Memorandum Circular No. 2016-025

bull Philippine Economic Zone Authority PElfi

MEMORANDUM CIRCULAR NO i 0 1 6 - G2

FOR Economic Zone Locator Enterprises Economic ZO~~d~tors and Managers

FROM JUSTO PORFIRJO LL YUSINGCO Officer In-Charge Deputy Director General for Finance and Administration

DATE 05 August 2016

SUBJECT Chemical Importation Advisory - PNPs Implementing Rules and Regulations on Controlled Chemicals

On 09 June 2016 former Philippine National Police (PNP) Director General Ricardo P Marquez has signed the Implementing Rules and Regulations (lRR) on Controlled Chemicals which was then approved by former Department of Interior and Local Government (DILG) Secretary Mel Senen M Sarmiento The said IRR has been published at the Office of the National Administrative Register on 25 July 2016 and thus shall take effect on 10 August 2016

The full text of the IRR entitled PNP Implementing Rules and Regulations on Controlled Chemicals is available at the Issuances section of the PEZA official website (wwwpeza govph)

SCOPE

The IRR on Controlled Chemicals covers importation exportation use manufacturing transport storage treatment andor disposal of industrial chemicals but can also be used for the manufacturing of explosives and explosives ingredients The said IRR does not cover the regulations on explosives

SALIENT POINTS

The following are the salient points of the IRR on Controlled Chemicals PEZA - DTS

[ IIIIIIIIIIIIIIIIIII~IIIIIIIIIIIIIIIIII~II~IIIIIIIIIIII11I11I1111 ] A Categorization of Controlled Chemicals 1519middot2016middot00230

a The List of Controlled Chemicals is provided herewith and in the IRR as Annex A

b The list of PNP controlled chemicals are now classified as high-risk or low-risk chemicals depending on its explosive potential and use in the manufacture of explosives

Building 5 DOE-PNOC Complex Energy Center 34 Strollt Bonifacio Global Ci ty Taguig City Metro Manila Telephones (632) 5513451 5513438 Facsimile (632) 5513442 E-mail infopezagoYph middot Website wwwpezagoYph

1509001 2008 Cort No AJA081 31 14 PAS Accreditation No MSA - 005

of 3

016-t2

c some of the chemicals listed they will be regulated on the concentrations specified in an aqueous solution

Example Aqueous 20 hydrogen peroxide solution is regulated because those with concentration of 13 - 52 hydrogen peroxide are considered as low-risk chemical

d The PNP Chief can update the list and may consult the Research and Development Team the group commissioned by the Secretary of Interior and Local Government as the Chairman of the National Police Commission who shall use available scientific methodology and security information in evaluating and determining the explosive potential of such new chemicals

PNP License or Special Permit Requirements

a Entities who are engaged in the manufacture dealing in andl or purchase of controled chemicals are still required to secure appropriate licenses and permits from the PNP through the Firearms and Explosives Office at Camp Crame to approved by designated authorities

b PNP may issue a Special Permit to Purchase and Move Controlled Chemicals to DTI-certified micro and small enterprises CHEDIDepEDITESDA certified academe DOST-certified analyticalltesting laboratories DOH-certified hospitals and 8arangay-certified if the controlled chemicals to be purchased will not exceed the maximum allowable quantity as defined in the IRR Maximum allowable quantity refers to 10 liters for liquid or 10 kilograms of solid which a user can purchase and consume within a day or it may also refer to a threshold quantity of a substance determined by the PNP

c The application form and requirements are provided herewith in this memorandum circular as Annex B (as listed in Annex of the IRR)

d A Certificate of Good Standing may be to a licensed entity if they have pa~sea the parameters listed in Annex F of the IRR which will grant them privileges such as exemptions for some documentary requirements andor license with longer validity period

e Procedures for processing for licences and permits schedule of and guidelines for the movement and transportation of controlled chemicals as well as inspection of storage facility are specified in the annexes of the IRR

C Reportorial storage transport and handling requirements

a License holders are required to

i Maintain an inventory report controlled chemicals including supporting documents such as delivery receipt sales reports consumption or production reports

ii Submit notarized monthly consumption reports with delivery receipt every 15th

day of the succeeding month to the PNP FEO

iii Avail of one police security escort for every movement and transport of high-risk controlled chemicals at no cost (based on issuance of the PNP on moratorium

Page 2 of 3

declaring no escort fee policy) pending the operationalization of the PNP accredited logistics service providerbrokerforwardertrucker and

iv Observe the Guidelines in the Movement and Transportation of Controlled Chemicals as provided in the IRR as Annex B

b Disposal or treatment of contaminated or expired controlled chemicals shall be reported to the PNP and shall be accompanied by a copy of a Certificate of Treatment issued by a Hazardous Waste Treatment Storage and Disposal (HW TSD) Facility duly registered with the Department of Environment and Natural Resources - Environmental Management Bureau (DENR-EMB)

c Storage transport and handling of controlled chemicals shall be guided by the Safety Data Sheet (SDS) of the chemical

