( SECURITIES AND EXCHANGE COMMISSION » The following document has been received: Receiving: Salvador Baculanta July 26, 2021 01:42:49 PM Company Information mE SEC Registration No.: CS200718423 Company Name: QF! DISCOM CL INC. Industry Classification: Company Type: Document Information Document ID: 0ST107262021881625 Document Type: GENERAL_INFORMATION_SHEET Document Code: GIS Period Covered: July 01, 2021 ‘Submission Type: GIS Remarks: NoneGENERAL INFORMATION SHEET (GIS) FORTHE YEAR 2021 STOCK CORPORATION ‘GENERAL INSTRUCTIONS: 1. FOR USER CORPORATION: THIS GIS SHOULD BE SUBMITTED WITKIN THIRTY (30) CALENDAR DAYS FROM THE DATE OF THE aNNuad| STOCKHOLDERS’ NEETING. DO NOT LEAVE ANY ITEM BLANK. WRITE °NA” IF THE INFORMATION REQUIRED 1S NOT APPLICABLE TO THE CORPORATION OR "NONE" IF THE INFORMATION iS NON-EXISTENT. If THE ANNUAL STOCKHOLDERS MESTING IS WELD ON A DATE OTHER THAR ‘THAT STATED IN THE BY-LAWS THE GS SHALL BE SUBMITTED WITHIN THIRTY (30) CALENDAR DAYS. AFTER THE ELECTION OF THE DIRECTORS| ‘TRUSTEES AND OFFICERS OF THE CORPORATION AT THE ANNUAL MEMBERS MEETING. IF NO MEETING IS HELD, THE CORPORATION SHALL SUBMIT THE IS NOT LATER THAN JANUARY 20 08 THE FOLLOWING YEAR. HOWEVER, sHoULD| [AN ANNUAL STOCKHOLDERS MEETING BE HELD THEREAFTER, & NEW GIS SHALL BE SUBMFTTED/FILED, ‘THIS GIS SHALL BE ACCOMPLISHED IN ENGLISH AND CERTIFIED AND SWORN TO BY THE CORPORATE SECRETARY OF THECORPORATION. 4 THE SEC SHOULD BS TIMELY APPRISED OF RELEVANT CHANGES INTHE SUBNYTTED INFORMATION AS THEY ARISE. FOR CHANGES RESULTING FROM ACTIONS THAT AROSE BETWEEN THE ANNUAL MEETINGS THE CORPORATION SHALL SUBMIT AMENDED GiS CONTAINING THE NEW INFORMATION ‘TOGETHER WITH A COVER LETTER SIGNED THE CORPORATE SECRETARY OF THE CORPORATION, THE AMENDED GIS AND COVER LETTER SHALL ‘SUBMITTED WITHIN SEVEN (7) DAYS AFTER SUCH CHANGE OCCURED OR BECAME EFFECTIVE SUBMIT FOUR (4) COPIES OF THEGIS TO THE RECEIVING SECTION AT THE SEC MAIN OFFICE, OR TO SEC SATELLITE OFFICES OR EXTENSION OFFICES ‘ALL COPIES SHALL UNIFORMLY BEON At OR LETTER SIZED PAPER. THE PAGES OF ALL COPIES SHALL USE ONLY ONE SIDE {6 ONLY THE Gls ACCOMPLISHED IN ACCORDANCE WITH THESE INSTRUCTIONS SHALL HE CONSIDERED AS HAVING BEEN FLED. ‘THIS GIs MAY BE USED 4S EVIDENCE AGAINST THE CORPORATION ANO ITS RESPONSIBLE DIRECTORS/OFFICERS FOR ANY VIOLATION OF EXISTING LAWS, RULES AND REGULATIONS |cORPORATE WANE: [DATE REGISTERED: (get Iscom. ct, 1K. eee BUSINESS TRADENAME Ft DIscom. ct Ne. rise eA NS [SEC REGISTRATION NORE cso0071a423 December Sist lower) [Acruat DATE OF ANNUAL MEETING: [waaSeToRL ADDRES onjuraa NONE: | COMPLETE FRINGIPAL OFFICE ADORE. aR Warehouse #10, Brgy Balt San Fernando City, Pampanga siaiscen2020@amelcam [COMPLETE HUSINESS ADDRESS NE ‘oa TS Warehouse #10, Bray. Bali, San Fernando Cty, Pampanga ‘OFFICIAL EAL ADDRESS “ALTERNATE EWA ADDRESS ‘OFFICIAL MOBILE NUMBER | ACTERATE MOTE OT sf.dacomaiz0eemai con siscomei0@@amai com '0999-5090121 me [NAME OF BRTERNAL AUDITOR TTSSIGNING PARTNER: ‘EC RTEREDT TO OR ap AAFTORE TET jose V.Bithao : sss08-c 621-5116 zi J NDUSTRY CLASSIFICATION: ——} rics other acvcerrutedandjrinnta aes, Dicribtin/ Wholesale Trade/Oher Jnsecng and waseleslinmtar ar maybe ported by alk eandana bevnags Services [mlaterconuersan PARENT COMPANY 'SECREGISTRATIONNO. SORES ‘QUANTUM FOODS, NC 50094-00000464 Kr. 14 West Service Rou Brgy. Merville, Parafaque City SUBSIDIARY /AFEIOATE, SECREGISTIATIONN, ADDRES, NA N/A NA TE OO EAT csroci2020) nt‘GENERALINFORNATION SHEET ‘STOCK CORPORATION PLEASE PRINT LEGIBLY porate Name GHDISCON. CL, ING, “Is the