Client Profile Registration System
CPRS - Importer Profile Information
DATA ITEM INFORMATION
Scanned Photo / Mandatory
Please submit your photo or logo in JPEG Form.
PETROLEUM GAS AND OTHER FUEL
Nature of Business / Mandatory PRODUCTS
Business Name / Mandatory
Accepts the following special characters [. / ' - & ( )] ALQUENES PETROLEUM INC.
First Name / Mandatory
Only for clients with business entity "Individual" or "Sole
Proprietorship"
Middle Name / Mandatory
Only for clients with business entity "Individual" or "Sole
Proprietorship"
Last Name / Mandatory
Only for clients with business entity "Individual" or "Sole
Proprietorship"
Country of Citizenship/ Mandatory PHILIPPINES
Address
Address / Mandatory THE VENUE BLDG, UNIT 202, LOT C-5
COMMERCIAL AREA SUBIC BAY GATEWAY
Accepts the following special characters [. / , -] PARK, PHASE 1, SUBIC BAY FREEPORT ZONE
City / Mandatory
Accepts the following special characters [. / , -] OLONGAPO CITY
Zip Code / Mandatory 2222
Country / Mandatory PHILIPPINES
Contact Information
Phone / Mandatory 02 8757488
Minimum must be 7 characters
Alternate Phone / Optional
Minimum must be 7 characters
Mobile Phone/ Optional
Minimum must be 7 characters 09667689299
Fax / Optional
Minimum must be 10 characters
Email/ Mandatory alquenespetroleuminc792@gmail.com
This is to certify that all information in this page are true and correct.
Approved for CPRS registration by: ALYSSA ESCARLAN BULOSAN Page - 1 / 6
Authorized Company Officer CPRS Importer Form
Client Profile Registration System
URL/Website / Optional api_email@alquenespetroleuminc.ph
Warehouse / Transit Shed Code/ Optional
JO 2-91 Reference Number / Only for clients with Nature of
Business "Government Services Jo 2-91"
Period of Effectivity / Only for clients with Nature of Business
"Government Services Jo 2-91"
Capacity / Only for clients with Nature of Business "Government
Services Jo 2-91"
TIN / Mandatory 008-881-849-00000
Social Security Number/ Optional 03-9482231-8-000
Passport Number/ Optional
Driver's License / Optional
PRC ID No. / Optional
Primary VASP CCN No. / Mandatory VA0000000434
Secondary VASP CCN No. / Optional
Informal Importers
Unique Reference Number
SEC Registration Number / Mandatory
This field becomes mandatory when the business entity is set to
"Company", "Corporation" or "Partnership". CS201419864
Amount of Authorized Capital Stock/ Mandatory
This field becomes mandatory when the business entity is set to
"Company", "Corporation" or "Partnership". 3,000,000.00
Amount of Paid up Capital/ Mandatory
This field becomes mandatory when the business entity is set to
"Company", "Corporation" or "Partnership". 75,000.00
Related domestic & foreign companies
Accepts the following special characters [. / ' -]
Related company 1 / Optional
Related company 2 / Optional
Related company 3 / Optional
Primary Broker / Mandatory
TIN / Mandatory 501-143-151-000
Code / Mandatory BR0000949515
Secondary Broker / Optional
TIN / Mandatory
Code / Mandatory
Plant Addresses/ Mandatory to indicate at least one (1) Plant Address
This is to certify that all information in this page are true and correct.
Approved for CPRS registration by: ALYSSA ESCARLAN BULOSAN Page - 2 / 6
Authorized Company Officer CPRS Importer Form
Client Profile Registration System
Address/ Mandatory BLDG.1428 POL PIER
COMPOUND,ARGONAUT HIGHWAY,
Accepts the following special characters [. / ' -] SUBIC BAY FREEPORT ZONE
City / Mandatory
Accepts the following special characters [. / ' -] ZAMBALES
Zip Code / Mandatory 2222
Country / Mandatory PHILIPPINES
Major Stockholders/ Mandatory to indicate at least one (1) Major Stockholder
This field becomes mandatory when the business entity is set to "Company", "Corporation" or "Partnership"
Please put the name of a member of the Board of Directors.
First Name / Mandatory AL
Middle Name / Mandatory BELIGANIO
Last Name / Mandatory ESCARLAN
Country of Citizenship/ Mandatory PHILIPPINES
TIN / Mandatory 101-472-354-000
Photo / Mandatory
Please submit in JPEG Form.
Signature / Mandatory
Please submit in JPEG Form.
Address
Address / Mandatory BLK 36 LOT 61 PHASE 2 AREA II
Accepts the following special characters [. / , -] MALIPUTO ST. NORTHBAY BLVD SOUTH
City / Mandatory
Accepts the following special characters [. / , -] NAVOTAS CITY
Zip Code/ Mandatory 1485
Country/ Mandatory PHILIPPINES
Phone / Mandatory
Minimum must be 7 characters
Alternate Phone / Optional
Minimum must be 7 characters
Mobile / Optional
Minimum must be 7 characters 0956 415 5051
Fax / Optional
Minimum must be 10 characters
Email / Mandatory alescarlan@yahoo.com
Principal Officers #1
First Name AL
This is to certify that all information in this page are true and correct.