Operationalization at the EcoZones

All economic zone enterprises who import export use manufacture transport and store PNP controlled chemicals as well as those who are engage in treatment andor disposal of these chemicals are enjoined to secure licenses and permits from the PNP prior to lodgement of PEZA electronic permit application andor processing of corresponding permits from PEZA

For your guidance and strict compliance

Page 3 of 3

ANNEXA

ANNEXA LIST OF CONTROLLED CHEMICALS

1 The following are the list of controlled chemicals

a HIGH-RISK CONTROLLED CHEMICALS

bull No Chemical Name Chemical Formula CAS Number

Ammonium Cerium (IV) Nitrate Ce(NH4MN03)6 16774-21-3 bull 1 2 Ammonium Nitrate (NH4)(N03) 6484-52-2

3 Fertilizer containing 270 Ammonium Nitrate

14 Ammonium perchlorate NH4CI04 ~4797 n G 7790-98-9 10124-37-55 Calcium Nitrate Ca(N03h

6 Guanidinium Nitrate CHsN40 3 506-93-4

7 Hydrogen Peroxide gt52 HzOz 7722-84-1

8 Magnesium Perchlorate Mg(CI04h 10034-81-8

9 Nitric Acid gt3 HN03 7697-37-2

110 Potassium Nitrate 240 KN03 7757-79-1

111 Potassium Perchlorate 240 KCI04 7778-74-7

112 Potassium Permanganate KMn04 7722-64-7 middot 13 Sodium Chlorate 240 NaCI03 7775-09-9

14 Sodium Nitrate NaN03 7631-99-4

15 Sodium Perchlorate 240 NaCI04 7791-07-3

b LOW-RISK CONTROLLED CHEMICALS No Chemical Name Chemical Formula CAS Number

1 Aluminum GranularPowder AI 7429-90-5

2 Ammonium Chlorate NH4CI03 10192-29-7

3 Barium Chlorate Ba(CI03)2 13477-00-4

14 Barium Chromate BaCr04 10294-40-3

15 Barium Nitrate Ba(N03h 10022-31-8

16 Calcium Chlorate Ca(CI03h 10137-74-3

17 Chromium (III) Nitrate Cr(N03h 7789-02-8

18 Copper Nitrate (Cupric nitrate) Cu(N03)2 10031-43-3 (trihydrate)

9 Ferric (III) Nitrate Fe(N033 78261 8 7782-61-8

10 Hydrogen P_eroxide 13-52 HZ0 2 7722-84-1

11 Nickel (II) Nitrate Ni(N03)2 13138-45-9

12 Potassium Chlorate lt40 KCI03 3811-04-9

13 Potassium Nitrate lt40 KN03 7757-79-1 I 14 Potassium Perchlorate lt40 KCI04 7778-74-7 i 15 Sodium Chlorite gt40 NaCI02 7758-19-2

16 Sodium Perchlorate lt40 NaCI04 7791-07-3

17 Sulfur FlakesPowder Sa 7704-34-9

2 Fertilizer containing lt70 Ammonium Nitrate Nitric Acid Hydrogen Peroxide lt13 and Sodium Chlorite 40 shalf be regulated but subject to actual to determine the explosive potential to be conducted by the PNP The

the chemicals which was subject of the actual testing issuance of appropriate license andor permit

The cost in the actual testing shall be shouldered by the requesting partyapplicant

Based on the corrected CAS (A separate Memorandum Circular will be issued by the PNP to formalize the correction of the CAS )

ANNEX B

ANNEXG FORMS

6-A APPLICATION FORM FOR 6A1 - Application for Manufacturers and

Purchasers License

6-A2 shy

6-A3 - Application for Purchasers License for DTI-certified Micro Enterprises and Barangay-certified Farmers

Permit

Permit to Unload Controlled Chemicals (PUCC) Permit to Controlled Chemicals (PECC)

Form 6-B APPLICATION FORM FOR PERMIT 6-B1 - Permit to Import Controlled Chemicals (PICC) 6-B2 - Permit to Purchase and Move Controlled Chemicals (PPMCC) 6-B3 - Permit to Transport Controlled Chemicals (PTCC) 6-84 - Special Permit to Purchase and Move Controlled Chemicals (SPPMCC)

- Permit to Transfer Controlled Chemicals (PTTCC) - National Level - Permit to Transfer Controlled Chemicals (PTTCC) - Regional Level

