BOI F PA PP 01-04 01/10/47 Page 1/10

BOARD OF INVESTMENT
APPLICATION FOR PROMOTION

ELIGIBLE ACTIVITY..
Date: ...
1. Applicant:
1.1 NameJeremyMarkerAge.47.. NationalityEnglish.......
Address69/13 Moo 6, The Little Village,Marp-yai-rai,Soi 26, Nernplabwan Road...
Blanglamung, Chonburi, 20260..
Telephone038 730527...Facsimile038 730527E-mail jmarker@petchemconstruction.com.
On behalf of company/co-operative/foundation (in Thai) ....
Name in English PetChemConstruction, Co,. Ltd....
Company/co-operative/foundation is established will be established later.
(In case of later establishment, please attach detail statement on applicants existing business)
1.2 The representative to contact on matters relating to this application in Thailand:
Name..Jeremy Marker..
Address: ....Street.. Tambol .
Amphur Province.Zip code...
Telephone ...Facsimile... E-mail.........
1.3 For the established company/co-operative/foundation/please specify following details
Registration number .....Date ... Tax ID No. .......
Registered capital .. Baht. Paid-up capital .. Baht
Percentage of shareholdings: Thai ......% Foreign .%
Foreign shareholdings:
Nationality ...., holding % of shares. Nationality ...., holding % of shares
Nationality ..., holding % of shares. Nationality ....., holding .% of shares
According to the attached latest balance sheet dated ...., Assets .....Baht
Liabilities...Baht, Shareholders Equity Baht
Address of the office:.. Street . Tambol ..
Amphur .... Province . Zip Code.
TelephoneFacsimile..........
E-mail .. Website...
Application No. .../..
Received by ....
Date .././.

BOI F PA PP 01-04 01/10/47 Page 2/10
1.4 List of shareholders holding at least 10 percent of registered capital as shown in 1.3, arranged
in order of portion of shareholdings from most to least.
Name of Shareholder Nationality Address/Telephone/Fax/E-mail
Percentage of
total shares








2. Finances:
2.1 In implementing this project: (Unit: Thousand Baht)
The company/co-operative/foundation will not increase registered capital
The registered capital of the company/co-operative/foundation
will be increased by .
The company/co-operative/foundation/to be established will have
a registered capital of .....
Sources of funds for this project:
Paid-in share capital .
Retained earnings .
Domestic loans ..
Foreign loans ..
Credit from foreign suppliers ..
Credit from domestic suppliers ......
Total (Must equal total capital investment as specified in 3.1) ..
2.2 The registered capital of the company/co-operative/foundation as show in 2.1
represents .. shares, at . Baht per share
Thai shareholdings .. %, Foreign shareholdings %
List of shareholders holding at least 10 percent of registered capital, arranged in order of portion of
shareholdings from most to least.
Name of Shareholder/
co-investor
Nationality Address/Telephone/Fax/E-mail
Percentage of
total shares









BOI F PA PP 01-04 01/10/47 Page 3/10
2.3 Sources of Loans and Credit:
Name of Funding Source Amount of money Currency
Country from which
funding was obtained
2.3.1 Financial Institution





2.3.2 Parent company and/or
subsidiary




3. Investment:
3.1 Capital investment proposed for this project
(Thousand Baht)
1) Cost of construction ...
(or rent for a period of longer than 3 years)
2) Cost of machinery ...
(or rent for a period of longer than 1 year)
3) Cost of installation ..
4) Cost of test-run ..
Total (For an expansion project, combine costs from #1 to #4) .
5) Preliminary expenses ..
6) Value of other assets ..
Total (For a newly-established company, combine costs from #1 to #6)
7) Cost of land ..
8) Cost of expertise .
9) Working capital .
Grand Total (Combine all costs) .
Note: Costs of construction and machinery, preliminary expenses, and value of other assets are defined
according to Office of the Board of Investment Announcement No. Por 1/2545
3.2 Factory site / location of activity: .. .. Street
Tambol ...... Amphur .....
Province .. .. Zip Code ...
Industrial Estate/Industrial Zone .....
Site area .. rai Telephone . Facsimile . ..

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4. Details regarding nature of project:
4.1 Production capacity according to project investment
Product(s) and
byproduct(s) (If any)
Maximum annual
production capacity
1)

Unit
Hours of operation
(hours/day: days/year)





Note 1) Calculated in accordance with maximum capacity of machinery specified in 4.4 and hours of operation
specified above.
4.2 Projected production of products listed in 4.1 for the first three years
Product(s) Unit 1
st
year Production 2
nd
year Production 3
rd
year Production
and by product(s) (if any) Quantity Quantity Quantity





4.3 Production process. Please specify main machinery to be used in each process. (Supplementary sheets may be
attached if additional space is required.)
Production process Main machinery to be used

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4.4 Main machinery (listed in 4.3) and other machinery to be used in this project
(Value unit: Thousand Baht)
Imported Purchased locally
New Used New
Items
Country
of
origin
Quantity Value
1)
Quantity
Year of
manufacture
Value
1)
Quantity Value
1)











Note: 1) Please use CIF price for imported machinery & equipment and contracted price for machinery & equipment purchased locally
2) In case of importing used machinery aged over 10 years, please also submit supplementary form for using imported used
machinery aged over 10 years (F PA PP 16).

