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ICARE Form - Corp Accreditation BOC

ICARE Form - Corp Accreditation BOC

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Published by Mona Jane Cha

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Published by: Mona Jane Cha on Jan 09, 2012
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ICARE FORM (REVISED 2010

)
INTERIM CUSTOMS ACCREDITATION AND REGISTRATION (ICARE) UNIT
REVENUE COLLECTION MONITORING GROUP
APPLICATION FOR ACCREDITATION
PARTNERSHIP CORPORATION
COOPERATIVE
NEW RENEWAL
APPLICANT REPRESENTATIVE
NAME: -
_____________________________________________________________________________________
_
Surname First Name
Middle Name
NAME OF FIRM
:_______________________________________________________________________________
Head Office Address:
___________________________________________________________________________
No./Bldg. Street Barangay
City/Province Zip Code
Year/s of Stay in the Premises:__________
Nature of Occupancy: ( ) Owned ( ) eased ( ) Shared
Others:_______________
!arehouse Address
:________________________________________________________________________
Year/s of Stay in the Premises:__________
Nature of Occupancy: ( ) Owned ( ) eased ( ) Shared
Others:_______________
"ranch Office
Address:_________________________________________________________________________
Year/s of Stay in the Premises:_____________________________________
Nature of Occupancy: ( ) Owned ( ) eased ( ) Shared

Others:________________
#e$ephone Num%er/s: ____________________________________________
&acsimi$e Num%er/s: _____________________________________________
'mai$ Address: _________________________________________________
(ompany #)N: __________________________________________________
Pre*ious (ertificate of Accreditation No+:____________________________________________
,epu%$ic of the Phi$ippines
-epartment of &inance
Bureu !" Cu#$!%#
./00 1ani$a
PERSON MANAGING THE AFFAIRS OF THE FIRM:
Name: _______________________________________________________________
-esi2nation: __________________________________________________________
#e$ephone Num%er/s: ___________________________________________________
Specimen Si2nature: ______________________________________________________
ATTACHMENTS
NEW APP!CA"!#N
Specia$ Power of
Attorney/"oard ,eso$ution of
Authori3ed ,epresentati*e
"(O, e*idencin2 payment
of re2istration fee
Printed (P,S App$ication
profi$e
1ayor4s Permit
"aran2ay ($earance
"), #)N (ard and/or 5A#
(or Non-5A#) (ertificate of
App$icant
5a$id 6o*ernment )ssued
)- with Photo (e+2+ Passport7
-ri*er4s icense7 etc+) and
(ommunity #a8 (ertificate of the
App$icant
&or (orporation7 S'(
(ertificate of ,e2istration7
Artic$es of )ncorporation and "y-
aws and 6enera$ )nformation
Sheet as may %e app$ica%$e
&or Partnerships7 S'(
(ertificate of ,e2istration7
Artic$es of Partnership and "y-
aws
&or (ooperati*es7
(ertificate of (ooperation issued
%y the (ooperati*e -e*e$opment
Authority
Audited &inancia$
Statements for the past year7 if
app$ica%$e
"ureau of )n*estments
("O)) (ertificate of ,e2istration7 if
app$ica%$e
)ncome #a8 ,eturn of the
(ompany/Partners for the past
three (9) years7 if app$ica%$e
(ertified #rue (opy of 5A#
,eturns for the past three (9)
years7 if app$ica%$e
Proof of ownership or
$awfu$ occupancy (i+e+ (ontract of
$ENEWA #F ACC$E%!"A"!#N
Specia$ Power of
Attorney/"oard ,eso$ution of
Authori3ed ,epresentati*e
"(O, e*idencin2 payment
of re2istration fee
Printed (P,S App$ication
profi$e
Affida*it of NO (HAN6' of
(),(:1S#AN(' (in case no
materia$ chan2es in the data and
circumstances as appearin2 in
pre*ious App$ication for
Accreditation)
(urrent 1ayor4s Permit
and "aran2ay ($earance
(ertified #rue (opy of
)ncome #a8 ,eturn for the past
three (9) years7 if app$ica%$e
(ertified #rue (opy of 5A#
,eturns for the past three (9)
years7 if app$ica%$e
N&B&: I' (#e $)ere re ()'*e#
+' $)e %$er+, +'"!r%$+!'
-re.+!u#,/ 0e(,re0 '0 "+,e01
$)e --,+('$1 +' 00+$+!' $! $)e
2!.e re3u+re%e'$#1 #),,
+'#$e0 #u2%+$ ' A""+0.+$ !"
C)'*e !" C+r(u%#$'(e (,er,/
#$$+'* $)e "($# (!'#$+$u$+'*
$)e ()'*e#1 $!*e$)er 4+$) $)e
'e(e##r/ 0!(u%e'$# +' #u--!r$
$)ere!"&
ease) of the %usiness premises7
as the case may %e+
Proof of :ti$ity "i$$in2
(ompany Profi$e with
Pictures of Premises
ocation 1ap of Principa$
P$ace of "usiness
(apita$ Structure
Persona$ Profi$e of
(orporate Officers and (ompany
,epresentati*es
OTHER INFORMATION:
Nature of "usiness:_____________________________________________________
1ain ine of "usiness: __________________________________________________
Secondary ine of "usiness:______________________________________________
Other "usiness Acti*ities: ________________________________________________
ist of )mporta%$e )tems:
(ommodity 5o$ume (. Year Pd+)
________________________________ ________________________________
________________________________ ________________________________
________________________________ ________________________________
Amount of (apita$ )n*ested: ______________________________________________
)nterest in Other "usiness/'nterprise (if any)
Name of &irm Nature of )nterest S'( ,e2+
No
__________________ ___________________ _ _________________
__________________ ___________________ _ _________________
__________________ ___________________ _ __________________
) here%y certify under oath that:
.+ A$$ information supp$ied in this app$ication are true and correct to the
%est of my %e$ief and ;now$ed2e<
2. A$$ documents su%mitted to support this app$ication are 2enuine and
true< and
9+ Any fa$se or mis$eadin2 information supp$ied7 or production of
materia$$y fa$se or mis$eadin2 document to support the app$ication
sha$$ %e a 2round for the appropriate crimina$7 ci*i$ and or
administrati*e action a2ainst me+