Corporation a covered person under the Anti Money Laundering Act (AMA), as amended? (Rep. Acts. 9160/9164/10167 10365) Pease check the appropriate box: CYes No Jewelty dealers in precious metals, who, asa ore Banking Units c 1b. Offshore Banking Us +0 ‘business, trade in precious metals 1 e Quaseanis Da trustenities De Nonstock Savings and Loan Associations OD £ Pawnshops a Foreign Exchage Dealers 5] leweley dealersin precious stones who asa Th Money changers i: business, tae in precious stone 1 & Remitance Agents 1 ji. Brecronie Money lnsuers ke Financial institutions which Under Special Laws ae subject to Bangko Sentral ng ilpinas (BSP) supervision and/or ego, Company service providers which, a business, shel sus af provide any ofthe folowing services a tird pares: a Taurance Companies Insurance Agents Seng ar oration agent of fOTa Poon «Insurance Brokers acting as (or arranging for another person to acts) 4. Professional Reinsurers a director or comporate secretary ofa compas, a e. Reinsurance Brokers partner ofa partnership, ora similar poston in 1 Hokie congeakes Felation wo ater jure persons & Hoteing Company Systems 1. Pre-need Companies c providing a epsered office, business address or 4. Mutual Benefit Association ccommodatin correspondence or administrative i Alter Persons and ents supervised and/or regulated by the audressforacompany,a partnership o any other ‘insurance Commission (10) degal person o arrangement ooooooooog = Secures Dales acing as (arranging for another person to3c 35) 1. Securities Brokers nominee shareholde for nether person De. Seeuries Salesman Perzonewho provi any ofthe following ences: 7 a tnvestment Houses ‘Hanaging of dient money, secures or Other ase Be. Investment Agents and Consultants D & trading Advisors ‘management of bank, savings or securities acount 8, Other entities managing Securities or rendering similar services 1h, Mutual Funds or Open-end Investment Companies organization of contributions for the creation, i. Close-end Investment Companies operation or management of companies }. Common Trust Funes or Issuers and other similar entities Transfer Companies and other similar entities creation, operation or management of juridical 1. Other entities administering or otherwise dealing in currency, persons or arrangements, and buying and selling commodities o nancial derivatives bazed thereon business entities 1m, Entities administering of otherwise dealing n valuable objects None ofthe above 1, Enttes administering or othervvise dealing in cash Substitutes and] Deserbe other similar monetary instruments or property supervised and/or] nature of ‘regulated by the Securities and Exchange Commission (SEC) business: B. Has the Corporation complied with the requirements on Customor Due Diligence (CDD) or Know Your Customer (KYC), record-keeping, and submission ofreports | Yes under the AMLA, as amended, since the last ling ofits GIS? «ais stock(v2020) Page?GENERAL INFORMATION SHEET STOCK CORPORATION PLEASE PRINT LEGIBLY conPoRATE NAME: (QF DIscoM. cL, INC CAPITAL STRUCTURE [aurnonizep carrraLsTock = |] wvomenor | panysraren vawue "AMOUNT (PRP) rath SHARES ve (No. ofshares X Par/Stated Value) COMMON ‘00900 To) 0000 07 Tora | -go07000.00 [SUBSCRIBED CAPITAL ee ‘NUMBER OF runspino | Stoce | reeorsuanes+ | SumBERor |suanesinmie] ranystareD | ssouyr ney oF ene sianes |nanpsorrie| — vatur OWNERSHIP PUBLIC of Connon Too oy Tag 70000000 Too Tora 700,000 | TOTAL TOTAL | Foo,000.09 roneian | No.or NuMBER OF numaexor |suaresinTae] panystareD 960F axorcaresy | stock: | Tvecorsanes- | NUMBEKOF [swanisiN THE Asoc ae NaTIoNALIT) | HOLDERS MRDSOFTHE| VALUE OWNERSHIP Wa Wa We Wr We Wm Wie Wie Percentage of Foreign Foul TOTAL roma Tora [PAID-UP CAPITAL, - NO.OF | sumer or s00F Fiutpino | srocx | Twreorsuants a PARYSTATED VALUE AMOUNT PHP) | gw nERstP COMMON Toa09) Ta] 00905 Toone Tori] ——roonma am pT] FORETEN | WOOF aworcateny | sroce. | rvveorsanes+ | NUNBEROF | pyyerarenvaLuE amounr enn) — | 2% ap sumonauiry | wovoens or wr we we we wa [~a00% TOTAL ‘Tora FOTALPAD-UP_P 700,000.00] THOT: USE ADDITIONAL SHEET IF NECESSARY [- common, referred or ote casicaon [F Otker han Directors iors Sharsholder ouring of oamRanaing aE cis rock (v2020) PageGENERAL INFORMATION SHEET ‘STOCK CORPORATION ssssssoes PLEASE PRINT LEGIBLY. = [CORPORATE NAME: ‘GFTOSCOM. cL, NC DIRECTORS 7 OFFICERS Nawe/cuRReNT Resin. ADDRESS | wariovauiry | wen JoanofceNnen] TOS | opmcen | S286 | MARIDENTINCATION TCEARILLOTATR FUPING Chainman 419 Emerald St Posdas Vilage vy |c fom | oy [Morte] c | 12ssi0136-000 Sacat antininp Gy Board T MARIA TERESA .DAYRT UPN reser 1577 Sebastian St, Bagbasun, nfm] oe | oy [etna] a | 239-336940.000 Valenzuela Cy Name T RENATOT. RENDON LIPID $105 Iga Mansion, #152 ga St we] fw | oy Preanrer] a | 12202595-000 Brgy Salracion Quezon ly TT ROELP. AGSAWAY IFUNG Benin Bulag losan highway, wou fom |v | oiecie | am | 231-952-756-000 Dagupan cy © ROGELIO. DELACRUZ IALIPIND 9 32th avenue Cuba, Quezon Cy vf foe fy |p | ae | so2944372 000 z a 7 7 7 co 7% era FOR SEX COLUMN, PUT “F*FOR FEMALE."M" FOR MALE. FOR BOARD COLUMN, PUT°O"FOR CHAIRMAN, ‘VF FOR MEMBER “FOR NOEPENDENT DIRECTOR FOR INCR COLUMN, PUT"Y IF AN INCORPORATOR, ‘IF NOT. FOR STOCKHOLDER COWUIN, PUT "IFA STOCKHOLDER, "IF NOT, FOR OFFICER COLUMN, INDICATE PARTICULAR POSITION AN OFFICER, FROM VP UP INCLUDING THE POSITION OF THE TREASURER, ‘SECRETARY, COMPLIANCE OFFICER ANDIOR ASSOGHTED PERSON, FOR EXECUTIVE COMMITTEE: INDICATE" IF MEMBER OF THE COMPENSATION COMMITEE: "A" FOR AUDIT COMMITTEE; N" FORNOMNATION {AND ELECTION COMMITTEE, ADDITIONALLY WRITE "C” AFTER SLASH IF CHARMAN AND "IF MEMBER, is sT0cK (72020) Page 4GENERAL INFORMATION SHEET STOCK CORPORATION PLEASEPRINT LEGIBLY = [conronaTe nan: OFT DISCOMEc. NC aaa = OF OCR. DES WTO WORT Hora women oF rood $ o-OFSTOC : | TOTAL ASSETS BASED ON LATEST AUDITED FINANCIAL STATEMENTS: 556,591.00 at STOcKHOLDER'S INFORMATION STS SUBSCRIBED sant NATIONALITY AND CURRENT Sor] MOUNT Trax exritcaTion ‘RESIDENTIAL ADDRESS wet | — dena amount | BOF ra ‘NUMBER (Php) ‘SHIP oy TOT ROOT lemon oa] Km. 14 West Service Road, Bray. Merville] 25% ‘aan (009-479-608-400 ie TOTAL| 25,000) 25,000.00| TTT co a ruriWo 40. fama & Paras Ming nual wm | somo | aessiosee ar TOTAL 15,000) 15,000.00) ea sar EC urn 11577 Sebastian St, Bagbaguin, Valenzuela City = ic mama Seen sara] as] rsa AST [amor EC) ur ‘$-105 Irlga Mansion, #152 Irlga St Brgy} - ieunees fee ateGene ‘TOTAL| 15,000] 15,000.00] SWORE SAAT [sa 5a Te ru Fern oan hwy, Pc ssw | asmoose | anrsses6s00 Tora] 0] asa T ROGELOT RR CRTT Eo rurwo (94 12th Avenue Cubso, Quezon City sued fe eee ara] ss] ——rs ToT Tota AwouNT oF susscripeD carat | soo.oonol aonmo2 Gaia TOTAL ANOUNT OF PAD-UP CAPITAL INSTRUCTION: SPECIFY THE TOP 20 STOCKHOLDERS AND INDICATE THE REST AS OTHERS [Rota For POTE omince tcc nest peas nda farther te benefital ownors owning mare Gian sof any ass ofthe cpanys Voting rears [aah separate sheet, f nccesary. ‘ais stock 2020) PagesGENERAL INFORMATION SHEET STOCK CORPORATION PLEASE PRNTISGIOTY. [CORPORATE NAME: QFIDISCOM. CL, ING F. INVESTMENT OF CORPORATE “AMOUNT (PHP) DATE OF BOARD RESOLUTION FUNDS IN ANOTHER CORPORATION. T1 STOCKS Nik we 72 BONDS/COMMERCIAL PAPER (issued 7 by Private Corporations) ae bls T3_LOANS/ CREDITS/ ADVANCES na a Ta GOVERNMENT TREASURY BILLS a We TS OTHERS ne nk P.INVESTMENT OF CORPORATE FUNDS IN ACTIVITIES UNDER ITS DATE OF BOARD RESOLUTION DATEOF SECONDARY PURPOSES (PLEASE SPECIFY:) STOCKHOLDERS cit a RATIFICATION NYA NA 5, TREASURY SHARES % ASTO THE TOTAL 2NDVOF SHARES NO. OF SHARES ISSUED N/A N/A [&— UNRESTRICTED /ONAPPROPRIATED RETAINED EARNINGS AS OF END OF LAST FISCAL YEAR: NONE [5 DIVIDENDS DECLARED DURING THE IMMEDIATELY PRECEDING YEAR: NONE ‘TYPE OF DIVIDEND AMOUNT (PhP) DATE DECLARED Sa cast NA NA 52_ STOCK N/A N/A 53 PROPERTY N/A N/A Toral_| N/A 6. ADDITIONAL SHARES ISSUED DURING THE PERIOD: NONE DATE NO. OF SHARES AMOUNT N/A N/A N/A [SECONDARY LICENSE/ REGISTRATION WITH SEC AND OTHER GOV'T AGENCY, INAME OF AGENCY: SEC ‘BSP Te [rvPE oF N/A LICENSE/REGN. ae ne le bare issuED: iA we mk DATE STARTED : loPERaTiOns: mA WA NIA ‘TOTAL ANNUAL COMPENSATION OF DIRECTORS DURING THE PRECEDING FISCAL | TOTALNO.OF OFFICERS | TOTALNO OF RANK&FILE | TOTAL MANPOWER: EMPLOYEES ‘COMPLEMENT YEAR (in PhP) N/A 10 is STOCK (w2020) Page 6|, ROGELIO |, DELA CRUZ, Corporate Secretary of _QFI DISCOM, CL, INC, declare under penalty of periury that all matters set forth in this GIS have been made in good faith, duly verified by me and to the best of my knowledge and belief are true and correct. Thereby attest that all the information in this GIS are being submitted in compliance with the rules and regulations of the Securities and Exchange Commission (SEC) the collection, processing, storage and sharing of said information being necessary to carry out the functions of public authority for the performance of the constitutionally and statutorily mandated functions of the SEC as a regulatory agency. | further attest that I have been authorized by the Board of Directors/Trustees to file this GIS with the SEC. understand that the Commission may place the corporation under delinquent status for fallure to submit the reportorial requirements three (3) times, consecutively or intermittently, within a period of five (5) years (Section 177, RA No, 11232). ee “Akar day ML 23200 og in anil Done this. (Signaturd ovdy printed name) “Saatregy Me 2920 ‘SUBSCRIBED AND SWORN TO before me in. on by affiant who personally appeared before me and exhibited to me his/her competent evidence of identity consisting of CTC#17195431 issued at_Paraflaque City on January 18.2021. OTAKY PUBLIC ATTY, JOHN po! APpORNTA Doc. No. tH Page No. #7 Book No. Series of 20¢1 Tt89-102-000, \ Puja Avcate, Pio del Ply, ty, Metro Manila as sTocK(y.2020) Page?FOR THE YEAR: SECREGISTRATION NUMBER: | 5200718423 CORPORATE NAME: FIDISCOM, CL, INC. BENEFICIAL OWNERSHIP DECLARATION 2024 Instructions: such categories, 1. Identify the Beneficial Owner/s ofthe corporation as described in the Categories of Beneficial Ownership in items A to [below. List down as many as you can identify. You may use an additional sheet ifnecessacy. 2, fillin the required information on the beneficial owner in the fields provided for. 3, Inthe "Category of Beneficial Ownership” column, indicate the letters) corresponding thereto. In the event that the person identified as beneficial owner falls under several categories, indicate all the letters corresponding to 4. If the category is under letter “I, indicate the position held (Le, Director/Trustee, President, Chief Executive Officer, Chief Operating Officer, Chief Financial Officer etc). 