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RDS 96-1DS Page 1 of 3

REGISTRATION DATA SHEET


CAPITAL STOCK/INCORPORATORS/DIRECTORS/OFFICERS INFORMATION
(FOR DOMESTIC STOCK CORPORATION ONLY)

SEC NUMBER

FILL UP INSTRUCTIONS: Type or print legibly. Light -shaded boxes are to be filled up by SEC, including the SEC number.
For no-par stockds, leave the authorized capital amount and the par value columns blank.
COMPANY NAME COMPANY TIN
BEAN AND GRAPE BISTRO, CORP.
CAPITAL STRUCTURE
AUTHORIZED SUBSCRIBED CAPITAL PAID-UP PAID
PAR NO. OF NO. OF
SHARE CODE SHARE TYPE P/N AMOUNT F/N AMOUNT AMOUNT IN
VALUE SHARES SHARES
COMMON P 1000 4,000 4,000,000.00 F 1,028 1,028,000.00 257,000.00

PAID -UP CAPITAL CASH 257,000.00 PROPERTY OTHERS TOTAL 257,000.00


BY ASSET TYPE
-
INCORPORATORS / STOCKHOLDERS / DIRECTORS / OFFICERS (Use additional sheets if necessary)
NAME TAXPAYER
SHARE NO. OF
(Company Name, if company) IDENTIFICATION BIRTH DATE CODE NATIONALITY BRD INC'R OFR SHARE TYPE SUBSCRIBED CAPITAL PAID-UP CAPITAL
CODE SHARES
(Last Name, First Name, MI, Maiden Surname, if person) NUMBER
TANDOG, SLYVIE BLANCHE F. 212-030-016 4/2/1980 FILIPINO M I N COMMON 112 112,000.00 28,000.00
PINGOY, ARIANNE DIANA G. 936-535-517 2/25/1981 FILIPINO M I PRES COMMON 112 112,000.00 28,000.00
ERUM, ZENAIDA C. 925-314-657 4/2/1981 FILIPINO M I COS COMMON 112 112,000.00 28,000.00
TANG, EUREKA S. 946-052-585 7/4/1982 FILIPINO M I N COMMON 112 112,000.00 28,000.00
ALMODIENTE, ELLAINE MARIE T. 928-524-806 2/21/1980 FILIPINO M I N COMMON 112 112,000.00 28,000.00
CHOMI, MARJORIE F. 267-673-503 8/16/1980 FILIPINO M I CFO COMMON 112 112,000.00 28,000.00
NAVARRO, MARIA CRISTINA R. 284-505-755 11/21/1987 FILIPINO M I N COMMON 112 112,000.00 28,000.00
MARAÑON, GRACIEL ANN M. 276-707-562 0/26/1980 FILIPINO M I N COMMON 112 112,000.00 28,000.00
DAÑOS , MARIVIC P. 926-361-397 5/18/1980 FILIPINO M I N COMMON 112 112,000.00 28,000.00
GALIT, JOANNE MARIE D. 927-684-222 4/24/1980 FILIPINO N N N COMMON 10 10,000.00 2,500.00
CASAN, KHAREN KHIRON Y. 213-866-074 4/28/1979 FILIPINO N N N COMMON 10 10,000.00 2,500.00
SUB-TOTALS 1,028 1,028,000.00 257,000.00
Note: For codes to use in filling up the columns, refer to the last page of this form. Refer also to the back of this page for additional instructions.
RDS 96-1DS Page 3 of 3
REGISTRATION DATA SHEET
CAPITAL STOCK/INCORPORATORS/DIRECTORS/OFFICERS INFORMATION
(FOR DOMESTIC STOCK CORPORATION ONLY)

SEC NUMBER FOR SEC TO PROVIDE: MAINTENANCE NO.: TRANSACTION DATE

FILL UP INSTRUCTIONS: Type or print legibly. Light -shaded boxes are to be filled up by SEC, including the SEC number.
COMPANY NAME
BEAN AND GRAPE BISTRO, CORP.
INCORPORATORS / STOCKHOLDERS / DIRECTORS / OFFICERS (Use additional sheets if necessary)
NAME TAXPAYER
(Company Name, if company) IDENTIFICATION CODE NATIONALITY BRD INC'R OFR SHARE CODE SHARE TYPE SUBSCRIBED CAPITAL PAID-UP CAPITAL
(Last Name, First Name, MI, Maiden Surname, if person) NUMBER

NO. OF DIRECTORS: 9 NO. OF STOCKHOLDERS: 11 TOTALS 1,028,000.00 257,000.00


FOREIGN EQUITY BREAKDOWN (Refer to the back of this page for instruction on how to fill-up this section.)
NATIONALITY CODE TOTAL FOREIGN EQUITY
NATIONALITY DESCRIPTION
SUBSCRIBED CAPITAL OF --
INDIVIDUALS
COMPANY (IES)
PAID UP CAPITAL OF --
INDIVIDUALS
COMPANY (IES)
TOTAL PAID-UP CAPITAL
PERCENTAGE OF FOREIGN EQUITY