6-87 - Permit to Transfer Controlled Chemicals (PTTCC) - Provincial Level

Form 6-C PERSONAL (PDS)

Form MONTHLY CONSUMPTION REPORT

Form 6-E OF BALANCE

Form 6-F CERTIFICATE OF GOOD STANDING

Form DECLARATION

ANNEX B REVISED PNP FORM 6-Al As of April 2016

Republic of the Philippines NATIONAL POLICE COMMISSION

I PHILIPPINE NATIONAL POLICEI

Camp Crame Quezon City PASSPORT SIZE OF THE APPLlCANTAPPLlCANT-

REPRESENTATIVE

APPLICA TION FOR LICENSE

CHIEF PHILIPPINES NATIONAL POLICE Camp Crame Quezon City

Type of Application DNew D Renewal D Amendment l Datamp of Application

Company Name

Nature I Line of IS~or IBusiness C Manufacturer D Dealer D Purchaser D Government D Private D School

Office Address ZIP Code

Facility Address ZlP Codamp

Warehouse Address

COMPANY HEAD ANDIOR AUTHORIZED REPRESENTATIVEIS INFORMA TlON

Name of Company 1 Designation Head Home Address ZIP Code

I

ContactS I Email Address

Name of Authorfnd I DesIgnation RejJresentative Home Address ZlPCodamp

ContactS I 1 Email Address

CONTROLLED CHEMICALIS TO BE LICENSED

KIND QUANTITY APPLIED QTY RECOMMENDED REMARKSBYFEO Indicate storage capacity versus production capacity for one (1) year

In support of this application the undersigned applicanVapplicant-representative enclosed hereto the originalauthenticated copies of the following documentary requirements

D For applicant shall be represented by the owner in case of sole proprietorships or partnerships or in case of corporations by the president or any corporate officer or member of the Board empowered through a Secretarys Certificate_

D For authorized representative Special Power of Attorney (SPA) stating that heshe has been authorized by the applicant for the purpose of processing the application for license

D For local corporationpartnership Certificate of Registration of the firm with the Securities and Exchange Commission (SEC) to include its machine validated Articles of Incorporation and General Information Sheet (GIS) (For New and Amendment)

D For foreign multi-corporation SEC Registration to do business to do business in the Philippines

D For Single Proprietorship Certificate of Registration with the Department of Trade and Industry (DTI) (For New and Amendment)

D Personal Data Sheet (PDS) of the applicant and the management personnel of the storage facilitywarehouse (For New and Amendment)

D NBI Clearance of the applicant (For New and Amendment)

D Business Permit

D Process flowchart (For New and Amendment)

D Material Safety Data Sheet (MSDS)Safety Data Sheet (SDS) of controlled chemicals (For New and Amendment)

D Vicinity Map of the factory and storage facility showing distance from the nearest Police Headquarters

D FloorLocation Plan of the storage facility (For New and Amendment)

D For Metro Manila Applicant Security Survey Inspection from Chief of Police and Certificate of Inspection from C EEMD FEO

D For outside Metro Manila Applicant Security Survey Inspection from ProvinCial DirectorCity Director

D Proof of Payment from the Land Bank of the Philippines

o Certificate of Good Standing (as applicable)

I solemnly swear that the information above are true and correct Further in compliance with the requirements pertaining to controlled chemicals which are now or hereafter maybe enforced and in adherence to existing laws rules and regulations I would like to request your good office to conduct security survey and storage facility inspection in connection with our application as indicated above

Printed Name and Signature of Applicant

_________________________ _

from the date of issuance to the conditions Iomonli Rules and other laws rules and

Attached are the following documents

o Incomplete documentary requirements ie

applicants documentary requirements


Incomplete documentary requirements ie

RECOMMEND

RECOMMEND

DAPPROVAL

DISAPPROVAL

APPROVED This license shall be valid for a and

DISAPPROVED

undersigned respectfully RECOMMENDS THE APPROVAL of the application and certifies the completeness and validity of applicants documentary requirements

Attached is the Security Survey Inspection Report

undersigned regretfully DENY THE APPLICATION due to the following

ANNEX B

o Incomplete documentary requirements ie __________________________ and

is not safe pursuant to the Security Survey Inspection Report

undersigned respectfully RECOMMENDS THE APPROVAL of the application and certifies the completeness of applicants documentary requirements The undersigned further recommends the following

DOuanlity of the controlled chemicals pursuant to the Storage Inspection Report and

o Properly labeled pictures (8x10 in size) of storage facility with PNP Inspecting Team printed in photo paper and

Storage Facility Inspection Report


___________________________

is not safe pursuant to the Security Survey Inspection Report and

fflrel Facility does not conform to the parameters pursuant to the Storage Facility Inspection Report

CHIEF REGIONAL CIVIL SECURITY UNIT

undersigned respectfully RECOMMENDS THE APPROVAL of the application and certifies the completeness of

labeled pictures (8x10 in size) of storage facility with PNP Inspecting Team printed in photo paper

Facility Inspection Report

undersigned regretfully DENY THE APPLICATION due 10 the following


Facility does not conform to the parameters pursuant to the Storage Facility Inspection Report

under RA No

ANNEX B REVISED PNP FORM 6-A2 As of April 2016

1


PHILIPPINE NATIONAL POLICE I Camp Crame Quezon City PASSPORT SIZE OF THE

APPLICANTAPPLICANTshyREPRESENTATIVE

APPLICATION FOR LICENSE


Type of Application o New o Renewal o Amendmenl 08 of Applicalon

Company Name

Nature Une of o Purchaser Secor Business

0 DlI-certlfied small enterprises o Govemmenl o Privale o School0 CHEDI DepEdlTESDA-certified academe 0 DOST-certified analyticaltesting laboratories 0 DOH-certified hospitals

Office Address ZlPCode

Facility Address ZlPCode

Warehouse Address

COMPANY HEAD ANDOR AUTHORIZED REPRESENT A TIVElS INFORMA TION

Name of Company Designation Head Home Address ZlPCode

COfIct lis EmlllI Address

Name of Authorized Deslgnalon Reoresentatlve I

Home Address ZlPCode

Contacl lIs EmIIl Address


KIND QUANTITY APPLIED QTY RECOMMENDED REMARKSBYFEO

In support of this application the undersigned applicanVapplicant-representative enclosed hereto the originalauthenticated copies Of the following documentary requirements

o For applicant shall be represented by the owner in case Of sole proprietorships or partnerships or in case Of corporations by the president or any corporate officer or member Of the Board empowered through a Secretarys Certificate

o For authorized representative Special Power of Attorney (SPA) stating that helshe has been authorized by the applicant for the purpose Of processing the application for license

o Certification from Department Of Trade and Industry (DTI) - For DTI DlI-certified small enterprises

o Certification from Commission on Higher Education (CHED)I Department Of Education (DepEd)fTechnical Education and Skills Development Authority (TESDA) shy For CHEDI DepEdfTESDA-certified academe

o Certification from Department Of Science and Technology (DOS1) - For DOST-certified analyticaltesting laboratories

o Certification from Department Of Health DOH) - For DOH-certified hospitals

o Proof Of Payment from the Land Bank of the Philippines



ANNEX B



documentary requirements ie __________________________


DThe undersigned regretfully DENY THE APPLICATION due to the following

Incnmnlptp documentary requirements ie __________________________

undersigned respectfully RECOMMENDS THE APPROVAL of the application and certifies the completeness of applicants documentary requirements


Incomplete documentary requirements ie __________________________

APPROVED This license shall be valid for a period oLJearls from the date of issuance to the conditions under RA No 9516 and ils Implementing Rules and Regulations other laws rules and

DISAPPROVED

and

ANNEX B

REVISED PNP FORM 6-AJ As of April 2016


PHILIPPINE NATIONAL POLICE Camp Crame Quezon City PASSPORT SIZE OF THE

i APPLICANTAPPLICANTshyREPRESENTATIVE



Type of AppllcaUon aNew a Renewal a Amendmenl IDate of Applfcatlon

ApplicantCompany Name

Naw I Line of a Purchaser ISector I a DTI-certined micro enterprises

Business a Barangay-certified famners

Home Address ZlP Code


Details of DealerlDlstrlbutor

Name of Company


Stonge Facility ZlPCode Address Contact tis IEmail Address

Name of Authorized IDesignation Repres entative Home Address ZIP Code

Contact tis I Email Address


KIND QUANTITY APPLIED QTY RECOMMENDED

REMARKSBY FEORCSU

In support of this application the undersigned applicant enclosed hereto the originalauthenticated copy of the below documentary requirement

o Certification from Department of Trade and Industry (OTI) - For OTI-certified micro enterprises

o Certification from Barangay Captain - For Barangay-certified farmers

I solemnly swear that this application has been accomplished in good faith verified by me and to the best of my knowledge and belief is a true correct and complete statement pursuant to the provisions of pertinent laws rules and regulations of the Republic of the Philippines


DO NOT WRITE BELOW THIS LINE FOR PNP USE ONLY

D The undersigned respectfully RECOMMENDS THE APPROVAL of the application and certifies the completeness of applicants documentary requirements

D The undersigned regretfully DENY THE APPLICATION due to the following


CHIEF EXPLOSIVES MANAGEMENT DIVISIONI CHIEF FIREARMS AND EXPLOSIVES SECTION RCSU

0 APPROVED This license shall be valid for a period o~earls from the date of issuance subject to the conditions and guidelines imposed under RA No 9516 and its Implementing Rules and Regulations other laws rules and regUlations

0 DISAPPROVED

CHIEF FIREARMS AND EXPLOSIVES OFFICEI CHIEF REGIONAL CIVIL SECURITY UNIT

ANNEX B

RepubliclhiliPPines NATIONAL POLICE COMMISSION

NATIONAL HEADQUARTERS PHILIPPINE NATIONAL POLICE OFFICE OF THE CHIEF PHILIPPINE NATIONAL POLICE

Camp Crame Quezon City

PERMIT TO EXPORT CONTROLLED CHEMICALS

PEEX-07-____

AUTHORIZATION

In accordance with the provisions of Section 24 (f) of Republic Act No 6975 in relation to PO No 1866 as amended by RA No 8294 and further amended by RA No 9516 AUTHORITY IS HEREBY GRANTED TO

NAME OF COMPANY Office Address

A LICENSED CONTROLLED CHEMICALS MANUFACTURER

to export the following controlled chemicals

NAMES OF CONTROLLED CHEMICALS QUANTITY 1 2 3 4 5 6 7 8 9

10 -x-x-xshy -x-x-xshy

to (Name of the Consignee) located at (Address of the consignee) for their legitimate customers in (Country)

This AUTHORIZATION which is non-transferable will expire on _______ unless sooner revoked and subject to the explosives and controlled chemicals laws rules and regulations of the country of destination and the Republic of the Philippines (including rules and regulations of the Bangko Sentral ng Pilipinas and the Bureau of Customs) and to the following additional conditions

1 The items shall not be exported to a third party country and shall not be shipped unless a certificate by the owner to this effect is presented

2 The items shall be packed transported and loaded on a carrier under the supervision of PNP escorts detailed for the purpose

3 The items shall be delivered to the Bureau of Customs with PNP escorts duly detailed for the purpose and

4 The exporter shall furnish this Headquarters (Attn Chief FEO) a document from the recipient attesting to the receipt of the said items

CHIEF PHILIPPINE NATIONAL POLICE Copy Furnished

Commissioner Bureau of Customs Governor Bangko Sentral ng Pilipinas C FEO

ANNEX B

Republic of the Philippines NATIONAL POLICE COMMISSION PHILIPPINE NATIONAL POLICE

CIVIL SECURITY GROUP Firearms and Explosives Office


D D D

Manufacturer

Dealer

Purchaser

PERMIT TO UNLOAD CONTROLLED CHEMICALS

DATE

CHIEF PHILIPPINE NATIONAL POLICE Camp Crame Quezon City

For information we have a shipment of controlled chemicals arriving from abroad which were imported under the Permit to Import Controlled Chemicals issued by the PNP on The details of the shipments are as follows

Company NameConsigneell mporter

Office Address Storage FacilitylWarehouse Address License No Permit to Import No _____________ Date Issued

KIND QTY

UTHORIZED I PERMIT

QTY PREVIOUSLY UNLOADED

QTYOF INCOMING SHIPMENT

BALANCE EXPECTED DATE OF ARRIVAL

CARRYING VESSEUSHIP PORT OF ENTRY

We hereby request permission to unload the controlled chemicals from the vesselship for transshipment to our storage facilitywarehousemagazine as aforestated under the escort to be provided by the PNP If this request is approved I do hereby covenant and agree that I will safely keep and lawfully dispose the above-described controlled chemicals and will faithfully comply with all laws rules and regulations which are now or hereafter maybe enforced

SBR NO Amount Date

Very truly yours

Print Name and Signature of Applicant

FEO PROCESSING

RECOMMENDS

D APPROVAL

D DISAPPROVAL

Chief Explosives Management Division

D APPROVED

D DISAPPROVED

Chief Firearms and Explosives Office

II

ANNEX B

Revised PNP FORM 6middot81 As of April 2016

APPLICATION FOR PERMIT TO IMPORT CONTROLLED CHEMICALS

Manufacturer

Dealer

D Purchaser


Company Name Office Address

__________________c_____

NatureLine of Business License No Purposeuse of controlled

--~--------------------

Request for authority to import the following controlled

MAXIMUM ALLOWABLE QUANTITY APPLIED FOR KIND QUANTITY

~~cc____ ________________c_c_ - __-l-__c_____

bull Storage Capacity X 12 + 25 for initial importation bull Maximum Annual Average lor the last 3 years +25) for succeeding importation

If this request is approved I do hereby covenant and agree that I will safely keep and lawfully dispose the above-described controlled chemicals and will faithfully comply with all laws rules and regulations which are now or hereafter maybe enforced