5. Donot leave any item blank. Write "N/A" ifthe information required is not applicable or "NONE" ifnon-existent. “Beneficial Owner” refers to any natural person(s) who ultimately own(s) or control(s) or exercise(s) ultimate effective control over the corporation. This definition covers the natural person(s) who actually own or control the corporation as ‘distinguished from the legal owners. Such beneficial ownership may be determined on the basis of the following: Category ‘Description ‘A Natural person(s) owning, directly or indirectly or through a chain of ownership, a least twenty-five percent (2596) of the voting rights, voting shares or capital of the reporting corporation. Natural person(s) who exercise control over the reporting corporation alone or together with others through any the corporation, D Natural person(s) having the abilty to exerta dominant influence over the management or policies of the corporation. contract, understanding, relationship, intermediary or tiered entity Natural person(s) having the ability to elect a majority of the board of directors/trustees, or any similar body, of E Natural person(s) whose directions instructions, or wishes in conducting the affairs of the corporation are cartied. ‘out by majority ofthe members of the board of directors of such corporation who are accustomed oF under an obligation to actin accordance with such person's directions, instructions or wishes, F Natural person(s} acting as stewards ofthe properties of corporations, where such properties are under the care or administration of said natural person(s). G Natural person(s} who actually own or contro the reporting corporation through nominee shareholders oF nominee directors acting for or on behalf of such natural persons. H_ Natural person(s) ultimately owning or controlling or exercising ultimate effective control over the corporation through other means not falling under any of te foregoing categories. 1 Natural person(s) exercising control through positions held within a corporation (i, responsible for strategic decisions that fundamentally affect the business practices or general direction ofthe corporation such asthe :members ofthe board of directors or trustes or similar body within the corporation; or exercising executive control over the daily or regular affairs ofthe corporation through a senior management position). This category is only applicable in exceptional cases where no natural person is identifiable who ultimately owns or exerts control over the corporation, the reporting corporation having exhausted all reasonable means of identification and provided there are no grounds for suspicion. TYPE OF COMPLETE NAME wor — | wenericiat (Sumame,Given | spsciric pareor | 74 lowyeneup'/| owner! || CATEGORY OF Name,Middle Name, | RESIDENTIAL | naTionaurry| PATECT | :pqvrancarin [OWNERSHIP / ‘BENEFICIAL Name Extension (Le,| ADDRESS no. OWNERSHIP 1, Stl) rugHts® — | Direct (D) or “Se Indirect () IS ERTS Poa ite Suet na CSA M LOTR, Gy ewe augur 5,195] 129-01-136.00 sslo acoe TST saben, vasa November 21 wus TERESA. oavm| Gay frueNO Test fasessesso ane solo 5.c.0.e Er Tas WaT ‘952 ga St Boy renaTor.nenoon | savacendursonCiy FLeWNO | puts 1565 |122.902508.00 slo sone ‘Sours wary om p.xcsaway | tighwe Daren iy [FLEINO oot fesasaseo00 silo 8.0.D.E 3 1h Avenue Cuban, Faust nocauo sea cau | ™ Wovsnéy ewewo “os foz944373.000 ssufo 2.c.0.E Note: This page isnot for uploading onthe SECView. "Ror Stock Corporations * For Non-Stock Corporations. + For Stock Corporations