SBF APPLICATION FOR REGISTRATION

Please provide all data required on this form. Answers are to be typewritten. If the space provided is insufficient, please attach additional sheets as needed. All incomplete forms will not be processed.

1GENERAL INFORMATION

1.1Particulars of Sponsoring Entity

Corporation / Partnership / Proprietorship / Other
Name
Nationality
Contact Person
Principal Address
E-mail Address / Tel No: / Fax No:
Place of Incorporation / Date of Incorporation:
Location of Business***
Primary Activity***
Is the sponsoring entity a publicly listed company? / Yes / No
If yes, kindly list the exchange(s) on which the company is traded:

1.2Sponsoring Entity’s Group Structure (if applicable)

Kindly provide a diagram depicting the sponsoring entity’s group structure. Please indicate the name, primary activity and business location of each business unit.

1.3Three Largest Shareholders/Owners of Sponsoring Entity (if applicable)

Name/Entity
Nationality
Primary Activity
Principal Address
Place of Incorporation / Date of Incorporation
Total Assets / % Ownership of Sponsoring Entity***
Location of Business*
Name/Entity
Nationality
Primary Activity
Principal Address
Place of Incorporation / Date of Incorporation
Total Assets / % Ownership of Sponsoring Entity***
Location of Business*
Name/Entity
Nationality
Primary Activity
Principal Address
Place of Incorporation / Date of Incorporation
Total Assets / % Ownership of Sponsoring Entity
Location of Business*

*if different from principal address

1.4Additional information

Kindly provide the following and any other information the sponsoring entity would deem helpful in SBMA’s evaluation of the proposal.

Company Profile/Brochures / SEC Registration of Sponsoring Entity
Articles of Incorporation & By-Laws / Client/Supplier List with Contact Information
Product Brochures
Annual Reports or Audited Financial Statements for the
Previous 3 Years / Credit References (including name and address of creditor, size
& description of loan facility, past repayment record and credit rating).

2.PROJECT INFORMATION

2.1General Information

Proposed Name of SBF Enterprise:
Nationality:
Intended Sector:
Manufacturing & Assembly / Electricity, Gas & Water Supply / Construction
Transport / Telecommunications / Warehousing
Real Estate / Wholesale Trade / Retail Trade
Financial Services / Hotels & Restaurants / Health & Social Services
Education / Other
Philippine Standard Industrial Classification (PSIC) Code of SBF Intended Enterprise:
International Standard Industrial Classification (SIC) Code:
Describe activity (product or service) of intended SBF Enterprise
Type of firm:
Corporation / Partnership / Proprietorship / Subsidiary
Branch / Joint Venture / Other

2.2Timetable of Operations - After Registration:

Construction/Renovation of Facility will commence within months.

Estimated start of production/operation is within months thereafter.

2.3Largest Shareholders of Intended SBF Enterprise

Name / Nationality / Place of Incorporation** / Address / % Ownership / Total Assets (US$)**
1.
2.
3.
4.
5.
Total number of shareholders for intended SBF Enterprise: .

**if shareholder is a business entity

2.4Directors of Intended SBF Enterprise

Name / Company / Address / Other Directorships Held
1.
2.
3.
4.
5.
6.
7.

2.5Output (if applicable)

For Manufacturing & Assembly and Warehousing/Trading, kindly complete the form attached as Annex “B”.

3.FACILITIES REQUIRED

3.1General Information

Size of Land/Building (in sqm) / Lease term required
Proposed Address in SBF

3.2Planned Investment in the SBF***

Item / Capital Expenditure / Country(ies) of Source
Construction/Renovation of Facility / US$ / xxx
Machinery & Equipment / US$
Transportation Equipment / US$
Office equipment / US$
Other / US$
TOTAL PLANNED INVESTMENT / US$ / xxx

3.3Utility Requirements

POWER REQUIREMENTS / PROCESS WATER REQUIREMENTS
Capacity / Kilovolt amperes / Input Potable Water / m3/day
Peak Load / Kilowatts / Output Waste Water / m3/day
Voltage / 120 / 208 / 240 / 480
Phase / Single / Three

4.EMPLOYMENT INFORMATION

4.1General Information

Number of persons employed: / No of shifts/day:
Canteen on site? / Yes / No

4.2Requirements

Skill / Educational / Work Experience / Number of Employees
Description / Attainment / Required / Y1 / Y2 / Y3 / Y4 / Y5

4.3Expatriates

Please list all

Skill Description / Job Title / Understudy? (Y/N)

5.FINANCE

5.1Sources of Debt

Creditor
Address
Contact Person / Fax no. / Tel no.
Amount of Loan / % of Total Investment
Creditor
Address
Contact Person / Fax no. / Tel no.
Amount of Loan / % of Total Investment

5.2Financial Projections

Please provide financial projections for first five (5) years of operations (follow pro-forma in Annex “A”).

