arn Deans a PBDB # waunaayiad seaniize, | AR Republic of the Philippines ace a camer | | Cy || CITY GOVERNMENT OF VALENZUELA Dare Sylow isons repr toisy raps ay esermay |S Metropolitan Manila Bement ne sucedng ue MINORS PERVIT / BUSINESS ACCOUNT NO. ONew CQUARTERLY COCHANGE BUSINESS NAME C2) CORRECTION OF ENTRIES CADDITIONAL COSEMI-ANNUAL, COCHANGE ADDRESS COSPECIAL PERMIT CORENEWAL ANNUALLY REQUIREMENTS, THEW BUSINESS REGISTRATION: RENEWAL OF BUSINESS APPLICATIONS: T. Proof of business registration, incorporation, or legal personality 1. Basis for computing taxes, fees and charges (e.g Income Tax Returns); and (ie, D1/SEC/ Cooperative Development Authority (CBA) registration), note certain cases ke Sarai Stores not ving any or without Easiness name the requrement of TVSEC regatation may be dlspensed with dung nal registration (se At No. 3883) 2. fasis for computing taxes, fees, and charges (e.g. business capitalization); 5. Occupancy Permit, requited by national laws (eg, Building Code) ané local aws (subjet to post aut requirements as per Ordinance no. 324, series of 2016) 4 Contract of Lease if Lessee); and 5. Barangay clearance (for business which are not requted occupancy 2, Barangay Clearance permish = ‘All other requirements required by law, ordinance and les ae SUDIEC To POST AUR BOOS BUSINESS TRADE NAME TEL NO, BUSINESS ADDRESS] HOUSENO: STREET NAVE TGARANGAT TAME OF TAXPAYER | SURNAME FIRST NAME TADDTE INTIAL TE RO, TRODRESS OF TARPAVER | HOUSE NO: STREET NAME BARANGAY CY TARORTCTPAUIT DATEOF ORTH PINCEF BIRTH ‘NAME OF PRESIDENT / CEO] MANAGER NN. EVAL ADDRESS ‘COMMUNITY TAX CERTIFICATE. ATE RSUED: PACE SUED: {iNbWIDUALOR CORPORATE] BUSINESS ACTIVITY TINE OF BUSINESS CAPTALTZATION, [GROSS/SALES RECEIPTS [FOR RENEWA TH (FOR NEW BUSINESS) [ee | NOR EET] Ey TS oa eam BUSHES AREA TW SOM [ino OF OWNERSHTP” CISINGLE PROPRIETORSHIP CJPARTNERSHIP CICORPORATION C_TcDOPERATIVE | DI/SECICDA Regraton Na ‘Are you enjoying tax incentive from any Government Entity? LJyes [Jno _Iyes, please specify the entity. [esoRS Na [eSSoRS CONTAETRO [Sr EADORES important Notice: As per Sechap 12 ofthe implementing Rules and Regulation of the Fire Code of 2008, certain establishments (ep. ulling lessor, fre, earthquake, and explosion hazard insurance companies, and vendors of firefighting equibment, applianees and devices] may Be requites o pay additional charges and fees othr than the Fre Safety inspection Fees, These shal be collected duving inspeeions or In another process o be communicated by representatives ofthe Bufeau of Fira Protection (8F#). DEED OF UNDERTAKING/WAIVER \. of legal age, Flipino and a fesident of Valenzuela city after having duly sworn to in accordance with law, aver that ‘Asan applicant for a business permitlicense forthe City of Valenzuela and as a law abiding citizen and taxpayer thereof, | undertake to comply with all the requirements forthe issuance of a business permit and license as required by the law oF City Ordinance. | further undertake toallow duly authoriaed inspectors of the ity Government to conduct ocular inspectian of my establishment to ensure faithful compliance to any regulatory measures and post inspection requirements and in ease of violation or non-compliance thereof it will regult in the closure of the business establishment without need of notice, Executive Order and revocation of my business Permit. | executed this undertaking and waiver to attest to the truth and veracity of the foregoing based on personal knowledge and fora egal intents and purposes. | DECLARE UNDER PENALTY OF PERJURY that the foregoing information are true based on my personal knowledge ahd authentic records Further, | agree to submit completely filed-out and signed application form and comply with the regulatory requirements and other deficiencies within 30 days from release ofthe business permit. Iftherels an error and/or mistepresentation, itll ender my application and the issued busi- ness permit and other issued clearances void ab initia from the begianing Thereby agree that all Personal Data (as defined under the Data Privacy Law of 2012 and its implementing rules and regulations), ‘customer data and account or transaction information or records (collectively, the "information") which may be with City Government from time to time relating to us may be processed, profiled or shared to requesting parties or-for the purpose of any court, legal process, examination, Inguiry, audit or investigation of any Authority. The aforesaid terms shall apply notwithstanding any applicable non-disclosure agreement. We ‘acknowledge that such Information may be processed or profiled by or shared with jurisdictions which do not have strict data protection or data a snocor QP-VAL-BPLO-1.10 F1