4.5 Specific details regarding the nature of the product, including its use and Harmonized System (HS) code.
(Please attach photos, illustrations or catalog.)

4.6 Environmental protection plan
Type of waste Quantity/year Treatment Methods
Solid waste -
-




Waste water - ..
-




Dust/air pollution - .
- ..




Project subjected to obtain an Environmental Impact Assessment (EIA) approval
Expansion project of existing project with ISO 14000 certification (please attach a copy of certificate)
Note: Activity in category 1.5.2, 1.6, 1.9, 1.10, 1.11, 1.12, 1.14, 1.15, 1.16, 1.26, 2.15 (if used asbestos), 3.1 (with bleaching
& dying process), 4.11, 5.3.2, 6.1, 6.2, 6.5, 6.7, 6.10, 6.11 (except projects located in industrial estate, projects subjected to
obtain an EIA approval, and expansion project with a ISO 14000 certification), please complete an preliminary environmental
impact evaluation form (F PA PP 15) as an attachment.

BOI F PA PP 01-04 01/10/47 Page 6/10
4.7 If the company/co-operative/foundation has commenced operation, please indicate production capacity and performance of both promoted and
non-promoted activities in the last 3 years. (Hours of operationhours/day: .days/year)
(Value unit: Thousand Baht)
Domestic sales Exports
Product
Year

Maximum
capacity per year
Current
production
Quantity Value Quantity Value
1.
2.
3.
4.
5.

4.8 Employment and net profit in the last 3 years

Employment Net Profit (Loss) (in Thousand Baht)
Year
No. of Thai employee No. of Foreign employee As of (Date)




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5. Raw and essential materials: (Value unit: Thousand Baht)
First year Second year Third year
Imported Purchased locally Imported Purchased locally Imported Purchased locally Item
Quantity Value Quantity Value Quantity Value Quantity Value Quantity Value Quantity Value
1.
Unit ..
... . . ... . .. . .
2.
Unit ..
... . . ... . .. . .
3.
Unit ..
... . . ... . .. . .
4.
Unit ..
... . . ... . .. . .
5.
Unit ..
... . . ... . .. . .
6.
Unit ..
... . . ... . .. . .
7.
Unit ..
... . . ... . .. . .
8.
Unit ..
... . . ... . .. . .
9.
Unit ..
... . . ... . .. . .
10.
Unit ..
... . . ... . .. . .
Total


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6. Manpower:
Total employment created when this project reaches full production.
Thai Foreign
Position
No. of employees No. of employees Nationality
Management personnel . .
Technical specialists . .
Supervisory staff . .
Office and clerical staff . .
Skilled and semi-skilled workers . .
Unskilled workers .
Total


7. Market:
7.1 Market Plan
Domestic sale %
Including indirect export
Export sale .%

7.2 Major customers
Name Country
1. ... ......................
2. .. ....
3. .
4. .
5. .









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8. Costs and profits:
8.1 Estimate of production costs and profits for the first three years of operation
(Unit: Thousand Baht)
Items First year Second year Third year
Revenue
Domestic
Overseas
Total

Expenses
Raw and essential materials costs (Total value
from item 5):
Domestic
Foreign
Labor costs (Salary and wages only):
Domestics
Foreign
Public utilities costs
1)

Depreciation costs
2)
Sales and administrative expenses
Interest charges:
Domestic
Foreign
Technical fees and royalties:
Domestic
Foreign
Other costs
Total


.

Profit (Loss) .. ..
Note: 1) e.g. costs of water supply, electricity, telephone, etc.
2) Calculation of Depreciation must be in accordance with the Revenue Code
8.2 Ex-factory price and profit per unit (At the third year of operation )
Product .... .... ....

Ex-factory price
Raw and essential materials
Public utilities costs
Miscellaneous expenses
Profit
( /.)





( /.)





( /.)







BOI F PA PP 01-04 01/10/47 Page 10/10
9. Request for additional incentives in accordance with
Investment promotion policy for STI. Please attach Supplementary Application for Promotion
Privileges in Accordance with BOIs Investment Promotion Policy to Develop Skill, Technology
and Innovation (STI) (F PA PP 14).
Investment promotion policy for HDD. Please attach Supplementary Application for Promotion
Privileges in Accordance with BOIs Investment Promotion Policy to Promote Hard Disk Drive
Production Industry (HDD) (F PA PP 18).
Investment promotion policy for SMEs. Please attach Supplementary Application for Promotion
Privileges in Accordance with BOIs Investment Promotion Policy to Promote Thai SMEs (F
PA PP 17).
10. Please propose date and time the applicant would like to set up an interview session at the Office of
the Board of Investment.
Proposed application interview session
1)
Proposed environmental interview session
2)

Date ..Time ., or On Friday, Time, or
Date ..Time ., or On Friday, Time, or
Date ..Time .. On Friday, Time.
Note: 1) Application interview session must be scheduled within 10 days of application submission.
If the applicant cannot attend an interview within 10 days of submitting this application,
please attach detailed explanation of special circumstances.
2) Environmental interview session must be scheduled on Friday between 9.00 12.00 hrs.
I hereby declare that the information contained herein is true and accurate and the estimates provided are, in my
opinion, the most reasonable possible.
(Signature).. (Signature)..
Representative Applicant
(.........................................) (.........................................)
Date Date.
Note: In case that company/co-operative/foundation was established, signature (s) of authorized
person(s) affixed with companys seal is required.