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ENROLLMENT FORM
DIRECTION: Kindly fill-out this form legibly and completely. Fields with * are MANDATORY

*Client Type:
( ) Importer ( ) Exporter ( ) Broker ( ) Forwarder/Consolidator
( ) Deconsolidator ( ) ELSE ( ) Airline/ShippingLine ( ) Warehouse Operator

*Please put an (X) mark in the space provided for the system/s you want to enroll.
Bureau of Customs (BOC)
( ) E2M ( ) e-Balikbayan ( ) AMS ( ) ABMS
Requirements: Kindly provide the following if applicable:
1. BOC COR (Certificate of Registration) - Transit Shed Code (if using E2m Transit Pertmit/OLRS): _________________
- Warehouse Code (if using E2M Warehousing) ______________________

Phiippine Economic Zone Authority (PEZA) Subic Bay Metropolitan Authority (SBMA)
( ) eIPS - Electronic Import Permit System ( ) eTAPS - Electronic Transit Admission Permit System
( ) AEDS (PEZA) - Automated Export Documentation System ( ) TAFS - Trade Automation & Facilitation System
( ) eZTS – Electronic Zone Transfer System ( ) AEDS Web - Automated Export Documentation System

*Requirements: *Requirements:
Locators (Importer/Exporter/ELSE) Locators
1. PEZA COR (PEZA Registration Certificate) 1. SBMA Certificate of Registration & Tax Exempt (CRTE)
Brokers/Forwarder Brokers/Forwarder
1. Letter of Authority (LOA) 1. Permit to operate (PTO)
Clark Development Council (CDC)
Authority of Freeport Area of Bataan (AFAB) ( ) eTAPS - Electronic Transit Admission Permit System
( ) eTAPS - Electronic Transit Admission Permit System ( ) EEDS - Electronic Export Document System
( ) AEDS Web - Automated Export Documentation System ( ) PBI-PBO – Permit to Bring In – Permit to Bring Out
( ) eZTS – Electronic Zone Transfer System
*Requirements:
Locators
*Requirements: 1. CDC Certificate of Registration & Tax Exempt (CRTE)
Locators 2. Documents required by CDC for account activation
1. AFAB COR (AFAB Certification of Registration) - BIR Form 2303 (for PBI-PBO)
Brokers/Forwarder - 4-digit Locator Code from Clark (for ETAPS) _______
1. Permit to operate (PTO) Brokers/Forwarder
1. Permit to operate (PTO) – NOT NEEDED
* COMPANY INFORMATION
*Company Name: *TIN: *Contact No.:

*Address:
(RM/FLR/UNIT NO. & BLDG NAME) (STREET NAME) (SUBDIVISION)

(BARANGAY/DISTRICT/LOCALITY) (CITY/MUNICIPALITY) (PROVINCE/STATE) (ZIP CODE)

*Contact Person / Designation: *E-mail Address: Birthdate(mm/dd):

By submitting this document, I confirm that the information in the e-documents (e.g., declarations, entries, etc.), to be lodged
through E-Konek’s VASP System, shall be true and correct. I cannot later deny or contest the information contained therein. I
also acknowledge that the information disclosed in the e-documents are necessary for E-Konek to perform the intended service. I
commit to pay directly or through my logistics provider whatever market-based fees E-Konek Pilipinas, Inc. shall charge for
services rendered. Finally, pursuant to REPUBLIC ACT NO. 10173 or the “Data Privacy Act of 2012”, I hereby agree to the
collection and processing of all information, personal or otherwise, by E-Konek for the fulfillment of its obligation under this
contract.

* ___________________________________________ *_______________________
Signature over Printed Name of Responsible Officer Date

Please e-mail all soft and hard copies of annexes to the Zone Manager for endorsement to e-Konek

6D, Washington Tower, Asiaworld City, Paranaque City, Philippines EK EF 016-19

Telephone No.: (02) 879-4699/ 0915 885 8918 / 0928 505 6635
Website: www.ekonek.com