ANNEX 1 (Page 1 of 2)

APPLICATION FORM FOR BUSINESS PERMIT

TAX YEAR 2022
MUNICIPALITY OF T U B A
INSTRUCTIONS:
1. Provide accurate information and print legibly to avoid delays. Incomplete application form will be returned to the
applicant.
2. Ensure that all documents attached to this form (if any) are complete and properly filled out.
I. APPLICANT SECTION
1. BASIC INFORMATION
New Renewal Mode of Payment Annually Semi-Annually Quarterly
Date of Application : DTI/SEC/CDA Registration No.:
TIN No.: DTI/SEC/CDA Date of Registration:
Type of Business: Single Partnership Corporation Cooperative
Amendment: From: Single Partnership Corporation
To: Single Partnership Corporation
Are you enjoying tax incentive from any Government Entity? YES NO; Please specify the Entity?
Name of Taxpayer / Registrant
Last Name: First Name: Middle Name:

Business Name:

Trade Name / Franchise:

2. OTHER INFORMATION
Note: For RENEWAL APPLICATION , do not fill up this section unless certain informations have changed.
Business Address:

Postal Code: E-mail Address:

Telephone No.: Mobile No.:
Owner's Address:

Postal Code: E-mail Address:

Telephone No.: Mobile No.:
In case of emergency, provide name of contact person:
Telephone / Mobile No.: E-mail Address:
Business Area (in sq. m.): Total No. of Employees No. of Employees Residing within Tuba
in the Establishment:
NOTE: FILL UP ONLY IF BUSINESS PLACE IS RENTED
Lessor's Full Name:
Lessor's Full Address:
Lessor's Full Telephone / Mobile No.:
Lessor's E-mail Address:
Monthly Rental:
3. BUSINESS ACTIVITY
Capitalization Gross/Sales Receipts (For Renewal)
LINE/S OF BUSINESS No. of Units
(For New Business) Essential Non-Essential
I DECLARE UNDER PENALTY OF PERJURY that the foregoing informations are true based on my personal knowledge and
authentic records. Further, I agree to comply with the regulatory requirement and other deficiencies within 30 days from
release of the business permit.

SIGNATURE OF APPLICANT/TAXPAYER OVER PRINTED NAME

POSITION / TITLE

ANNEX 1 (Page 2 of 2) Application Form for Business Permit

II. LGU SECTION (Do Not Fill Up This Section)
1. VERIFICATION OF DOCUMENTS
DESCRIPTION OFFICE/AGENCY YES NO NOT NEEDED
Occupancy Permit (For New) Office of the Building Official
Barangay Business Clearance Barangay (Where business is located)
Sanitary Permit / Health Clearance Municipal Health Services Office
Municipal Environmental Clearance Municipal Environment and Natural Resources Office
Market Clearance (For Stall Holders) Office of the Municipal Market Administrator
Valid Fire Safety Inspection Certificate Bureau of Fire Protection
Verified by: BPLO
SHARON C. SAINGAN
2. ASSESSMENT OF APPLICABLE FEES
Local Taxes Amount Due Penalty / Surcharge Total
Gross Sales Tax
Tax on Delivery Vans / Trucks
Tax on Storage for Combustibles/ Flammable or
Explosive Substance
Tax on Signboard / Billboards
REGULATORY FEES AND CHARGES
Mayor's Permit Fee
Garbage Charges
Delivery Trucks / Vans Permit Fee
Sanitary Inspection Fee
Police Clearance
Laboratory Fee & Health Certificate
Occupational Permit Fee
Secretary's Fee
Weights and Measure
Business Plate
Building Inspection Fee
Electrical Inspection Fee
Mechanical Inspection Fee
Plumbing Inspection Fee
Signboard / Billboard Renewal Fee
Storage and Sale of Combustible / Flammable or
Explosive Substance
Others

TOTAL FEES for LGU

FIRE SAFETY INSPECTION FEE (15%)

Assessed By: CTO FSFI Assessment Approved By: BFP

III. CITY / MUNICIPALITY FIRE STATION SECTION
DATE:
Application No.:
(TO BE FILLED UP BY APPLICANT/OWNER)
Name of Applicant/Owner:
Name of Business:
Total Floor Area: Contact No.:
Address of Establishment:

Signature of Applicant/Owner

Certified by: FIRE SAFETY INSPECTION

Customer Relations Officer FEE ASSESSMENT:
Time and Date Received:
Important Notice: As per Section 12 of the Implementing Rules and Regulations of the Fire Code of 2008, certain establishments (e.g. building lessors, fire, earthquake, and
explosion hazard insurance companies, and vendors of fire fighting equipment, appliances and devices) may be required to pay additional charges and fees other than the
Fire Safety Inspection Fees. These shall be collected during inspections or in another process to be communicated by representatives of the Bureau of Fire Protection (BFP).
ANNEX 1 (Page 1 of 2)
APPLICATION FORM FOR BUSINESS PERMIT
TAX YEAR 2018
MUNICIPALITY OF T U B A
INSTRUCTIONS:
1. Provide accurate information and print legibly to avoid delays. Incomplete application form will be returned to the
applicant.
2. Ensure that all documents attached to this form (if any) are complete and properly filled out.
I. APPLICANT SECTION
1. BASIC INFORMATION
New Renewal Mode of Payment Annually Semi-Annually Quarterly
Date of Application : DTI/SEC/CDA Registration No.:
TIN No.: DTI/SEC/CDA Date of Registration:
Type of Business: Single Partnership Corporation Cooperative
Amendment: From: Single Partnership Corporation
To: Single Partnership Corporation
Are you enjoying tax incentive from any Government Entity? YES NO; Please specify the Entity?
Name of Taxpayer / Registrant
Last Name: First Name: Middle Name:

