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 VALIDATION OF TRANSFERRED EQUIPMENT, with
details as follows:
Company Name

Complete Address (including floor/unit)

PEZA Certificate of Registration No. & date

PEZA HO/ERD/ZONCR LOA No., date, and
validity
Status of PEZA HO/ERD/ZONCR LOA
Compliance (please list down the conditions
or items that the company has complied and
has not yet complied with)
Status of Supplemental Agreement &
amended PEZA Certificate of Registration (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 (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)
BOI OR/ Certificate of Registration No. and
date (as applicable)
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 List of Transferred Machinery and Equipment

Copy of approved PEZA Form 8106/8105 or 8112 for the transferred machinery &
 equipment/goods from old site to new site

Copy of Transfer Invoice

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

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

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.

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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