheet for more than one (1) warehouse

Storage/Container (For Molasses)

Number of warehouse/tanks: _____________________________________________

Location: ______________________________________________________________
Dimension (Per Meter- Length x Width x Height) : _____________________________
Made of (materials): ____________________________________________________
Capacity: _____________________________________________________________

4. Supporting documents for three (3) sets of application Submit one (1) copy of each document per
application.

a. City/Municipality Business Permit

b. Mayor’s Permit
c. Certificate of Registration of firm/business issued by Department of Trade & Industry (DTI)
d. Securities and Exchange Commission (SEC) registration
e. Articles of Incorporation and By-laws
f. If applicant is a Cooperative
1) Certificate of Registration issued by Cooperative Development Authority (CDA)
2) By laws
3) Certificate of Good Standing issued by the CDA
g. Taxpayer’s Identification Number (copy of card) TIN : _______________________
h. Current Year General Information Sheet (GIS) submitted and issued by SEC
i. Passport size picture of the owner/representative
j. Notarized Application form
k. Tract record of domestic and export transaction (for Int’l Sugar Trader)
l. Corporate Income Tax Return (ITR) of the preceding year and Financial Statements
m. For Trader/Producer of Muscovado whose products are declared as Organic: Certificate issued
by the Organic Certifying Body (OCB) accredited by the Bureau of Agriculture and Fisheries
Product Standards (BAFPS) of the Department of Agriculture (DA):
n. For Trader/Non-Producer of Organic Muscovado (Traders whose sources of Organic Muscovado
are from Organic Muscovado Producers);
Organic Certificate issued by OCB to Muscovado Producers where the Trader/Non-Producer will
source its muscovado products for sale and distribution.

The certificates issued by the OCB are valid only for one (1) year. For Trader/Producer of
Muscovado whose products are declared as Organic and for Trader/Non-Producer of Organic
Muscovado are required to secure OCB Certificate every year and submit the same to SRA two
(2) months prior to the start of the Crop Year within the validity period of the Certificate of
Registration (or COR) issued pursuant to Muscovado Order No. 2

I HEREBY CERTIFY to the correctness of the above information and I HEREBY AGREE that SRA may
cause the suspension/cancellation or revocation of the LICENSE TO OPERATE or in lieu thereof, the
imposition of a fine for non-observance or violation of its rules/regulations/issuances.

_________________________________
Proprietor/Managing Partner/President
(Signature Over Printed Name)

SUBSCRIBED AND SWORN TO before me this _____ day of ______________________

Affiant exhibited to me his/her Community Tax Certificate No. ___________________________ Issued on
____________________________ at _______________________________________

NOTARY PUBLIC

2
 UNDERTAKING

KNOW ALL MEN BY THESE PRESENTS:

_____________________________________________________________________________
(Name of Proprietor/Company/Corporation/Cooperative)

With office address and principal place of business at

______________________________________________________________________________ hereby
undertakes to faithfully abide and comply with all the Sugar Orders/Circulars/Rules and Regulations and
other issuances of the Sugar Regulatory Administration; to allow SRA authorized representative/s to inspect
my/our warehouse(s)/storage container/s anytime of the day; and that I/We shall be held civilly, criminally
and administratively liable for any violation thereof including payment of damages, if any.

Furthermore, SRA may, for just cause/cancel/revoke/terminate at any time my/our license either
temporarily or permanently.

IN WITNESS WHEREOF, i have hereunto set my hand this _______ day of ___________________ at
_______________________________ , Philippines.

____________________________________________________________
Name of Proprietor/Company/Corporation/Cooperative
(Signature Over Printed Name)

By: __________________________________
Position
(Signature over printed name or person duly authorized for this purpose)

SUBSCRIBED AND SWORN TO before me this _________ day of ______________ affiant exhibited to
me his/her Community Tax Certificate No. _________________________ issued on
____________________________ at _______________________________ .

NOTARY PUBLIC

FM-REG-LMD-001, Rev.01
Effectivity Date: July 28, 2016