____________________________________
Si2natory of App$icant /
Authori3ed Si2natory

____________________________________
Position

PHOTO
25 6 25
____________________________________
Name of App$icant-
)mporter
S:"S(,)"'- AN- S!O,N #O %efore me this ____th day of ______________=/./
in ______________7 Phi$ippines < affiant e8hi%itin2 to me his / her (ommunity #a8
(ertificate No+ _____________________ issued in _________________________on
____________________+
NO#A,Y
P:")(
(:nti$ -ecem%er
___)
-oc+ No+:
Pa2e No+:
"oo; No+:
Series of:

) and Community Tax Certificate of the Applicant For Corporation. together with the . Articles of Partnership and Bythe applicant. in previously declared and filed. Contract of N. if applicable Income Tax Return of the Company/Partners for the past three (3) years. if applicable Proof of ownership or lawful occupancy (i.e. Certificate of Cooperation issued instead submit an Affidavit of by the Cooperative Development Change of Circumstance clearly stating the facts constituting Authority Audited Financial Statements for the past year. SEC Certificate of Registration. Driver’s License. if applicable For Partnerships. SEC the material information Certificate of Registration. etc. applicable Bureau of Investments (BOI) Certificate of Registration. Passport.B. if applicable Certified True Copy of VAT Returns for the past three (3) years.PERSON MANAGING THE AFFAIRS OF THE FIRM: Name: _______________________________________________________________ Designation: __________________________________________________________ Telephone Number/s: ___________________________________________________ Specimen Signature: ______________________________________________________ ATTACHMENTS NEW APPLICATION Special Power Attorney/Board Resolution Authorized Representative of of RENEWAL OF ACCREDITATION Special Power Attorney/Board Resolution Authorized Representative of of BCOR evidencing payment of registration fee Printed CPRS Application profile Mayor’s Permit Barangay Clearance BIR TIN Card and/or VAT (or Non-VAT) Certificate of Applicant Valid Government Issued ID with Photo (e. in addition to the Laws For Cooperatives. Articles of Incorporation and ByLaws and General Information Sheet as may be applicable BCOR evidencing payment of registration fee Printed CPRS Application profile Affidavit of NO CHANGE of CIRCUMSTANCE (in case no material changes in the data and circumstances as appearing in previous Application for Accreditation) Current Mayor’s and Barangay Clearance Permit Certified True Copy of Income Tax Return for the past three (3) years. shall the changes.: In case there are changes above requirements.g. if necessary documents in support thereof. if applicable Certified True Copy of VAT Returns for the past three (3) years.

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