Approved for CPRS registration by: ALYSSA ESCARLAN BULOSAN Page - 3 / 6
Authorized Company Officer CPRS Importer Form
Client Profile Registration System
Middle Name BELIGANIO
Last Name ESCARLAN
Position PRESIDENT & CEO
TIN 101-472-354-000
BLK 36 LOT 61 PHASE 2 AREA II
Address MALIPUTO ST. NORTHBAY BLVD SOUTH
City NAVOTAS CITY
Zip code 1485
Country PHILIPPINES
Mobile Phone 0956 415 5051
Email alescarlan@yahoo.com
PRINCIPAL OFFICERS #2
First Name ALJON
Middle Name LABAHATA
Last Name ESCARLAN
Position CORPORATE SECRETARY
Tin 456-700-441
40 STO.NIÑO ST. A PAYATAS , QUEZON
CITY,METRO MANILA
Address
City QUEZON CITY
Zip Code 1113
Mobile Number 0915 906 4480
Email escarlanaljon@gmail.com
Principal Officers #3
First Name / Mandatory ALEXIS
Middle Name / Mandatory LABAHATA
Last Name / Mandatory ESCARLAN
Position / Mandatory VICE PRESIDENT
TIN / Mandatory 453-829-938-000
Photo / Mandatory
Please submit in JPEG Form.
This is to certify that all information in this page are true and correct.
Approved for CPRS registration by: ALYSSA ESCARLAN BULOSAN Page - 4 / 6
Authorized Company Officer CPRS Importer Form
Client Profile Registration System
Signature / Mandatory
Please submit in JPEG Form.
Address
Address / Mandatory BLK 36 LOT 61 PHASE 2 AREA II MALIPUTO
Accepts the following special characters [. / , -] ST. NORTHBAY BLVD SOUTH
City / Mandatory
Accepts the following special characters [. / , -] NAVOTAS CITY
Zip Code / Mandatory 1485
Country / Mandatory PHILIPPINES
Phone / Mandatory
Minimum must be 7 characters
Alternate Phone / Optional
Minimum must be 7 characters
Mobile / Optional 09663482355
Minimum must be 7 characters
Fax / Optional
Minimum must be 10 characters
Email / Mandatory escarlanlex@gmail.com
Responsible Officers/ Mandatory to indicate at least one (1) Responsible Officer
First Name / Mandatory ALYSSA
Middle Name / Mandatory ESCARLAN
Last Name/ Mandatory BULOSAN
Position/ Mandatory CORPORATE AUDITOR
TIN / Mandatory 456-700-871-000
Area of Responsibility / Mandatory ACCOUNTING
Photo / Mandatory
Please submit in JPEG Form.
Signature / Mandatory
Please submit in JPEG Form.
Address
Address / Mandatory BLK 36 LOT 61 PHASE 2 AREA II MALIPUTO
Accepts the following special characters [. / , -] ST. NORTHBAY BLVD SOUTH
City / Mandatory
Accepts the following special characters [. / , -] NAVOTAS CITY
Zip Code / Mandatory 1485
Country / Mandatory PHILIPPINES
Phone / Mandatory
Minimum must be 7 characters N/A
Alternate Phone / Optional
Mobile / Optional 0995 726 4845
Minimum must be 7 characters
Email/ Mandatory alyssaescarlan@yahoo.com
Approved for CPRS registration by: ALYSSA ESCARLAN BULOSAN Page - 5 / 6
Authorized Company Officer CPRS Importer Form
Client Profile Registration System
Responsible Officer #2
First Name / Mandatory MELINDA
Middle Name / Mandatory BAJAMONDE
Last Name/ Mandatory DELFIN
Position/ Mandatory TREASURER
TIN / Mandatory 406-032-469-000
Area of Responsibility / Mandatory ACCOUNTING
Photo / Mandatory
Please submit in JPEG Form.
Signature / Mandatory
Please submit in JPEG Form.
Address
Address / Mandatory BLK 36 LOT 61 PHASE 2 AREA II MALIPUTO ST.
Accepts the following special characters [. / , -] NORTHBAY BLVD SOUTH
City / Mandatory NAVOTAS CITY
Accepts the following special characters [. / , -]
Zip Code / Mandatory 1485
Country / Mandatory PHILIPPINES
Phone / Mandatory
Minimum must be 7 characters
Mobile / Optional 09954914518
Minimum must be 7 characters
Fax / Optional
Minimum must be 10 characters
Email/ Mandatory melindadelfin09@gmail.com
This is to certify that all information in this page are true and correct.
Approved for CPRS registration by: ALYSSA ESCARLAN BULOSAN Page - 6 / 6
Authorized Company Officer CPRS Importer Form
Client Profile Registration System
Major Suppliers/ Mandatory to indicate at least one (1) Major Supplier
TIN / Mandatory 0000000
Name / Mandatory SOYUZ TERMINAL LLC.
Address
Address / Mandatory
Accepts the following special characters [. / , -] 7 VOLZHSKOE HIGHWAY
City / Mandatory
Accepts the following special characters [. / , -] SAMARA
Zip Code / Mandatory 443112
Country / Mandatory RUSSIA
Phone / Mandatory
Minimum must be 7 characters +7499-391-2420
Alternate Phone / Optional
Minimum must be 7 characters
Mobile / Optional
Minimum must be 7 characters
Fax / Optional
Minimum must be 10 characters
Email/ Mandatory Sales-soyuzterminal@inbox.ru
Kindly send your duly accomplished form via email at cprs@ekonek.com. Thank you.
E-KONEK HELPDESK HOTLINE NUMBER: (02) 8879-4699
This is to certify that all information in this page are true and correct.
Approved for CPRS registration by: ALYSSA ESCARLAN BULOSAN Page - 7 / 6
Authorized Company Officer CPRS Importer Form
