COVER SHEET

COMPANY REGISTRATION AND MONITORING

DEPARTMENT

Nature of Application SEC Registration Number

REGISTRATION

Company Name

Safehaven Addiction Treatment and Recovery Village Inc.

Principal Office (No./Street/Barangay/City/Town/Province/

SAFEHAVEN RECOVERY VILLAGE TIGBAO SAN JOSE CEBU CITY (CAPITAL) CEBU, PHILIPPINES

COMPANY INFORMATION
Industry Code Industry Description

Q87201 Rehabilitation of people addicted to drugs or alcohol

Company's Email Company's Telephone Number/s Company's Mobile Number

atty.marlon.i.yap@gmail.com 088 3465817 09055134921

CONTACT PERSON INFORMATION

The designated person MUST be a Director/Trustee/Partner/Officer/Resident Agent of the Corporation

Name of Contact Email Address Telephone Number/s Mobile Number

atty.marlon.i.yap@gmail.
Marlon Yap 032-2319709 09505134921
com

To be accomplished by CRMD Personnel

Date Signature
Assigned

Document I.D.

Received by Corporate Filing and Records Division

Forwarded to:

Corporate and Partnership Registration

Green Lane Unit

Financial Analysis and Audit Division

Licensing Unit