RECOMMEND

APPROVAL

DISAPPROVAL

ANNEX B

FEO PROCESSING

I BAlANCE AS QTY TOTAL rlORIZEu

DISPOSITION I RECOMMENDED HAND KIND (DATE) BYFEO FOR)

I LICENSE

I

I I

-~-f--

r--middotmiddotmiddot----middot

f---shy

RECOMMEND

APPROVAL

DISAPPROVAL

Chief Firearms and Explosives Office Director Civil Security Group

APPROVED

DISAPPROVED

Chief Philippine National Police

PHILIPPINE NATIONAL POLICE Crame Quezon City

-_____

ANNEX B

APPLICATION FOR PERMIT TO PURCHASE AND MOVE CONTROLLED CHEMICALS

Manufacturer

Dealer

Purchaser

_-__-------_

Request for authority to purchase and move the following controlled chemicals

KIND QUANTITY APPLIED FOR REMARKS

r------- -----~------_t_--------__I Indicate storage capacity versus production for one (1) year

-------------+---------~

If this is approved I do hereby covenant and agree that I will safely keep and lawfully the above-described controlled chemicals and will faithfully comply with all laws rules and

which are now or hereafter maybe enforced

RECOMMEND

o APPROVAL

DISAPPROVAL

PROVINCIAL DIRECTORCITY DIRECTOR

ANNEX B

FEO PROCESSING

I _OJ I

I UVV I AS OTY TOTAL STOCK ON

RECOMMENDED QTY KIND ~KtLJ

(DATE) BY FEO FOR) LICENSE

I

~

-shy

1-------

__ r---~-

--

- -shy --_

i

--

RECOMMEND

APPROVAL

DISAPPROVAL

Chief I=vnlncives Mal tment Division

APPROVED

DISAPPROVED

Chief Firearms and ives Office

I

Request for Natural Resources-Environment Management Bureau (DENR-EMB) accredited treatment facility

KIND QUANTITY

(FOR DISPOSAL)

is approved I do hereby covenant and agree that I will safely keep and lawfully dispose the controlled chemicals and will faithfully comply with all laws rules and regulations which are now or hereafter maybe enforced


ANNEX B


APPLICATION FOR PERMIT TO TRANSPORT CONTROLLED CHEMICALS

Manufacturer

D Dealer

D Purchaser

CHIEF PHILIPPINES NATIONAL POLICE Camp Quezon City


to move and transport the following controlled chemicals to the Department of

REMARKS unusedcontaminatedex

RECOMMEND

APPROVAL

DISAPPROVAL

APPROVED

DISAPPROVED

Chief Regional Civil Security Unit

ANNEX B

FOR SPECIAL PERMIT TO PURCHASE AND MOVE CONTROLLED CHEMICALS

for authority to purchase and move the following controlled chemicals

REMARKS

I----~~____~__________+_----- -------J Indicate storage capacity versus f---~--------~------+---------1 production capacity for one (1) year

KND QUANTITY APPLIED FOR

request is approved I do hereby covenant and agree that I will safely keep and lawfully above-described explosivesexpl ingredientscontrolled chemicals and will faithfully

all laws rules and regulations which are now or hereafter maybe enforced

ANNEX B

PROCESSING

-I TOTAL STOCK ON BAlANCE AS QTY HAND QTYRECOMMENDEDI DISPUIIIUN FOR)(DATE) BHEO

LICENSE I

i i

i i

shy

r--- shy

-~~--

---------shy

I

RECOMMEND

APPROVAL

DISAPPROVAL

Chief Explosives Manajt Itrt Division

APPROVED

DISAPPROVED

Chief Fhtdl Igt and Jvnlnci Offie

i

I

ANNEX B

Revised PNP FORM 6middotB5 (National Level) As of April 2016

APPLICATION FOR PERMIT TO TRANSFER CONTROLLED CHEMICALS

Manufacturer

Dealer

D Purchaser

CHIEF PHILIPPINES NATIONAL Camp City

Company Name

Purposeuse

Request for authority to transfer and move the following controlled chemicals


capacity versus-----------------+~-------____1 Indicateproduction for one (1) year

r---------------------~----------____1

r----------~ ------~-_+_------___i

--------------1-----------1

If this request is approved I do hereby covenant and agree that I will keep and lawfully dispose the controlled chemicals and will faithfully comply with all laws and

which are now or maybe

RECOMMEND

APPROVAL

DISAPPROVAL

ANNEX B

FEO PROCESSING

I QTY BALANCE AS QTY 1TOTAL STOCK ON JTHlt)RiZED ACQUISITION DISPOSITION

RECOMMENDED HAND QTY

LICENSE (DATE) I BY

t---

i

~-

i

f--- shy

i

RECOMMEND

APPROVAL

DISAPPROVAL

chief EXlllosives Mal lentDivision

RECOMMEND

APPROVED

DISAPPROVED

chief Fi md Explosi Offic

NatureLine of

ANNEX B

Revised PNP FORM 6middot86 (Regional Levell As of April 2016


Manufacturer

o Dealer

Purchaser


Company Name

Office Storage

No Purposeuse

------~------


---------+-----------1 production capacity for one

the regulations which are now or hereafter maybe enforced

KIND QUANTITY APPLIED FOR

Indicate

is approved I do hereby covenant and agree that I will safely and lawfully controlled chemicals and will faithfully comply with all laws rules

RECOMMEND

APPROVAL

DISAPPROVAL

AIJNEX B

I FES PROCESSING

I QIY I I I D I

KIND 1~~~ttU ACQUISITION DISPOSITION (DAlE) BY FED

LICENSE - shy

I i

--r shy ---~-

- _shyi

i

-shy

i i I

--~--

-shy

_---shy

r----shy

I- shy

_- r shy -shy

j

RECOMMEND

APPROVAL

DISAPPROVAL

Chief Fi md 1 _ivdS Sectio~ RCSUI Chief Regional Operations and Plans Division

APPROVED

DISAPPROVED

Chief Regio 1 Civil Seci ~ity Unitl Regional Director Police Regional Office

ANNEX B

Revised PNP FORM 6middotB7 (Provincial Level) As of April 2016


0 Manufacturer

Dealer

Purchaser

DATE

Camp PHILIPPINES NATIONAL POLICE

Quezon City

Company Name Office Address Storage Addl _ -shyNatureLine of Business --_____

License No of JUllll UiltU lieals

Request for authority to (Date)

and move the following controlled chemicals

)

1_

KIND

__

QUANTITY APPLIED FOR REMARKS

Indicate storage capacity versus production capacity for one (1) year

I

r-shy

-

shy

I

~

1----

1 -shy -- I

If this is I do hereby covenant and that I will lawfully the Iboll I

~ ~~~~ controlled chemicals and will faithfully comply with all laws rules and regulations which are now or hereafter maybe enforced


ANNEX B

PROCESSING

I I I I RECOMMENDED I HANDAUTHORIZED

DISPOSITION I QTY KIND

LICENSE I (DATE) BYFEO FOR)

i- shy

I

i------~---

i

Ifshy --shyi

----- I

f- shy

RECOMMEND

APPROVAL

DISAPPROVAL

Chief Operations ~ptin PPOGPO

APPROVED

DISAPPROVED

vvhial Directo PPOJ CityDrrector~ CPO

ANNEX B

Revised PNP FORM 6-C As of April 2016

PERSONAL DATA SHEET

2X2 PICTURE

I PERSONAL DATA

Name Date of Birth Place of Birth Sex Civil Status Religion Blood Type Build Height Weight Complexion Ethnic Group Spouse Name Occupation Permanent Address Children

II EDUCATIONAL BACKGROUND

III FAMilY HISTORY

I Fathers Name I Date of Birth I Place of Birth I Occupation I Address i l I I I Mothers Name

l l I I Brothersl Sisters Name

I I I I I I I l

NEMPlOYMENTRECORDS

Designation Job Any other Reason responsibilities relevant for

information leavin

V lOCAL AND INTERNATIONAL ORGANIZATION (AFFILIATION)

ANNEX B

Revised PNP FORM G-C

VII HOBBIESINTEREST (PAST TIMEPASSION)

VIII CHARACTER REFERENCE

I declare under oath that this Personal Data Sheet has been accomplished in good faith verified by me and to the best of my knowledge and belief is a true correct and complete statement pursuant to the provisions of pertinent laws rules and regulations of the Republic of the Philippines

I also authorize the rrgtcgtnltfjgt to verifyvalidate the contents stated herein I trust that this information shall remain confidential

SIGNATURE

RIGHT THUMBARK

ANNEX B

Revised PNP FORM 6 middot0 Name As ot April 2016 Address

MONTHLY CONSUMPTION REPORT

THE CHIEF OF PHILIPPINE NATIONAL POLICE

CAMP CRAME QUEZON CITY

THRU Chief Firearms and Exolosives Office

Sir

Submitted is the and disoosition report of controlled chemicals for the month of __________

ANtol Name of Address PPEPI No

On Hand

infuIltcd

Total

Name of bull IF npany Address Authority

PPEPI No

SoldUsed

Total

Balance

List of Controlled Chemicals (Pis indicate the chemical names in the column

-

Note Acquisitions procurements purchases sales importationsexportations unloading transferlmovement andor disposition must be supported by appropriate documents such as delivery receipts purchase orders and issued

TO WHOM IT MAY CONCERN

I CERTIFY that the of controlled chemicals reHected on this report have been validated to be accurate