CERTIFIED CORRECT: ZENAIDA C. ERUM POSITION: CORPORATE SECRETARY DATE: September 1, 2016
(Signature over printed name)
PROCESSING ATTORNEY: PROCESSING EXAMINER: DATA CONTROL CLERK: DATA ENCODER:
DATE REVIEWED: DATE REVIEWED: DATE REVIEWED: DATE ENCODED:
INSTRUCTIONS FOR FILLING UP THE FOLLOWING COLUMNS:
PAR/NO PAR (P / N) FILIPINO / FOREIGN WITH PAID-IN BOARD (BRD) OFFICER (OFR) INDICATOR -- LEG - LEGAL COUNSEL
VALUE INDICATOR (F/N) OWNED SURPLUS? INDICATOR -- PRE - PRESIDENT AUD - EXTERNAL AUDITOR
P - PAR INDICATOR -- Y - YES C - CHAIRMAN CEO - CHIEF EXECUTIVE OFFICER GOV - GOVERNMENT REPRESENTATIVE
N - NO PAR F - FILIPINO N - NO M - MEMBER CFO - CHIEF FINANCIAL OFFICER OTH - OTHERS
N - NON-FILIPINO / N - NEITHER COO - CHIEF OPERATING OFFICER N - NONE
FOREIGNER COS - CORPORATE SECRETARY
REGISTRATION DATA SHEET
GENERAL / BUSINESS / COMPANY RELATIONSHIP INFORMATION
(FOR DOMESTIC COMPANIES ONLY)

SEC NUMBER

FILL UP INSTRUCTIONS Type or print legibly. Light-shaded boxes are to be filled up by the SEC. Check appropriate boxes.
FILL UP ONLY THOSE ITEMS FOR WHICH AMENDMENTS OR CHANGES ARE TO BE MADE. Refer to the back of this page for additional instructions.
COMPANY NAME
BEAN AND GRAPE BISTRO, CORP.
GENERAL INFORMATION
CHANGE FROM STOCK TO NON CHANGE IN PRIMARY
( x ) DS - DOMESTIC STOCK ( ) DN - DOMESTIC NON-STOCK ( ) DP - DOMESTIC PARTNERSHIP STOCK ( ) YES PURPOSE ( ) YES
PRINCIPAL OFFICE ADDRESS MARBEL TELEPHONE SYSTEMS INC., GEN.SANTOS DRIVE, BRGY ZONE II KORONADAL CITY
AREA CODE +63083 POSTAL CODE 9506 TEL. NO. FAX NO.
BUSINESS OFFICE ADDRESS MARBEL TELEPHONE SYSTEMS INC., GEN.SANTOS DRIVE, BRGY ZONE II KORONADAL CITY
AREA CODE +63083 POSTAL CODE 9506 TEL. NO. FAX NO.

BUSINESS INFORMATION
PARTNERSHIP TYPE OF ENTERPRISE [ ] N- NO SPECIAL REGISTRATION [ ] H- FIA HOLDING [ ] F - FINANCIAL INSTITUTION
[ ] LIMITED [ ] E - FIA EXPORT [ ] R - FIA REPRESENTATIVE OFF [ ] Z - EPZA REGISTERED
[ ] GENERAL [ ] D - FIA DOMESTIC [ ] S - SUBIC REGISTERED [ ] B - BOI REGISTERED
INDUSTRY CODE TERMS OF EXISTENCE FISCAL YEAR END (MM/DD) ANNUAL MEETING (For Domestic Companies only)

50 YEARS 12/31 X F - FIXED (MM/DD) 4 15 [ ] V - VARIABLE ____________________

TYPE OF NON STOCK CORPORATION (Refer to the back of this page for the classification) TOTAL CONTRIBUTION (of domestic non-stock companies) % OF FOREIGN MEMBERSHIP (Of non-stock companies)

COMPANY RELATIONSHIP - List all companies related to the registrant. (Use additional sheets, if necessary)

RELATIONSHIP TYPE C - DISSOLVED COMPANY ( if due to consolidation) S - PARENT COMPANY (if registrant is a subsidiary) O - OTHERS

(RELN TYPE) V - DISSOLVED COMPANY ( if change in company type) A - AFFILIATE (of registrant)
RELN TYPE SEC NUMBER TIN COMPANY NAME

CERTIFIED CORRECT: ZENAIDA C. ERUM POSITION: CORPORATE SECRETARY DATE: September 1, 2016
(Signature over printed name) TIN: 925-314-657 B-DATE: 04/02/1981
PROCESSING ATTORNEY: PROCESSING EXAMINER: DATA CONTROL CLERK: DATA ENCODER:
DATE REVIEWED: DATE REVIEWED: DATE REVIEWED: DATE ENCODED: