You are on page 1of 1

Form 1

HALAL DEVELOPMENT INTITUTEOF THE PHILIPINES


Central Building, 4th Flr.Unit 401, 37 Arayat Cor. Malabito St.Cubao, QuezonCity

I. NAME OF COMPANY:

Address:

Telephone and FAX No.:


Permit License No. from DTI:
Date Issued: Valid until:

II. ITEMS TO BE APPLIED:


(Specify the product whether meat or non-meat)
1.
2.
3.
4.
5.
6.
(Attached separate Sheet if necessary)

III. IS THE PRODUCT LOCALLY MANUFACTURED? Yes No

If no, state country origin:

If yes, state how many plant(s) and addresses:

I hereby certify that the above answers are true and correct.

Signature over Printed Name


Position

You might also like