ANNEX A-1

Note: To be accomplished and signed by an individual applicant or by an authorized officer of a non-individual applicant.

PLEASE CHECK APPLICABLE BOX: INDIVIDUAL APPLICANT NON-INDIVIDUAL APPLICANT

NAME OF APPLICANT: _______________________________________________________________________________________DTI-REGISTERED BUSINESS NAME (IF ANY): ______________________________________________________________________TAXPAYER IDENTIFICATION NUMBER (TIN): _________________________ EMAIL ADDRESS: _______________________________RESIDENTIAL ADDRESS: ______________________________________________________________________________________________________________________________________________________ CONTACT NO: ______________________________PRINCIPAL PLACE/HEAD OFFICE OF BUSINESS ADDRESS: ___________________________________________________________________________________________________________________________ CONTACT NO: ______________________________LINE OF BUSINESS: ___________________________________________________________________PSIC: __________________NAME OF AUTHORIZED OFFICER (FOR NON-INDIVIDUAL APPLICANTS): ________________________________________________POSITION/DESIGNATION: ____________________________________ TIN: ____________________________________________

ENCLOSED ARE THE FOLLOWING SUPPORTING DOCUMENTS TO THIS APPLICATION (PLEASE CHECK):

____ CERTIFIED TRUE COPY OF THE LATEST BIR CERTIFICATE OF REGISTRATION OF PRINCIPAL PLACE/HEAD OFFICE OF BUSINESS AND OF ANY BRANCH/FACTILITY

____ AUTHENTICATED COPY OF LATEST ANNUAL INCOME TAX RETURN (WITH ATTACHMENTS)____ CERTIFIED TRUE COPY OF LATEST MAYOR’S BUSINESS PERMIT OR DULY RECEIVED APPLICATION FOR SUCH PERMIT____ PROOF OF OWNERSHIP/LAWFUL OCCUPANCY OF PRINCIPAL PLACE/HEAD OFFICE OF BUSINESS____ VICINITY MAP, LOCATION PLAN AND PHOTOGRAPHS OF PRINCIPAL PLACE/HEAD OFFICE OF BUSINESS (SUBJECT TO ADDITIONAL REQUIREMENTS FOR SPACE-SHARING ARRANGEMENTS) ____ PHOTOCOPY OF LATEST UTILITY BILLS FOR THE PRINCIPAL PLACE/HEAD OFFICE OF BUSINESS____ UNDERTAKING TO COMPLY WITH THE DUTY TO PRESERVE AND MAINTAIN RECORDS FOR A PERIOD OF TEN (10) YEARS AND

TO ALLOW ACCESS TO EXAMINATION BY THE BIR, BOC, AND THE DOF-FIU____ PHOTOCOPY OF THE OFFICIAL RECEIPT FOR THE PAYMENT OF THE BIR ACCREDITATION PROCESSING & CERTIFICATION FEE

ADDITIONAL REQUIREMENTS FOR INDIVIDUAL APPLICANTS:____ CERTIFIED TRUE COPY OF DTI CERTIFICATE OF REGISTRATION OF BUSINESS NAME (IF A BUSINESS TRADE NAME IS USED) ____ ORIGINAL COPY OF PERSONAL PROFILE WITH TWO (2) RECENT 2X2 PICTURES (FOR INDIVIDUAL APPLICANTS)

ADDITIONAL REQUIREMENTS FOR NON-INDIVIDUAL APPLICANTS:

____ CERTIFIED TRUE COPY OF SEC REGISTRATION AND ARTICLES OF INCORPORATION/ARTICLES OF PARTNERSHIP____ CERTIFIED TRUE COPY OF LATEST GENERAL INFORMATION SHEET FILED WITH THE SEC____ CERTIFIED TRUE COPY OF COOPERATIVE DEVELOPMENT AUTHORITY (CDA) CERTIFICATE OF REGISTRATION AND ARTICLES

OF COOPERATION____ ORIGINAL COPY OF THE CERTIFICATE OF GOOD STANDING ISSUED BY THE SEC OR THE CDA ____ ORIGINAL COPY OF THE PROFILE OF THE CORPORATION, PARTNERSHIP, COOPERATIVE OR ASSOCIATION ____ ORIGINAL COPY OF THE PROFILE OF EACH MEMBER OF THE BOARD, CORPORATE OFFICERS, PARTNERS____ ORIGINAL COPY OF THE PROFILE OF EMPLOYEES, REPRESENTATIVES OR AGENTS DEALING WITH THE BUREAU OF CUSTOMS____ ORIGINAL COPY OF THE SECRETARY’S CERTIFICATE OF THE MINUTES/CONTENTS OF THE BAORD RESOLUTION AUTHORIZING

THE DESIGNATED REPRESENTATIVE TO SIGN THIS APPLICATION

I HEREBY DECLARE, UNDER THE PENALTIES OF PERJURY, THAT THIS APPLICATION HAS BEEN MADE IN GOOD FAITH, AND THAT THE REPRESENTATIONS INCUDING THE ACCOMPANYING SUPPORTING DOCUMENTS HAVE BEEN VERIFIED BY ME AND TO THE BEST OF MY KNOWLEDGE, BELIEF, AND INFORMATION ARE CORRECT, COMPLETE AND TRUE.

_______________________________________________ Signature over Printed Name of Individual Applicant/

Authorized Officer of Non-Individual Applicant

SUBSCRIBED AND SWORN to before me this ______ day of ________________ 20___ in _______________________________, applicant exhibiting to me his/her competent evidence of identity (government-issued identification) No. ____________, bearing his photograph and signature, issued on __________ by ____________ at _____________.

ANNEX A-1

APPLICATION FORM FOR ACCREDITATION OF IMPORTER

ANNEX A-1

NOTARY PUBLIC