PEZA Building, Roxas Boulevard

ERD.3.F.001

Date: ______

PHILIPPINE ECONOMIC ZONE AUTHORITY

PEZA Building, Roxas Boulevard

cor. San Luis Street, Pasay City

Attention: ENTERPRISE SERVICES DIVISION

Dear Sir:

We are submitting herewith our Annual Report on the Actual Operations of our registered activity/ies under Registration Certificate No. ______covering January 1, 20_____ to December 31, 20_____ as required to be submitted not later than March 31, 20_____ by the implementing rules and guidelines of R.A. 7916, Section 4, Rule XXI and General Circular No. 84-001 dated January 2, 1984.

ANNUAL REPORT ON ACTUAL OPERATIONS

Deadline for Submission: For Calendar Year: 31-March

For Fiscal Year: 3 Months after the end of Fiscal Year For the year ending ______

NAME OF ENTERPRISE:
ADDRESS / Office:
Plant:
Tel. No.
E-Mail
Fax No.
TIN
DATE OF REGISTRATION:
REGISTRATION NUMBER:
REGISTERED ACTIVITY/IES: / START OF COMMERCIAL OPERATIONS / STATUS OF OPERATION (Pre-Operating, Operating)
(If Stopped Operating & Delisted Projects Pls. Indicate the date of Closure or Date of Delisting)

CERTIFICATION

It is certified that I have read and understood the contents thereof and all the information in this report are true and correct.

Very truly yours,

______

Signature of Reporting Official

______

Official Position

______

Date

Name and address of person who should be contacted if question/s arise regarding this report.

______

Name Telephone No. / Fax No.

______

Address E-mail Add:

14

ERD.3.F.001

I - A. IMPORTATION DATA

Capital Goods Machinery and Equipment / Import Permit Number / Date of Importation / Volume (Units) / Value / Terms of Payment
(Whether Open Account, Consignment, etc.) / Country of Origin
(US $) / (Php)
TOTAL
RAW MATERIALS
TOTAL
MISCELLANEOUS
TOTAL
GRAND TOTAL

Use additional sheets if necessary.

B. PRODUCTION AND SALES DATA

PRODUCT: / A / B / C / D / E / TOTAL
PRODUCTION / Volume (Unit)*
Cost of Prod’n (P)
SALES (DOMESTIC) / Volume (Units)
Value of Sales (P)
SALES (EXPORT) / Volume (Units)
Value (US$)
SELLING PRICE (Ave.) / Domestic (P)
Exports (US$)
INVENTORY
C. LABOR DATA / D. FUEL USAGE
Male / Female / Total / BUNKER OIL / Volume (MT)
AVERAGE NUMBER OF EMPLOYEES IN REGISTERED ACTIVITY FOR THE PERIOD / General & Admin. / Value (P)
Direct / Indirect Labor / DIESEL / Volume (MT)
Others / Subcontractor / Value (P)
TOTAL / GAS, FUEL & OIL / Volume (MT)
TOTAL PAYROLL FOR THE PERIOD / General & Admin. / Value (P)
Direct Labor / LUBRICANTS / Volume (MT)
Others / Value (P)
TOTAL / LIGHT & WATER / Value (P)
KWH
NO. OF PRODUCTION SHIFTS: / OTHERS / Volume
Value (P)

* FOR SEMICONDUCTOR INDUSTRY: please indicate production volume for each type of semiconductor produced (transistors, IC’s, modules, etc.) according to number.

E. SALES DATA (Detailed)

EXPORT / PERMIT NO. / DATE OF SALE / REGISTERED PRODUCTS / VOLUME
(UNIT) / VALUE / COUNTRY OF DESTINATION
Existing / New
(US $) / (Php)
a) Direct
TOTAL
b) Indirect/Constructive
·  Intra Zone
·  Inter Zone
·  CBW – Subic/Clark/BOI
TOTAL
DOMESTIC / PERMIT NO. / DATE OF SALE / REGISTERED PRODUCTS / VOLUME (UNIT) / VALUE (Php) / Receiving Zone Enterprise or CBW
a) Local Sales
TOTAL
b) Scraps / PERMIT NO. / DATE OF SALE / REGISTERED PRODUCTS / VOLUME (UNIT) / VALUE (Php) / BUYER / ADDRESS
·  Hazardous
·  Non-Hazardous
TOTAL

