NEW RENEWAL

DATE APPLIED: MODE OF PAYMENT: SEMI-ANNUALLY

BUSINESS INFORMATION OTHER LICENSES
BUSINESS NAME License to Sell Liquor
ADDRESS OF BUSINESS License to Serve Liquor till 10:00PM
License to Serve Liquor till 2:00AM
Retail Cigar
Retail Softdrinks
KIND OF OWNERSHIP: ASSOCIATION PARTNERSHIP SINGLE PROPRIETORSHIP
NAME OF PRESIDENT/CEO TEL. NO. EMAIL ADDRESS:
OPERATION MANAGER NO. OF PERSONNEL. OFFICIAL WEBSITE:
FLOOR AREA: MOBILE PHONE:
BUSINESS OWNER INFORMATION
OWNERS NAME/COMPANY NAME TEL. NO. T.I.N
RESIDENCE CERTIFICATE NO.(CEDULA) MOBILE PHONE SSS NO.
ISSUED AT:
ISSUED ON:
BUSINESS OWNER ADDRESS INFORMATION
STREET ADDRESS BARANGAY TOWN/CITY
OTHER BUSINESS DETAILS
RENT START FOR DTI REGISTERED BUSINESSES FOR SEC REGISTERED BUSINESSES FOR CDA REGISTERED BUSINESS
MONTHLY RENTAL DTI REG.NO. SEC. REG. NO. CDA REG. NO.
PEZA REGISTERED DATE ISSUE DATE ISSUE
EXPIRATION DATE EXPIRATION DATE
___________________________________
ADMINISTERING OFFICER
ASSESSMENT REVIEWED BY:
ATTY. FANELLA JOY B. PANGA-CRUZ

COOPERATIVE CORPORATION
REPUBLIC OF THE PHILIPPINES
CITY OF TAGUIG
BUSINESS PERMITS AND LICENSING OFFICE (BPLO)
2nd Floor City Hall,Gen.Luna St., Tuktukan, Taguig City
APPLICATION FORM
ANNUALLY QUARTERLY
LINE OF BUSINESS SUBSCRIBED CAPITAL / GROSS SALES REMARKS
*** SUBJECT FOR FURTHER ASSESSMENT AND ADJUSTMENT ***
(Applicant / Representativee's Signature Over Printed Name / Date) ( Evaluator's Signature Over Printed Name / Date )
PERMIT NUMBER: _______________
PLEASE DO NOT WRITE BELOW ( FOR NOTARY PURPOSES ONLY)
SUBSCRIBED AND SWORN TO BEFORE ME THIS ___________ DAY OF _________________________,20___ AT THE CITY OF TAGUIG, AFFIANT
EXHIBITED TO ME HIS / HER COMMUNITY TAX CERTIFICATE NO. ___________________________________ ISSUED AT_________________________
ON______________________________
RECOMMENDED BY:
____________________________________
CHIEF LICENSE DIVISION, TREASURY B.P.L.O / O.I.C
MA. LAARNI "Lani" L. CAYETANO
CITY MAYOR
O.R NUMBER:___________________