II.

COMPANY PERFORMANCE FOR THE YEAR

Current Assets
Non-Current Assets
Property, Plant and Equipment
Stock Investments ₱ -
Total Assets ₱ -

Foreign Loans
Total Liabilities

Retained Earnings
Retained Earnings intended for reinvestment ₱ -
Additional Paid-In ₱ -
Total Stockholders' Equity

Debt-Equity Ratio #DIV/0!

EQUITY PROFILE
Authorized Capital (P):
Equity by Nationality Percentage (%) Subscribed (P) Paid-up (P)
Filipino
Foreign 0% ₱ - ₱ -
(pls. indicate nationality)
Major Stockholders
Name Nationality Percentage (%) Subcribed (P) Paid-Up (P)

Gross Income
Training expense
Research and Development expense
Logistics Expense
Rental Expense under Capital Expenditure
Total Expense
Taxable Income
NOLCO (if applicable)

TAXES PAID FOR THE YEAR

Total taxes paid other than income tax during ITH period -
documentary stamps
withholding taxes on employees' salaries and
wages
annual registration
real estate taxes
business taxes/permits
occupation taxes
taxes on importation -
Total taxes paid after ITH entitlement period
Taxes paid on importation (raw materials, supplies, and capital equipment)
Total VAT paid
Total VAT Paid for Raw Materials 0.00

DUTIES PAID FOR THE YEAR -

LCS-CSD-FORM-MR-S1Updated as of 25 April 2017 Page 2 of 7

Major Stockholder
Name Nationality Percentage (%) Subcribe (P) Paid-Up (P)

LCS-CSD-FORM-MR-S1Updated as of 25 April 2017

III. BOI - REGISTERED PROJECT PROFILE

Registration No. / Date

Registered Activity
Registered Capacity
Governing IPP
Export Commitment (if applicable)
Date of Actual Start of Commercial Operation
Actual Start of Commercial Operation (for RE projects) Applicable Not applicable
Date:
Certification No.
Pre-Operating
P Operating
Status of Operation
Stopped Operation
Date:

Project Cost (per STC)

Actual Investment Cost (for the year)
Actual Aggregate Investment Cost (from date of registration)

Expenses for Infrastructure Works

Environmental Compliance Certificate / Certificate of Non-Coverage P Applicable Not applicable

Not yet submitted
Submitted/Date:
Tree Planting (please indicate type of trees and location) Applicable P Not applicable
Total Number of Trees Planted Not yet submitted
Submitted/Date:
Corporate Social Responsibility (please indicate) Applicable P Not applicable
Not yet submitted
Submitted/Date:
Certification based on internationally recognized standards (please indicate Applicable P Not applicable
type of certificate) Not yet submitted
Submitted/Date:
Certification of Compliance (for power projects) Applicable P Not applicable
Not yet submitted
Submitted/Date:
License to Operate/Food and Drugs Administration (FDA) Certification (if Applicable P Not applicable
applicable) Not yet submitted
Submitted/Date:
Undertaking that the incentives availed shall translate to the benefit of the Applicable P Not applicable
end-users (if applicable) Not yet submitted
Submitted/Date:
Proof of Financial Close (if applicable) Applicable P Not applicable
Not yet submitted
Submitted/Date:
Certificate of Good Standing from Mines and Geosciences Bureau (for mining Applicable P Not applicable
projects) Not yet submitted
Submitted/Date:
Self-accomplished good governance scorecard Applicable P Not applicable
Not yet submitted
Submitted/Date:

Reportorial Requirements:
AFS (Date submitted)
ITR (Date submitted)

LCS-CSD-FORM-MR-S1Updated as of 25 April 2017 Page 3 of 7

IV. LABOR GENERATION AND FOREIGN EXCHANGE INFLOWS AND OUTFLOWS FOR THE YEAR

A. LABOR GENERATION

Annual
Aggregate
No. of personnel hired Payroll/Expense of the
number of
for the year aggregate number of
employees employees

Filipino Management
Administrative/Sales
Direct Labor
Indirect Labor
Outsourced Labor
Expatriate
(specify
position &
nationalit
y)
Total Labor Expense -

B. EXCHANGE INFLOWS AND OUTFLOWS (if applicable)

Applicable P Not applicable
Foreign Exchange Inflows Currency Value
Export Earnings
Foreign Exchange Outflows
Acquisition of Equipment
Purchase of Spare parts
Purchase of Raw Materials and Supplies
Remittances
Others

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V. PRODUCTION AND PERFORMANCE DATA FOR THE REGISTERED PROJECT FOR THE YEAR

A. NET VALUE ADDED

B. PERFORMANCE DATA
Total Production Value Unit of Measurement
Volume
Cost
Total Sales
Domestic Sales
Volume
Value
Export Sales
Direct
Volume
Value
Value (Other Currency)
Indirect
Volume
Value
Value (Other Currency)
Constructive
Volume
Value
Value (Other Currency)

Export Market

C. COST OF SALES Applicable P Not applicable

Cost of Goods Manufactured/Sold (engaged in manufacturing)
Cost of Raw Materials sourced from micro and small
enterprises (if applicable)
Cost of Raw Materials locally sourced

D. COST OF SERVICE P Applicable Not applicable

Cost of Service (engaged in trading/other services)
Cost of service sourced from micro and small enterprises (if
applicable)

E. NET PROFIT FROM REGISTERED PROJECT -

LCS-CSD-FORM-MR-S1Updated as of 25 April 2017 Page 5 of 7

VI. COMPLIANCE FOR MASS HOUSING PROJECTS
Applicable P Not applicable

A. Profile of Horizontal/Vertical Project

HLURB Certificate of Registration No./Date
License to Sell No./Date

B. Compliance on 20% Socialized Housing Requirement (SHR)

1. Name of Socialized Housing Project
2. Project Location Street No./Brgy: City/ Municipality:
Province: Region:
3. Approach Applied 20% of Land Area
20% of Project Cost
Investment Scheme (20% of saleable area)
Direct Participation
30% of 20% of Building Construction Cost
40% of Income Tax Holiday Incentive Claimed
€
4. Status of Completion
a. Required 20% SHR Compliance (unit)
b. No. of actual units constructed
c. Size per unit ( sq. m.)
d. Construction cost per unit
e. Percentage of completion to date (b/a) #DIV/0!
5. Proof of Compliance
HLURB Certificate of Registration No. Applicable P Not applicable
Not yet submitted
Submitted/Date:
License to Sell No. Applicable P Not applicable
Not yet submitted
Submitted/Date:
Engineer’s Affidavit Applicable P Not applicable
Not yet submitted
Submitted/Date:
Project Development Plan Applicable P Not applicable
Not yet submitted
Submitted/Date:
Development Permit Applicable P Not applicable
Not yet submitted
Submitted/Date:
Verified Survey Return Applicable P Not applicable
Not yet submitted
Submitted/Date:
Memorandum of Agreement with LGU or Developer’s Applicable P Not applicable
Not yet submitted
Submitted/Date:
Subsidiary (indicating amount of firm’s participation) Applicable P Not applicable
Not yet submitted
Submitted/Date:
Philippine Contractors Accreditation Board (PCAB) Applicable P Not applicable
License Not yet submitted
Submitted/Date:
Memorandum of Agreement with Accredited NGO’s Applicable P Not applicable
Not yet submitted
Submitted/Date:
Certificate of Donation Applicable P Not applicable
Not yet submitted
Submitted/Date:
Amount: Official Receipt No.
Others (Please specify) Applicable P Not applicable

LCS-CSD-FORM-MR-S1Updated as of 25 April 2017 Page 6 of 7