Use additional sheets if necessary

F. LOCAL PURCHASE

LOCAL PURCHASE / PERMIT NUMBER / DATE OF PURCHASE / DESCRIPTION / QUANTITY (UNIT) / VALUE (P) / TAXES PAID (P)
MACHINERY & EQUIPMENT
TOTAL
RAW MATERIALS
TOTAL
GRAND TOTAL
Total Area Occupied Including Lawns/Open Spaces:
Total Floor Area Of Self-Constructed Building:
Total Rented SFB Space:
Total Assets Of The Period:
Specific Problems:

Use additional sheets if necessary

G. PAYMENTS MADE FOR TELECOMMUNICATIONS SERVICE:

NAME OF TELECOMMUNICATION FIRM / FACILITIES/SERVICES AVAILED / TOTAL PAYMENTS MADE (P)

Above information will be used by PEZA for verification and audit of PEZA dues remitted by telecommunication firms

H. OTHER DATA

(Sub-contracts)

A.  FARM-OUT
Company name
(Sub-contractor) / Address / Process Sub-contracted / Skills Requirement / Volume / Value
Total
B.  Farm-In
Company Name
(Contractor) / Address / Process Sub-contracted / Skills Requirement / Volume / Value
Total

14

ERD.3.F.001

II - A. Balance Sheet

ASSETS / As of
December 31, 20_____ / As of
December 31, 20_____
CURRENT ASSETS
Cash
Accounts Receivables, Notes Receivables, Marketable Securities / Receivables
Raw materials, Work in process, Finished goods / Inventories
Net Allowance for Inventory obsolesce
Prepaid Expenses supply inventories, etc. / Other Current Assets
TOTAL CURRENT ASSETS
PROPERTY PLANT AND EQUIPMENT
Include land Improvements / Land
Include building improvements, construction in process / Building
Less: / Accumulated Depreciation
Include transport and office equipment, tools, etc. / Machinery and equipment
Less: / Accumulated Depreciation
TOTAL PROPERTY, PLANT & EQUIPMENT
Deferred charges, pre-operating expenses, intangible assets, etc. / OTHER ASSETS
TOTAL ASSETS

IMPORTANT: If firm is engaged in activities other than registered activity, please fill in data below on assets used in the registered activity only.

PROPERTY, PLANT AND EQUIPMENT USED IN REGISTERED ACTIVITY
LAND
Building and improvements
Machinery and equipment
Less: Accumulated depreciation
TOTAL PROPERTY, PLANT, EQUIPMENT (NET)
LIABILITIES AND STOCKHOLDERS’ EQUITY / As of
December 31, 20_____ / As of
December 31, 20_____
CURRENT LIABILITIES
Due to PEZA, trade creditors, subsidiaries and other affiliates, employees, loans, others / Accounts Payable
Notes and acceptance payables, bank overdrafts, Others / Notes Payable
Income Tax Payable
Sinking fund installments, dividends payable deposits accrued liabilities, others / Other Liabilities
LONG TERM LIABILITES
Deferred credits such as advance collections of income applicable beyond next period, premium on long-term debt/s, etc. / Long term loans
Foreign
Local
Government
Private
TOTAL LIABILITIES
STOCKHOLDERS’ EQUITY
Paid-In Capital
RETAINED EARNINGS
Balance, Beginning
Net of Dividends / Net Profit (Loss)
for the period
Balance, End
Total Stockholders’ Equity
TOTAL LIABILITIES AND
STOCKHOLDERS’ EQUITY

B. Equity Profile

Equity by Nationality / % Nationality / Subscribed (P) / Paid-up (P)
Filipino
Foreign (Pls. Specify)
Total

C - 1 Income Statement

January 1 to
December 31, 20_____ / January 1 to
December 31, 20_____
Net of returns and allowances and cash discounts / Sales
Refer to II-A / Cost of Sales
Gross Income (Loss)
Refer to II-B / Operating and Administrative Expenses
Income (Loss) from Operations
Other Income (Expense)
Interest Income
Realized Foreign Exchange Gain
Realized Foreign Exchange Loss
Bank Charges
Interest Expanse
Dividends on stock owned, royalties on patents, net income in rental of dwelling, profits on sale of machinery, reversal of excessive provision of bad debts in previous years, interest in bonds payable, amortization of goodwill, net gain on sale of investments, others. / Other Income (Expenses)
Income (Loss) before tax
Provision for Income Tax
NET PROFIT (LOSS) AFTER
INCOME TAX

