Please use COMPANY LETTERHEAD

___________________
(Date)

(NAME OF HEAD OF THE AUTHORITY)

(Director General or Officer-In-Charge of the Authority)
PHILIPPINE ECONOMIC ZONE AUTHORITY
10th Floor, DoubleDragon Center West Building
DD Meridian Park, Macapagal Avenue, 1302 Pasay City

Attention: ______________________
Zone Manager, Zone Office NCR

Dear (Director General or OIC) _______________:

This is to formally file our application for CERTIFICATE OF NO OBJECTION/CLEARANCE FOR

TRANSFER OF OPERATIONS, with details as follows:
Company Name

Complete Address (including floor/unit)

PEZA Certificate of Registration No. & date

Reason/Explanation for Transfer of

Operations
Complete address of Old site (FROM)
Complete address of New or Existing site New site:
(TO) Existing site:
Total number of affected employees (please
indicate also the date of payment of
separation benefits/salary, as applicable)
Description (General description only, i.e. IT
or Non-IT Equipment)
Total Quantity with corresponding unit of
measurement, i.e., unit, pc., set, lot, etc.
(Please attach detailed inventory list)
Value of machinery and equipment/goods for
transfer/disposal/retained (PHP/USD)
Mode of Acquisition or Source of machinery
and equipment/goods (Imported or Locally
Purchased)
Status of Operations (Operational, Non-
Operational or Cancellation of PEZA
registration)
With Effect in Operations & Manpower  Yes  No
If Yes:
Total no. of workers affected: _________
What will happen to workers?

BOI OR/ Certificate of Registration No. and

date
Contact Person/Representative
(Name/Position/Email Address/Number)
Other Details

In support of our application, we have attached the following documents:

 Completely and properly filled out Inventory for Disposition/Local Sale with Net Book Value (For
disposal/retained).
The items in the inventory list must be in chronological order (from oldest date of purchase to newest date
of purchase; Ex: 2015 to 2022). Also, please have a separate list for items onsite and under WFH and a
separate list per consignee, i.e., for the developer, PEZA-registered scrap buyer, etc.

Completely and properly filled out Inventory List of Items/Equipment for Transfer to the new site
or existing site (separate list).

(For items that were not farmed-in) Completely and properly filled out Inventory List of
Machinery and Equipment for Late Farm-in (see attached template – you may edit the template
heading to indicate if the assets are on site or deployed under work from home). The items in
the inventory list must be in chronological order (from oldest date of purchase to newest date of
purchase; Ex: 2015 to 2022). Please have a separate Inventory List for items, (a) locally
purchased (with invoices); (b) imported (with invoices); (c) without invoices (locally purchased &
imported); (d) separate list of items onsite; (e) and deployed under WFH, as applicable.

Invoices attached in chronological order to the Inventory List of Machinery and Equipment for
Late Farm-in

(For machinery & equipment/goods without invoices) Notarized Affidavit/Undertaking signed

by the highest responsible official or authorized signatory with explanation, description of items,
quantity, value, and date of purchase, source or reference of records, i.e., company’s book of
accounts, etc.

Notarized Affidavit (for disposal)

Photos of machinery & equipment/goods (deployed under WFH only)

Copy of the approved PEZA Form 8106 for machinery & equipment/goods (deployed under
WFH only)

Clearance from the Developer re: Company’s accounts & liabilities and proper garbage/waste
disposal

Also, I/we hereby ensure that the:

The designated company representative/s shall make themselves available to fully assist the
PEZA Examiner during the inspection.

The designated company representative/s have full knowledge of the location, quantity,
condition, and description of the machinery and equipment/goods.

Electronic/IT/non-IT goods are segregated as either obsolete/working or defective.

Thank you.

Very truly yours,

__________________________________
Signature over printed name of the authorized signatory

ZONCR Remarks:
Application Accepted. An inspection (physical or virtual) will be conducted on
_______________.

Application Rejected. Please comply all the items with “x” remarks.

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