Business Name:
Trade Name / Franchise:
2. OTHER INFORMATION
Note: For RENEWAL APPLICATION , do not fill up this section unless certain information have changed.
Business Address:

Postal Code: E-mail Address:

Telephone No.: Mobile No.:
Owner's Address:

Postal Code: E-mail Address:

Telephone No.: Mobile No.:
In case of emergency, provide name of contact person:
Telephone / Mobile No.: E-mail Address:
Business Area (in sq. m.): Total No. of Employees No. of Employees Residing within Tuba
in the Establishment:
NOTE: FILL UP ONLY IF BUSINESS PLACE IS RENTED
Lessor's Full Name:
Lessor's Full Address:
Lessor's Full Telephone / Mobile No.:
Lessor's E-mail Address:
Monthly Rental:
3. BUSINESS ACTIVITY
Capitalization Gross/Sales Receipts (For Renewal)
LINE/S OF BUSINESS No. of Units
(For New Business) Essential Non-Essential

I DECLARE UNDER PENALTY OF PERJURY that the foregoing information are true based on my personal knowledge and
I DECLARE UNDER PENALTY OF PERJURY that the foregoing information are true based on my personal knowledge and
authentic records. Further, I agree to comply with the regulatory requirement and other deficiencies within 30 days from release
of the business permit.

SIGNATURE OF APPLICANT/TAXPAYER OVER PRINTED NAME

POSITION / TITLE

ANNEX 1 (Page 2 of 2) Application Form for Business Permit

II. LGU SECTION (Do Not Fill Up This Section)
1. VERIFICATION OF DOCUMENTS
DESCRIPTION OFFICE/AGENCY YES NO NOT NEEDED
Occupancy Permit (For New) Office of the Building Official
Barangay Business Clearance Barangay (Where business is located)
Sanitary Permit / Health Clearance Municipal Health Services Office
Municipal Environmental Clearance Municipal Environment and Natural Resources Office
Market Clearance (For Stall Holders) Office of the Municipal Market Administrator
Valid Fire Safety Inspection Certificate Bureau of Fire Protection
Verified by: BPLO

2. ASSESSMENT OF APPLICABLE FEES

Local Taxes Amount Due Penalty / Surcharge Total
Gross Sales Tax
Tax on Delivery Vans / Trucks
Tax on Storage for Combustibles/ Flammable or
Explosive Substance
Tax on Signboard / Billboards
REGULATORY FEES AND CHARGES
Mayor's Permit Fee
Garbage Charges
Delivery Trucks / Vans Permit Fee
Sanitary Inspection Fee
Building Inspection Fee
Electrical Inspection Fee
Mechanical Inspection Fee
Plumbing Inspection Fee
Signboard / Billboard Renewal Fee
Storage and Sale of Combustible / Flammable or
Explosive Substance
Others
TOTAL FEES for LGU
FIRE SAFETY INSPECTION FEE (10%)

Assessed By: CTO FSFI Assessment Approved By: BFP

III. CITY / MUNICIPALITY FIRE STATION SECTION

DATE:
Application No.:
(TO BE FILLED UP BY APPLICANT/OWNER)
Name of Applicant/Owner:
Name of Business:
Total Floor Area: Contact No.:
Address of Establishment:

Signature of Applicant/Owner

Certified by: FIRE SAFETY INSPECTION

Customer Relations Officer FEE ASSESSMENT:
Time and Date Received:
Important Notice: As per Section 12 of the Implementing Rules and Regulations of the Fire Code of 2008, certain establishments (e.g. building lessors, fire, earthquake, and
explosion hazard insurance companies, and vendors of fire fighting equipment, appliances and devices) may be required to pay additional charges and fees other than the Fire
Safety Inspection Fees. These shall be collected during inspections or in another process to be communicated by representatives of the Bureau of Fire Protection (BFP).
15000

180 1800
1080
NEW RENEWAL NAME
NUMBER No. of No. of Citizenship Native of
Tick Capital Tick Gross FNAME MI LNAME
Employ Employ
ees ees
Address Bus Address Bus Name
DATE OF ISSUE OR
EFFECTIVI
Line of Business
TY/ MONTH day month NO AMOUNT
OR
PERMIT
DATE NUMBER
Republic of the Philippines
PROVINCE OF BENGUET
TUBA
Office of the Municipal Mayor