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Business Permit Form

This document is an application for a business permit from the Island Garden City of Samal in Davao del Norte, Philippines. It collects personal information about the applicant as well as details about the proposed business such as the name, address, type of business, capital, and required attachments. The applicant must declare that they have no unpaid taxes, will comply with regulations, and understand non-payment of fees could result in permit cancellation. Assessment of annual taxes and fees due is included, with space to note vehicles used for delivery.

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836 views1 page

Business Permit Form

This document is an application for a business permit from the Island Garden City of Samal in Davao del Norte, Philippines. It collects personal information about the applicant as well as details about the proposed business such as the name, address, type of business, capital, and required attachments. The applicant must declare that they have no unpaid taxes, will comply with regulations, and understand non-payment of fees could result in permit cancellation. Assessment of annual taxes and fees due is included, with space to note vehicles used for delivery.

Uploaded by

charlotte
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Republic of the Philippines Control No.

: _________________
Province of Davao del Norte
ISLAND GARDEN CITY OF SAMAL Date : ________________

APPLICATION FOR BUSINESS PERMIT


(Completethis form and submit with complete documents)

PERMIT TYPE (Please check):  New  Renew


1 PERSONAL INFORMATION

Taxpayer’s Name: ____________________________________________________________________________________________


Last Name First Name Middle Name
Date of Birth: _________________________ Age: ________ Sex:  Male  Female
Civil Status:  Single  Married  Widow/er  Legally Separated/Divorced
If Married, Name of Spouse: ____________________________________________________________________________________
Residence Address: ___________________________________________________________________________________________
II. BUSINESS ESTABLISHMENT INFORMATION
Business Name: ______________________________________________________________________________________________
Business Address: ___________________________________________ Contact No: ______________________________________
Purok Barangay District
TIN: __________________________________________________ No. of Employee: ______________________________________
Contact Person/Representative: _____________________________Position: _____________________________________________
Date Business Began Operating: _____________________ Area of Business Occupied:_____________________________________
 Owned  Rented if rented, owner of building: ___________________________________________________
DTI Reg. No. ________________________________Date of Registration:_______________________________________________
SEC  CDA Registration No. ______________ Date of Registration: ______________________________________________
CAPITAL: ____________________

II1. ASSESSMENT
GROSS SALES/RECEIPTS OF ANNUAL/QUARTERLY
NATURE OF BUSINESS PRECEEDING YEAR TAX/FEE PAYABLE
Essential Non-Essential Tax Due Permit Fee

No. of delivery vehicles


Remarks:

(Location sketch at the back) Assessed by: ____________________________


SUBMITTED ATTACHMENTS/REQUIREMENTS:
Barangay Clearance Barangay Resolution BFAD Clearance CDA/SEC Registration Lease Contract
Community Tax Certificate DTI R Registration Certificate of Tax Exemption OTHERS: ___________________________
CLEARANCES:
CHO CENRO CPDO CEO CTO CVET CFARMO CASSO CAGRO BFP PNP

I/ We further declare
a. That I have no unsettled tax obligation in favor of the City Government;
b. That I undertake to comply strictly the rules and regulations and existing law;
c. That my failure to pay the taxes, fees and charges on time shall be sufficient ground for the cancellation/revocation of
my permit and licenses;
d. ____________________ hereby declare under oath that the foregoing facts are true and correct to the best of my
knowledge and the same have been voluntarily and with no fraudulent or deceitful purpose.
IN WITNESS HEREOF, I have hereunto affixed my signature this, ________ day of ________ in the ISLAND GARDEN CITY OF
SAMAL, DAVAO DEL NORTE, PHILIPPINES.

_________________________
Affiant Signature

SUBSCRIBED AND SWORN before me this ______ day of _______________, affiant exhibits his/her Community Tax Certificate
No.________________ issued on ___________________at ________________________________, Philippines.

___________________________
PUBLIC NOTARY

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