REPUBLIKA NG PILIPINAS

LALAWIGAN NG CAVITE BAYAN NG CARMONA BUSINESS PERMIT APPLICATION FORM

New Renewal Retirement Additional Transfer Ownership Location Amendments From Single to Partnership From Single to Corporation From Partnership to Single From Partnership to Corporation From Corporation to SIngle From Corporation to Partnership Mode of Payment Annually Semi - Annually Quarterly

Date of Application: Reference No: Kind of Organization: Are you enjoying incentive from any Govenment Entity? ( ) yes ( ) no Please specify the entry: Name of the Taxpayer: Business Name: Tradename/Franchise: Name of President/Treasurer of corporation: Business Address House No/Bldg No: Building Name: Unit No: Street: Subdivision: Barangay: City/Municipality: Province: Tel. No.: Email Address: Property Index Number (PIN): Business Area in (sqm): Last Name:

DTI/SEC/CDA Registration No: DTI/SEC/CDA Date of Registration: TIN:

First Name:

M.I.

Owner's Address House No/Bldg No: Building Name: Unit No: Street: Subdivision: Barangay: City/Municipality: Province: Tel. No.: Email Address: Total # of Employees in Establishment: Total # of Employees Residing LGU: Monthly Rentals M.I. Subdivision: City/Municipality: Province: Email Address:

If Place of Business is Rented, please identify the following: Lessor's Name Last Name: First Name: Lessor's Address: House No/Bldg No: Street: Barangay: Tel. No.: In case of emergency Contact Person: Tel No / Mobile phone no/ email address: Business Activity Code Line of Business

No of Units

Capitalization (for new business)

Gross Sales / Receipts (for renewal) Essential Non - Essential

SIGNATURE OF APPLICANT OVER PRINTED NAME POSITION / TITLE

For corporation, only responsible person (President, Chief Accountant and corporate Secretary) should sign the form. In case of Liaison Officer or any authorized representative, kindly present an authorization letter signed by the identified responsible person of the corporation Assessed by: Approval Recommended by:: Approved by::

TERESA P. LAURORA
Licensing Officer II

EDWINA R. LEDESMA
Municipal Treasurer

DR. DAHLIA A. LOYOLA

Municipal Mayor

REQUIREMENTS: NEW 1 . SEC/DTI Registration 2 . Brgy. Clearance/Permit to Operate 3 . Sedula (Individual/Corporation) 4 . RPT Payment (Amilyar) / Lease Contract RENEWAL 1. Previous year Mayor's Permit Payment 2. Declaration of Gross Sales/Receipts for the preceding year 3. Sales Book/Photocopy of Qtrly/Annual Tax Receipts (BIR) for the preceding year 4. Brgy. Clearance/Permit to Operate 5. Sedula (Individual/Corporation) 6. RPT Payment (Amilyar) / Clearance CLEARANCE FROM THE FF. DEPARTMENTS 1. Zoning / Locational Clearance EDGARDO T. DE GUZMAN Municipal Assessor 2. Environmental Clearance ROMMEL D. PENEYRA MENRO 3. Occupancy / Annual Inspection ENGR. SERAMEL JAY V. DE GUZMAN Municipal Building Officer 4. Sanitary / Health Clearance DR. HOMER L. AGUINALDO Municipal Health Officer ASSESSMENT (OFFLINE) TAXES & FESS Mayor's Permit Fee Municipal Tax Sanitary Permit Fee Zoning Sticker Business Plate Environmental Protection Fee Weight & Measure Fire Inspection Fee Other Fee Total 25% Surcharge Interest Grand total AMOUNT Remarks Remarks Remarks Remarks RETIREMENT 1 . Affidavit of retirement/closure (end of operation and reason) 2 . Latest Mayor's Permit and Official receipt/s 3 . Brgy. Clearance - retirement 4 . Gross Sales/Receipts of last /current year of operation

Assessed by : TERESA P. LAURORA Licensing Officer II Note: 1. Provide accurate information print legibly to avoid delays. 2. Ensure that all attached documents to this application form are complete properly filled up. 3. To avoid surcharge of 25% and additional 2% interest per month, please file and pay this application on or before January 20, 20___ .