6.ENVIRONMENTAL SECTION

6.1Construction

Will the proposed investment involve:
Type of building: ______
new construction (new buildings, addition parking lots, etc.)?
substantial renovation (removal of interior walls, floors, new electrical system, etc.) of existing structure(s)?
minor renovations of existing structure(s)?

6.2Operations Summary

Check () which of the following operations will be employed in the project. Kindly provide a process flowchart with narrative description of each of the basic unit processes proposed. The description should clearly explain the processes being performed.

Bleaching
Bonding
Brazing
Coating
Digressing
Dry Cleaning / Dyeing
Etching
Extrusion
Heating
Injection molding
Machining / Metal cutting
Metal shaping
Painting
Parts Cleaning
Photo Processing
Plating / Sand blasting
Soldering
Welding
Others:______
______
______

6.3Raw Materials Summary

Check () which of the following materials are used in the project. For each item checked, please provide an estimate of the amount used/stored on a monthly basis and a description of the storage method. In addition, kindly attach Material Safety Data Sheets (MSDS).

Materials / Volume Stored
/ month / Materials / Volume Stored
/ month / Materials / Volume Stored
/ month
Abrasives / Dyes / Plating Materials
Acids / Fuels / Plastics
Adhesives / Industrial Gases / Resins
Alkalis / Inks / Rubber Products
Bleaches / Inorganic Chemicals / Solder/Flux
Coating Materials / Lubricants / Solvents
Coloring Agents / Metals / Others:
Cooking Oils / Organic Chemicals
Cutting Fluids / Paints

6.4Waste Products (Emission and Effluent)

6.4.aSolid Waste

Include trash from offices and canteens. Indicate disposal method (e.g. landfill, reused in process, recycled).

Description / Est. Amt./Day / How Disposed?
1.
2.
3.

6.4.bNoise

Kindly identify all equipment that generates noise in excess of 65 decibels (including pumps, motors, presses, etc.)

Source of Noise / Noise Level / Control Measures
1.
2.
3.

6.4.cGaseous Emissions

Please identify all source emissions to the air, including those from boilers, heaters, furnaces, ovens, smelters, melters, painting booths, etc. Describe ventilation or filtering system that will be utilized.

Source / Properties / Treatment/Discharge
1.
2.
3.

6.4.dProcess Water Use

Process

/ Consumption/Day / Treatment Required?
1.
2.
3.

6.4.eLiquid Waste

Please identify and describe any liquid wastes produced, the source of the wastes and the quantity produced per day. Kindly indicate if pre-treatment prior to discharge is proposed.

Source / Description / Quantity/Day / Treatment?
1.
2.
3.

6.5Possible effects of waste products on adjacent environment/business/community

Please identify and explain.

The information submitted in this Form shall remain confidential. As the Sponsoring Entity’s authorized representative, I certify that the information contained herein presents fairly, in all material respects, the projected requirements and performance of the activities. Further, we understand that salient information contained herein shall be the basis for SBMA’s decision to register the candidate SBF-Enterprise and shall be listed as obligations within our Lease Agreement and Registration Agreement with SBMA.

Signature

Authorized Representative______

Name/Position

Date

______


Received at SBMA
By :
Date/Time :

FOR INDUSTRIAL AND WAREHOUSING/TRADING ACTIVITIES

Output – Goods

Product Description / HS6 Code / Mode of Export / Unit Value (US$) / Country of Destination / Percentage
1. / Air
Sea / 1.
2.
3. / 1.
2.
3.
2. / Air
Sea / 1.
2.
3. / 1.
2.
3.
3. / Air
Sea / 1.
2.
3. / 1.
2.
3.
Annual Quantity Over 5 Years / Annual Value Over 5 Years (US$)
Y1 / Y2 / Y3 / Y4 / Y5 / Y1 / Y2 / Y3 / Y4 / Y5
1.
2.
3.

Inputs – Goods

Product Description / HS6 Code / Mode of Import / Unit Value (US$) / Country of
Origin / Percentage
1. / Air
Sea / 1.
2.
3. / 1.
2.
3.
2. / Air
Sea / 1.
2.
3. / 1.
2.
3.
3. / Air
Sea / 1.
2.
3. / 1.
2.
3.
Annual Quantity Over 5 Years / Annual Value Over 5 Years (US$)
Y1 / Y2 / Y3 / Y4 / Y5 / Y1 / Y2 / Y3 / Y4 / Y5
1.
2.
3.

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