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O-52822 Application Form
O-52822 Application Form
FORM
O-52822
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I hereby declare and certify that I am the data subject and that I voluntary provided the Quezon City Government the
abovementioned information or data, which are true and correct to my knowledge, and that I have complied with all laws and
regulations governing the establishment, maintenance and operation of my business.
I hereby further declare that I authorize or consent to the collection, recording, organization, storage, use and processing
of the data or information herein provided for the purpose of establishing a databank which shall be a source of all
information necessary for project monitoring, research and policy studies and informal dissemination campaigns as part of
the Pangkabuhayang QC program and mandated by RA 10173 - Data Privacy Act of 2012.
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PANGKABUHAYANG QC
APPLICATION FORM
Complete Name
Oo
Hindi
Oo
Hindi
Oo
Pangalan ng opisina o barangay:
Posisyon:
Hindi
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MUNGKAHING PLANONG PANGNEGOSYO
C. Edad: 44
D. Kasarian Female
LAYUNIN KO PO NA PALAGUIN ANG AKING MUNTING TINDAHAN UPANG MAKATULONG SA AKING ASAWA
UPANG MATUSTUSAN ANG PANG ARAW ARAW NA PANGANGAILANGAN
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IV. MGA KABAHAGI NG NEGOSYO (PARTS OF BUSINESS)
DISHWASHING
24 LITER 32.00 768.00
LIQUID
PANCIT
50 PCS 13.75 687.50
CANTOON
DETERGENT
10 DOZEN 67.00 670.00
POWDER
TOTAL: 18,449.50
Pangalan ng Negosyo:
Uri ng Negosyo:
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V. MGA KINAKAILANGANG DOKUMENTO (LIST OF REQUIREMENTS)
Microentrepreneurs/Vendors
• Approved QCitizen ID
• Updated Barangay Business Clearance /Barangay Business Permit issued at least 2 weeks before application) or latest
Hawkers Permit /MDAD Registration for Market Vendors
• Attach pictures of existing business (inside and outside with owner)
• Pangkabuhayang QC Certificate signed and dry sealed by the Barangay
• Completed Application Form and Business Plan
Email: rowenaferrerlapso@gmail.com
Phone: 09482848181
Department: Pangkabuhayang QC
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