C - 2 Statement of Cost of Sales

January 1 to
December 31, 20_____ / January 1 to
December 31, 20_____
Raw Materials
Wages, Salaries, Fringe benefits and SSS contributions for factory employees / Direct Labor
Manufacturing Expenses Indirect Materials and Supplies
Wages, Salaries, Fringe benefits and SSS contributions for factory employees / Indirect Labor
Electricity, water, gas, other fuel except lubricants / Utilities
Depreciation
Other Manufacturing Expenses / Factory Supplies
Repairs & Maintenance
Insurances
Royalties
Fuel & Oil
Power & Water
Transportation
Taxes & Licenses
Miscellaneous
Total Manufacturing Overhead
TOTAL MANUFACTURING COST
Work in process, beginning less work in process, end / Increase (Decrease) in Work in process
Finished goods inventory beginning of the period less finished goods inventory end of the period / Increase (Decrease) of Finished Goods Inventory
COST OF SALES

C - 3 Statement of Operations and Administrative Expenses

Operating and Administrative Expenses / January 1 to
December 31, 20_____ / January 1 to
December 31, 20_____
Salaries and Wages
Fringe Benefits
SSS, GSIS, Philhealth, HDMF
Employee benefits and allowances
Rent
Transportation and Travel
Representation and Entertainment
Telephone, Telegraph
Advertising and Promotion
Professional Fee
Stationary and Office Supplies
Repairs and Maintenance
Power and Water
Gas and Oils
Delivery and Handling
Dues, Subscriptions and Contributions
Insurance and Security
Taxes and Licenses
Depreciation
Miscellaneous
TOTAL

C - 4 Incentives Availment

Amount (P)
1. Income Tax Holiday (ITH)
2. 5% on Gross Income Earned
3.  Tax & Duty Free Importation:
a.  Raw Materials
b.  Capital Equipment (Machineries & Spare Parts)
c.  Miscellaneous
4.  Wharfage Due & Export Tax, Impost or Fees
5.  VAT Zero Rating of Local Purchases
6.  Local Government Imposts, Fees Licenses, or Taxes
7.  Additional Deductions for Training Expenses (ADTE)
8.  Others (Pls. Specify)
TOTAL

DEFINITION OF TERMS

1.  VALUE ADDED / This refers to the remainder, if from the value of the manufactured product, there is subtracted cost of raw materials, supplies and utilities. (NEDA)
2.  VALUE OF OUTPUT / This refers to sum of sales revenues and ending inventory minus beginning inventory.
3.  TOTAL SALES / This refers to total receipts/sales for the year resulting from the predominant activity of the business. This includes export sales, local sales and intra-zone sales.
4.  EXPORT SALES / Sales to foreign countries.
5.  LOCAL SALES / Sales to domestic entities excluding those to other zone enterprises.
6.  INTRA-ZONE SALES / Sales of a zone enterprise to other zone enterprises.
7.  BEGINNING INVENTORY / This refers to the value (at cost) of inventory of finished goods and goods-in-process at the beginning of the year/period.
8.  ENDING INVENTORY / This refers to the value (at cost) of inventory of finished goods, and goods-in-process at the end of the year/period.
9.  RAW MATERIALS / This refers to the value of local and imported raw materials (excluding transshipment cost) used by the enterprise as input in the production of goods. If the enterprise purchases finished or semi-finished components that go into its finished product, the value of these components should be included under this item.
10.  FACTORY SUPPLIES / This refers to the value of local and imported supplies used in the production of the product.
11.  UTILITIES / This refers to the value of power, water and fuel used in the production of the product

C - 5

Computation of Value Added

For the Year ______, 20_____

(Value in Peso)
VALUE OF OUTPUT
Total Sales:
Export Sales / P
Local Sale
Intra Zone Sales
TOTAL / P
Add: Inventory Ending
Finished Goods / P
Goods In process
TOTAL
Less: Inventory Beginning
Finished Goods / (P / )
Goods In Process / (P / )
TOTAL / (P / )
LESS: VALUE OF INPUTS
Raw Materials Used:
Imported / P
Local
Factory Supplies Used:
Imported
Local
Utilities Used:
Power
Water
Fuel
TOTAL VALUE OF INPUTS / P
VALUE ADDED / P
VALUE ADDED COEFFICIENT
(Value Added / Value of Output / P

DEFINITION OF TERMS FOR NET DOLLAR EARNINGS COMPUTATION

1.  EXPORTS / Exports earned or accruable during the period consistent with generally accepted accounting practices.
2.  IMPORTED RAW MATERIALS USED / This refers to the CIF cost of imported raw materials used on finished goods exported during the period (local landing charges and/or transshipment cost shall not be included).
3.  DEPRECIATION OF IMPORTED MACHINERY / Depreciation of imported machinery at CIF cost at accounting rate of depreciation
4.  INTEREST, ROYALTIES, COMMISSION, FOREIGN TECHNICIANS, ADVERTISING & PROMOTION, EXPENSES & FOREIGN TRAVEL / Amount paid or accrued during the period which are paid or to be paid in foreign currency.

DEFINITION OF TERMS FOR DOLLAR CASH FLOW STATEMENT

1.  FOREIGN EQUITY / Paid up capital and actually remitted to the Philippines and used for the project registered with the PEZA.
2.  FOREIGN LOANS / Loans actually availed of and remitted to the Philippines for the project registered with the PEZA.
3.  EXPORTS / Actual export proceeds during the period consistent with generally accepted accounting practice.
4.  IMPORTATION OF CAPITAL EQUIPMENT / Amount actually paid for in foreign currency for capital equipment if the terms of purchase is spot cash or amount of amortization during the period, excluding interest, if the terms are on deferred credit.
5.  IMPORTATION OF RAW MATERIALS / Actual payments during the period for raw materials directly imported by the enterprise.
6.  FOREIGN TECHNICIANS EXPENSES / Payments to foreign technicians including local expenses which are paid for in foreign currencies whether or not remitted out of the country.
7.  ROYALTIES, INTEREST, COMMISSIONS / Remittance during the period net of Philippine withholding tax.
8.  ADVERTISING, PROMOTIONS, SHIPPING / Expenses incurred and actually paid during the period and paid for in foreign exchange.
9.  SHARE OF FOREIGN INVESTORS IN NET PROFIT / This refers to dividends actually paid of foreign stockholders during the period, net of Philippine withholding tax, whether or not in exchange and whether or not remitted out of the country.

C – 6 Computation of Net Dollar Earnings

For the Year ______, 20_____

(Value in US$)
EXPORTS / $
INTEREST INCOME
TOTAL / $
LESS DOLLAR COST:
Imported Raw Materials Used / $
Depreciation of Imported Machinery
Interest and Bank Charges
Royalties
Commissions
Foreign Technicians
Advertising and Promotional Expenses
Shipping Expenses
Others (Specify)
______
______
TOTAL / $
NET DOLLAR EARNINGS / $

C – 7 Dollar Cash Flow Statement

For the Year ______, 20_____

(Value in US$)
DOLLAR RECEIPTS
Foreign Equity / $
Foreign Loans
Exports
Others
______
______
TOTAL / $
DOLLAR DISBURSEMENT
Importation of Capital Equipment / $
Importation of Raw Materials
Foreign Costs Paid
Foreign Technicians
Royalties
Commission
Advertising and Promotion Expenses
Payment of Foreign Loans/Credits
Principal
Interest
Other Financial Charges
Share of Foreign Investors in Net Profit
Others (Specify):
______
______
TOTAL / $
NET DOLLAR-INFLOW (OUTFLOW) / $

D. Statement of Income Tax Paid

As of Year End 200___ / As of Year End 200___
Total taxable income (net of all deductions other than deduction from taxable income allowed by PEZA laws)
Less: Total deductions from taxable income as allowed by PEZA laws and approved by the Board of Investment
Net Taxable Income
Taxes Payable
Net Profit (Loss)

III. Payment of Taxes, Licenses, Fees & Other Contributions to Government