REPUBLIC OF THE PHILIPPINES

City of Pasay
BUSINESS PERMITS AND LICENSING OFFICE
Application of Business Permit
Please check (  ) applicable box: NEW RENEWAL Payment Mode: Annually Bi-Annually Quarterly
Kind of Organization
Single Proprietorship Partnership Corporation
Transfer Amendment From Single to Corporation From Partnership to Corporation From Corporation to Partnership
Business Account No. (BAN) RM 207: Date of Application:
Property Index No. (PIN) RM. 112:
Nature of Business:
DTI / SEC / CDC Registration No.: Date Issued:
Kind of Organization: TIN: SSS No.:

NAME OF TAXPAYER
LAST NAME FIRST NAME MIDDLE NAME
Business Name:
Trade Owner/Franchise/Name:
Name of President/Treasurer of Corporation:
Business Address Owner’s Address
House No./Bldg. No.: House No./Bldg. No.:
Building Name: Building Name:
Unit No.: Unit No.:
Street: Street:
Barangay: Barangay:
Subdivision: Subdivision:
City/Municipality: City/Municipality:
Province: Province:
Tel. No.: Tel. No.:
Email Address: Email Address:
Bus. Area (in sq.m): Total No. of
Employees:
Male Female No. of Delivery/Service Vehicle/s:
No. of Employees
Residing in Pasay City:
Type of Vehicle/s Used:
In case of emergency, Contact Person:
Tel. No./Mobile no./Email Address:
Please identify the following: Owned Rented(if rented, please attach contract of lease) Monthly Rental: Rent Started:
Lessor’s Name LAST NAME FIRST NAME MIDDLE NAME (MM/YR)

Lessor’s Address
House No./Bldg. No.: Subdivision:
Street: City/Municipality:
Barangay: Province:
Tel. No.: Email Address:
Business Activity
Capital Gross Sales (Renewal) Capitalization (for new Business)

Clearance
Office Remarks & Recommendation Signature Date
City Planning & Dev’t Office (RM. 211)
City Engineer Office (RM. 315)
City Fire Marshal’s Office (Dolores St.)
City Health Office (RM. 106)
Tourism & Cultural Office (RM. 417)
Traffic Management Office
City Veterinarian Office
PCENRO (RM. 304)
Business Permits & Licensing Office(RM. 207)
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 LOCATIONAL SKETCH OF BUSINESS ESTABLISHMENT

Note for Corporations: Only responsible person (e.g. President, Manager, Accounting or Finance Officer, and Corporate Secretary) should
sign the Application Form. In case of liaison officer or an authorized representative, he/she should present an authorization letter duly signed by
responsible person from the company responsible person of the corporation.

1. Should the BPLO discover/find any misrepresentation(s) in this application, I/We agree to the immediate
cancelation of the business permit & license and/or closure of the establishment without notice and hearing and shall
not file any case of whatever kind to question the closure of establishment and/or withdrawal/cancelation of the license
permit and shall hold the Pasay City Officials free and harmless from any civil, criminal and/or administrative liability
arising from any action taken of the of the application and/or BPLO permit license. Should I/We violate any of the
undertakings and/or commitments, I/We agree liquidated damages equivalent to twenty-five percent (25%) of my/our
gross earnings of the proceeding year as determined by the City.

2. I affirm that the information listed above is true and correct. I also undertake to allow any duly authorized
inspector from various offices or departments of the City Government of Pasay as well as the National Government
agencies, to conduct lawful inspection and verification inside the business premises during office hours. Violation of the
foregoing condition shall mean suspension or revocation of Business Permit. Any misdeclaration on the above
information would mean suspension or revocation of Business Permit.

____________________________________________________________________ _________________________
SIGNATURE OVER PRINTED NAME OF THE APPLICANT/REPRESENTATIVE POSITION/TITLE

SUBSCRIBED AND SWORN to before me this _____ day of ___________________, ________ at

_________________.

DOC. Number ______

PAGE Number ______
BOOK Number_______
Series of 20__

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