REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF FINANCE
SECURITIES AND EXCHANGE COMMISSION
TARLAC CITY EXTENSION OFFICE

STOCK AND TRANSFER BOOK / MEMBERSHIP BOOK

REGISTRATION FORM

Note: STB / MB must be registered within 30 days from receipt of Certificate of Registration

Please check one:

Stock and Transfer Book

Membership Book

DATE

SEC REG. NO.

NAME OF COMPANY

DATE OF APPROVAL

SHARE TYPE (if STB)

This is to certify that the STB / MB beign registered is (please check appropriate box)

VOLUME 1 Additional Volume

(pls. Specify Volume No. being registered
Replacement for VOL. No. _____________
Lost VOL. No. The latest volume registered is
(refer to attached VOL. No. _____________
Affidavit of Loss)

and that this company is not in possession of any other copy of the volume being
registered under this application or under previous registration.

Corporate Secretary

TIN

PAID:
O.R. NO.
DATE:

PUT HERE STB/B REGISTRATION STAMP

AND STB/MB SERIAL NO.

(to be filled up by DTU)

Registering Officer:
DOC ID. ____________________
Date: