( SECURITIES AND EXCHANGE COMMISSION > The following document has been received: Receiving: Mark Jason Orcine Receipt Date and Time: July 15, 2021 10:26:19 AM Company Information aa a SEC Registration No.: CS200806238 Company Name: QFI DISCOM BCL INC Industry Classification: Company Type: Document Information Document ID: OST107152021869307 Document Type: GENERAL_INFORMATION_SHEET Document Code: GIS Period Covered: June 24, 2021 ‘Submission Type: GIS Remarks: None‘GENERAL INFORMATION SHEET (GIS) FORTHE YEAR 2021 ‘STOCK CORPORATION ‘GENERAL INSTRUCTIONS: FOR USER CORPORATION: THIS CIS SHOULD BE SUBMITTED WITKIN THIRTY (30) CALENDAR DAYS FROM THE DATE OF THE eal STOCKHOLDERS’ MEETING, DO NOT LEAVE ANY ITEM BLANK. WRITE “NAA” IF THE INFORMATION REQUIRED IS NOT APPLICABLE TO THE CORPORATION OR "NONE" IF THE INFORMATION Is NON-EXISTENT. IF THE ANNUAL STOCKHOLDERS’ MEETING IS HELD ON A DATE OTHER THAN THAT STATED IN THE BY-LAMS, THE GIS SHALL BE SUBMITTED WITHIN THIRTY (20) CALENDAR DAYS AFTER THE ELECTION OF THE DIRECTORS| ‘TRUSTEES AND OFFICERS OF THE CORPORATION AT THE ANNUAL MEMBERS MEETING. | NO MEETING IS HELD, THE CORPORATION SHALL SUBMIT THE GIS NOT LATER THAN JANUARY 30 OF THE FOLLOWING YEAR. HOWEVER, stoULO {AN ANNUAL STOCKHOLDERS’ MEETING BE HELD THEREAFTER, A NEW GISSHALL BE SUBMITTED/FILED, THIS Gis SHALL BE ACCOMPLISHED IN ENGLISH AND CERTIFIED AND SWORN TO BY THE CORPORATE SECRETARY OF THE CORPORATION, ‘THE SEC SHOULD BE TIMELY APPRISED OF RELEVANT CHANGES IN THE SUBMITTED 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 BE| SUBMITTED WITHIN SEVEN (7) DAYS AFTER SUCH CHANGE OCCURED OR BECANE EFECTIVE, ‘SUBMIT FOUR (4) COPIES OF THE GIS TO THE RECEIVING SECTION AT'THE SEC MAIN OFFICE, OR TO SEC SATELLITE OFFICES OR EXTENSION OFFICE] ‘ALL COPIES SHALL UNIFORMLY BE ON A4 OR LETTER-SIZED PAPER. TIE PAGES OF ALL COPIES SHALL USE ONLY ONE SIDE {© ONLY THE GIS ACCOMPLISHED IN ACCORDANCE WITH THESE INSTRUCTIONS SHALL BE CONSIDERED AS HAVING BEEN FILED, ‘THIS GIS MAY BE USED AS EVIDENCE AGAINST THE CORPORATION AND ITS RESPONSIBLE DIRECTORS/OFFICERS FOR ANY VIOLATION OF EXISTING] LAWS, RULES AND REGULATIONS [coRPORATE NAME DATE REGISTERED? FI DISCOM. BCL, INC. 2 a 04/25/2008 [BUSINESS /TRADE WANE QFIDISCOM. BCL, INC SCA A me SEC REGISTRATION NUMBER: cs200s06238 December 213¢ [DATEOF ANNUAL MEETING PER BYLAWS: Kewanee rape 2nd Wednesday of May or.09-425 ACTUAL DATE OF ANNUAL MEETING: [W/m ORES 2ajun2t NONE [COMPLETE PRINCIPAL OFFICE ADDRESS: Es ADORE {G/F Wi Tone Bldg, Diversion Road, Bogtong, Legazpi, Albay discombel2@amal.com COMPLETE BUSINESS ADDRESS: Na G/F Mi Tone Bldg, Diversion Road, Bogtong, Legazpl, Albay ‘OFFICIAL E-MATL ADDRESS “ALTERNATE E-MAIL ADDRESS, ORICALNOSLENMEER | aTEMORCE NORTE | ‘f.tiscom2020@4maiLeom Aiscombel2@gmailcom 0998-s090121 ov22-a003920 NAME OF EXTERNAL AUDITOR & 1TSSIGNING PARTNER: SE RCCREDT TON OER pS TELNET Laiecsiaad s204¢ ae2i-sii6 PRINIARY PURPOSE/ACTIVITY/INDUSTRY PRESENTLY ENGAGED TN INDUSTRY CLASSIFICATION: [GEOGRAPHICAL CODE [roengape im conduct ates on the baie of rendeingsorie nthe frm tae po, Jove stechersorvie reed andjr sient sles agency, ylagancctingatarieg_| Distribution Wholesale Trade/Other sereaseay [nerecngsd wos on instar ar ay bepermted oy ands aed bere Services| iotheranvumer gods = TINTERCOMPANY AFFILIATIONS PARENT COMPANY ‘SEC REGISTRATION NO. ADDRESS ‘QuaNTUM FOODS. INC ‘8S0094-00008454 ‘Kin 14 West Service Road, Bray. Merville, Paraiague Gy ‘SUBSIDIARY /APRICIATE ‘SECRECISTRATION NO. ‘ADDRESS NOTE TSE ADOCTONAL SHEET ENECESAR cis sTock2020) ape‘GENERAL INFORMATION SHEET STOCK CORPORATION PLEASE PRINT LEGIBLY [Corporate Name= ‘GHDISCOM. BCL, ING ‘A Is the Corporation a covered person under the Anti Money Laundering Act [Please check the appropriate box: Yes © No Offshore Banking Units Quasi-Banks Trust Entities Non-Stock Savings and Loan Associations Pavnshops Foreign Exchage Dealers Money Changers Remittance Agents Electronic Money Issuers Financial Institutions which Under Special Laws are subject to Bangko Sentra ng Pilipinas’ (BSP) supervision and/or regulation, Including their subsidiaries and affiliates, gooooo00000g “ar nsurance Companies b. Insurance Agents Insurance Brokers Professional Reinsurers Reinsurance Brokers Holding Companies Holding Company Systems Presneed Companies Mutual Benefit Association All Other Persons and entities supervised and/or regulated by the Insurance Coramission (IC) a Qa QO Q Q Oo Qa im Q Oo 1, Securities Dealers O b Securities Brokers Oe Securities Salesman © a. investment Houses CO «. investment Agents and Consultants © trading Aisors © ¢, other ens managing Secor or rendering sina services 1 Murua Funds or Openend investment Companies Close-nd Investment Companies } Common Trust Funds o eters and othe simar entities XTranser Companies and oter sma enties L ther entities administering o otherwise dealing ncurene, commodities or financial dervatives bse thereon Dt. enehies administering of otherwise dealing invaluable objects Jewelry dealers in precious metals, who, asa business trade in precious metals Jewelry dealers in precious stones, who, sa business, trade in precious stone Company service providers which, asa business, provide any ofthe following services tothird parties: Ta cting as formation agent of urdica persons Cb ectingas (or arranging for another person tact 25} 2 direcioror corporate secretary ofa company, partner ofa partnership, or sila position in relation to other urdial persons Oi « providing registered ofice, business address or ‘accommodation, correspondence or administrative address fora company, a partnership or any other legal person or arrangement Ca. actingas (or arranging for another person to act as} nominee shareholder for another person 7. Persons whe provide any ofthe following services: TT a managing of cent noey secures or other a6 1b management oftank savings or secures aon Zc organization of contributions forthe creation, ‘operation or management of companies CO a creation, operation or management of juridical persons or arrangements, and buying and selling business entities BLT None ofthe above On Enuities administering or otherwise dealing in cash Substitutes and] Describe other similar monetary instruments or property supervised and/r} Yes No regulated by the Securities and Exchange Commission (SEC) nature of business B. Has the Corporation complied with the requirements on customer Die Diligence (CDD) or Know Your Customer (KYO), record-keeping, and submission of reports under the AMLA,as amended, since the lat fling ofits GIS? ‘15 sT0cK(y2020) age?GENERAL INFORMATION SHEET. ‘STOCK CORPORATION PLEASE PRINT LEGIBLY |CORPORATE NAME: (FI DISCOM, BCL, INC. CAPITAL STRUCTURE [AUTHORIZED CAPITAL STOCK NUMBER OF AMOUNT (PhP) ‘TYPE OF SHARES* Al ee ‘SHARES eee (No.ofshares X Par/Stated Value) COMMON 3,000,000, Ta] 3000,000-00 TOTAL 3,000,000 TOTAL P| 3,000,000.00 [SUBSCRIBED CAPITAL Nate ‘NUMBER OF q | Numperor |swaresin THe) parysrateD 5 0F FiLipiNo | stock. | TVPEOFSHARES mens Bos IN TH EAN STA AMOUNT (PhP) Prlits HOLDERS bees PuRLIC** | _ common 350,000 N/A 700 950,000.00 700% Toran 35000 roa ToT Sona NUMBER OF roreicn | No.oF awpieateny | stock. | Twrxorsuaness | NUMDEROF |SHARESINTHE] PAR/STATED | youyrqny) | 5,2 0F avtonaur | wouDeRs oe Wa wa] Wa WA Wa Wa Wh 7 [Percentage of Foreign Equity: TOTAL [nora oral >| "TOTAL SUBSCRIBED P| 950,000.00 [PAID-UP CAPITAL NO.OF Fitipino | stock- | TyPEorsHaress | NUMBEROF PAR/STATED VALUE. AMOUNT (PHP) en SHARES. OWNERSHIP HOLDERS 3] common 9350;000 00] '9505000:00 700% TOTAL 350,000] TOTAL P| 950,000.00 FOREIGN | NO.OF axpicare ny | stock. | TvpEorsHares+ | NUMBER OF PAR/STATED VALUE AMOUNT (PhP) er Nariovaury) | HouDERs oe et N/A N/A N/A N/A Nia Nia NAA TOTAL Tora? TOTALPAID-UP_P. 950,000.00] NOTE: USE ADDITIONAL SHEET IF NECESSARY Common, Proferred or ther dassicaton F Other than Directors, Oficers Shareholders owning 10% of eutstanding shares Gis STOCK (v2020) PagesGENERAL INFORMATION SHEET ‘STOCK CORPORATION sseccceccsccsccseeescsecasccscr_ PLEASE PRINT LEGIBLY [CORPORATE NAME: GFIDISCOW, BCL, ING DIRECTORS / OFFICERS : S700 AEG | TARIDINTITCATION aMa/curneN RESIDEVTIAL ADDwESS | waTionauTy | wen [HoaRD]ceNDER] STOCK T opricen | EX, | PAXIDENTIFIC 7 CESARWLOTATE FINO Chalmman 419 Emerald St Posadas Vilage vy fc] om | oy ore 123-910-136-000 Sucat Muntinlupa Cty Board ZT EDREDA.ALMERO LIFINO 365 Purok 7 Baclayon, Bacacay, . M M Y Boe ae 133-845-470-000 a Gan ing 3 RENATOT RENDOR FIFINO 5-05 rga Mansion, #152 niga St wef om | om |v | rveancer] a | 122-202-s05-000 Bray. elvacion Quezon iy 7 ROMYSAN P DELA CRUZ FLIFINO Bike ot 13 Upper Beatan Taguig x [om | om |v ] dieser | a | 224-373-056-000 City © ROGELIOT DELA CRUZ FINO 94 12 Avenue Cubao, Quezon iy vf] om |v | oereme | aw | 02-964372.000 < 7 7 3 wm iT 7 a 7 = pasTaUSTON FOR SEX COLUVN, PUT "F FOR FEMALE, "W? FOR MALE FOR BOARD COLUNIN, PUT °C" FOR CHAIRMAN, °F FOR MEMBER, "" FOR INDEPENDENT OIRECTOR FORINGR COLUMN, PUT" IF AN INCORPORATOR,°N" IF NOT. FOR STOCKHOLDER COLUMN, PUT" FA STOCKHOLDER, NF NOT. FOR OFFICER COLUMN, INDICATE PARTICULAR POSTION IF AN OFFICER, FROM VP UP INCLUDING THE POSITION OF THE TREASURER, SECRETARY, COMPLIANGE OFFICER ANDIOR ASSOCIATED PERSON. FOR EXECUTIVE COMMITTEE. INDICATE °C" IF MEMBER OF THE COMPENSATION CORMMITTEE; "A" FOR AUDIT COMMITTEE, "W” FOR NOMINATION [AND ELECTION COMMITTEE. ADDITIONALLY WAITE"C" AFTER SLASH CHAIRMAN AND -N" IF MEMBER. Gis stock (2020) Page 4GENERAL INFORMATION SHEET STOCK CORPORATION S555 _PLEASEPRINT LEGIBLY =: conmonaTE NE FF DICoM. RC. NE Sa Foo OTS TT TOTOR WONT a : [SHARES EACH 6 Fors ASESnisn OxLTEraHOrEDRNNGHLSTATENENIS_sazpaseon Saas ssc ‘arin x conse ‘100et lexxioswmncaion resionmiat sous sx | amouxe NuNaER Peet eee (PhP) (Par) soe “TOTAL| 237,500] 237,500.00 TE a a 419 Bmerald Se Posadse Vilage Suc 15% | 1s2soq00 | 125-910-136-000 hein ‘TOTAL 142,500] 142,500.00| $105 rigs Mansion, #152 Inga St. Bray ssw | s4zsnao0 | rzzsna-sesc00 Mien Geers TOTAL] 142,500] 142,500.00] ‘Bk Lot 13 Upper Scum Taguig Cy Pee ern) eerie ee <=amnno| s0n00% ciate TETALANOURT OF PAD-UF APTA TRSTRUCTION: SPECIFY THE TOP 20 STOCKHOLDERS AND INDICATE THE REST AS OTHERS [ote For PDTC Nominae cluded nthe in pase indicate further he Beefcl owners orng more than Sof any elas ofthe Company ¥ VOTING Fea [atech separate thet, fneessry. ais stock(v2020) agesGENERAL INFORMATION SHEET STOCK CORPORATION PLEASE PRINT LEGIBLY [CORPORATE NAME: QFTDISCOM. BCI, ING. fl. INVESTMENT OF CORPORATE ‘AMOUNT (PhP) DATE OF HOARD RESOLUTION FUNDS IN ANOTHER CORPORATION 11 STOCKS na wa T2_BONDS/COMMERCIAL PAPER (Issued by Private Corporations) mia en 13 LOANS/ CREDITS/ ADVANCES Wa T4 GOVERNMENT TREASURY BILLS Wh WA TS OTHERS We a 2. INVESTMENT OF CORPORATE FUNDS IN ACTIVITIES UNDER ITS DATE OF BOARD RESOLUTION DATE OF SECONDARY PURPOSES (PLEASE SPECIFY:) STOCKHOLDERS NyA NA NYA ‘TREASURY SHARES Staines % AS TO THE TOTAL : NO. OF SHARES ISSUED N/A N/A /4._ UNRESTRICTED /UNAPPROPRIATED 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_CASH NA NYA 5.2 STOCK N/A N/A 5.3 PROPERTY N/A N/A Toral_| N/A [6._ ADDITIONAL SHARES ISSUED DURING THE PERIOD: NONE DATE NO. OF SHARES ‘AMOUNT NA N/A N/A [SECONDARY LICENSE/REGISTRATION WITH SEC AND OTHER GOV'T AGENCY: INAME OF AGENCY: SEC BSP 1c TYPE OF JLICENSE/REGN. ve we “a [DATE ISSUED: mn = aia IDATE STARTED JOPERATIONS: nA ue er ‘TOTAL ANNUAL COMPENSATION OF DIRECTORS DURING THE PRECEDING FISCAL | TOTALNO. OF OFFICERS YEAR (In PhP) ‘TOTALNO.OF RANK &FILE | ‘TOTAL MANPOWER EMPLOYEES COMPLEMENT. N/A 6 3 9 Gis STOCK (v.2020) Pages|, ROGELIO |. DELA CRUZ, Corporate Secretary of QFIDISCOM, BCL, INC. declare under penalty of perjury 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. Junderstand that the Commission may place the corporation under delinquent status for failure to submit the reportorial requirements three (3) times, consecutively or intermittently, within a period of five (5) years (Section 177, RA No, 11232). Done this__daylof_1_3 209). 20__im_Bsnr ap Ther SUBSCRIBED AND SWORN TO before me in Tn by affiant who personally appeared before me and exhibited to me his/her competent evidence of identity consisting of CTC#17195431 issued at _Parafiaque City on _lanuary 18.2021. NOTARY PUBLIC Dos. No. ty, avi Page No. ae Book No. Bat erat Series of 2021 Sen, Git Pu Makati Copy eto Mauala cis.stock(v2020) Page7BENEFICIAL OWNERSHIP DECLARATION FOR THE YEAR: 2021 SECREGISTRATION NUMBER: 5200806230 ‘CORPORATE NAME: {QFI DISCOM, BCL, INC. Instructions: 1, Identify the Beneficial Owner/s of the corporation as described in the Categories of Beneficial Ownership in items A tol below. List down as many as you can identify. You may use an additional sheet if necessary. 2, Fill in the required information on the beneficial owner in the fields provided for. 3. In the "Category of Beneficial Ownership” column, indicate the letter(s) corresponding thereto. In the event that the person identified as beneficial owner falls under several categories, indicate all the letters corresponding to such categories. 4. If the category is under letter “T", indicate the position held (ie, 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” rofers to any natural person(s} who ultimately own(s) or control(s} oF 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 ofthe following Category, Description A Natural person(s) owning, directly or indirectly or through a chain of ownership, at least twenty-five percent (2596) of the voting rights, vating shares or capital ofthe reporting corporation. Natural person(s) who exercise control over the reporting corporation, alone or together with others, through any B contract, understanding, relationship, intermediary or tered entity. © Natural person(s) having the ability to elect a majority of the board of directors/trustees, or any similar body, of the corporation, D Natural person(s) having the ability to exert a dominant influence over the management or policies of the corporation. E Natural person(s) whose directions, instructions, or wishes in conducting the affairs of the corporation are carried out by majority of the members of the board of directors of such corporation who are accustomed or under an obligation to act in 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 control the reporting corporation through nominee shareholders or 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 ofthe foregoing categories. 1 Natural person(s) exercising control through positions held within a corporation (Le, responsible for strategic decisions that fundamentally affect the business practices or general direction of the corporation such as the ‘members of the board of directors or trustees or similar body within the corporation; or exercising executive control over the daily or regular affairs of the 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, COMPLETE NAME, mon eee (Surname, Given SPECIFIC ae TAX | ounensiue'; | owner’ | CATEGORY OF ‘Name, Middle Name, | RESIDENTIAL | Nationatrry | PATEOF | oewrimicarion | OWNERSHIP / ‘BENEFICIAL Name Extension (Le,] ADDRESS No, nucirs® | bivect(p) or | OWNERSHIP Jr. Se I) Indirect () [39 Emerald St Posada Vile (CESARM.LOTA, JR, Jrwirio august 15, 1089]120-910-196-000, ssxlo B.0.D.E. TEs Perex 7 Sana, varuay 2, EDREDA.ALMERO |" seeacay Albay [FILIFINO ‘982 _|199-048-470.000 sexlo B.C.O.E. ‘E05 tiga Manson, 8182 ga St Boy RENATOT.RENOON | Selvecon Quezon Cy [FILIPINO | August , 1055 |12-302-55.000 seul. B.C.OE Bk 4 Lot 13 Upper ROMSAN.OELACRUZ| BleutanTaqugcly [rLPNO [January 4, 1979|224373-056.000 silo. 8.6.0.6 24 12th Averua Cu, Fobra, Rogeuo ostAcRuZ |" GuszonGiy. |FILPINO “048 _|1o2.944-979.000 ssxlo B.C.D.E. Tote This page snot for uploading onthe SECMiew. 2 For Stock Corporations. * For Non-Stock Corporations. *For Stock Corporations