Purchasing Officer

-------------------

Revised PNP FORM 6-E ANNEX B As of April 2016


PHILIPPINE NATIONAL POLICE CIVIL SECURITY GROUP

Firearms and Explosives Office ~~ Camp Crame Quezon City ~

EMDFEO CONTROL NR 2016 shy

CERTIFICATE OF BALANCE (PERMIT TO UNLOAD)


THIS IS TO CERTIFY (Company Name) that a licensed (type of license) of controlled chemicals with office address

aUin

and storage facility aUin has been (kind of permit) granted by (Approving Authority) (designation) on _ _ -gt te-lt)_(da-- _ valid until (date) for _ ______--gt-l(P--=ucr-posceCL)__________

Below is the inventory of controlled chemicals as of (date)

AUTHORIZED QTY INTHE STOCK ON

LIST OF CHEMICALS PERMIT TO HAND IMPORT (b)

(a)

QTY OF INCOMING BALANCE SHIPMENT (d=a-(b+eraquo

(e)

This certification is being issued upon the request (name of applicant) of (position) of (name of company) as one of the

documentary requirements in the application for Permit to Unload

Issued this _____ e)_____(gt-c-urr=entdat~ at Camp Crame Quezon City

Name of C EMD

--------------------


Rank Designation

middotPursuantto Section 565 of the IRR on Controlied Chemicals approved by the SILG on June 92016


CIVIL SECURITY GROUP

Firearms and Explosives Office ~~~ Camp Crame Quezon City -~


CERTIFICATE OF BALANCE (PERMIT TO PURCHASEfTRANSFER AND MOVE)



atin (address)

and storage facility atin (address) has been (kind of permit) granted by (Approving Authority) (designation) on (date)

------------- shyvalid until (date) for (purpose)

----------------~~--~----------------


AUTHORIZED STOCK ON LIST OF CHEMICALS QTY HAND

Cal (bt

QUANTITY TO BALANCE BE PURCHASED (d=a-(b+c))

(cl



Issued this (current date) at Camp Crame Quezon City ----~--------~----


Name of C EMD Rank Designation

Revised PNP FORM 6-F ANNEX 8

As of April 2016




CERTIFICATE OF GOOD STANDING CN (License No of the Company - _ccG=s---___

(Line 1 - Company Name) (Line 2 - Company Address)

THIS IS TO CERTIFY after diligent examination of the of the documents and records of the aforementioned company on file at this Office that said company has satisfactorily complied with all the laws rules and regulations governing controlled

chemicals and is likewise compliant with the following

a Maintenance of a permanent and complete record of all transactions from the effectivity of the IRR

b Timely submission of complete and correct notarized monthly reports for at least a year

c Prompt renewal of license starting from the effectivity of the IRR on Controlled Chemicals

d No derogatory reportfs such as but not limited to the following 1) Possession importation manufacture or selling of controlled

chemicals not covered in the approved license 2) Selling or transfer of controlled chemicals to unlicensed person

or entity 3) Purchase of controlled chemical from unlicensed person or

entity 4) Movement and transportation of controlled chemicals without

appropriate PNP permit and 5) Use of unregistered and unaccredited logistics service

providerbrokerforwardertrucker in the movement and transportation of controlled chemicals

e Endorsement from related government regulatory or investment promotion agencies

This further certifies that the above-named company is entitled to all the privileges provided under the Implementing Rules and Regulations on Controlled Chemicals Pursuant to Section 4-C to 4-F of PO lJo 1866 as amended by RA No 9516

WITNESS my hand and the official seal of the Firearms and Explosives Office (FEO) on

(date of issuance)

FEO

DRY SEAL Name of C FEO Rank Designation

This ceritificate expires on (date)

ANNEX B

COMPANY

DECLARATION (EUD)

Please fill-out this form and completely

No Pack Size

DECLARATION

I

on behalf of

declare that the above controlled chemicals will be used as

declaring that aforecited controlled chemical will not be used for the manufacture of explosives or diverted for illegal purposes Further affirm that the company is amenable in the conduct of inspectionlverification of aforementioned by PNP-FEO at any reasonable business hours

DETAILS OF BUYERS IDENTIFICATION (Allach photocopy of presented identification with current photo)

Drivers License No ----shy Issued at _____ Valid Until

Company 10 No Valid Until

Contact Nos (Landline amp Mobile) add

Noted by Company Responsible Officer

To be filled by Supplier

------

Revised PNP FORM 6middotG (For Purchaser) As of April 2016

DECLARATION (EUD) For personal use

Please fill-out this form legibly and n1nlmiddotIlv

with DECLARATION I

(Full Name)

residence address at

not be used for personal use as

Further declaring that aforecited controlled chemical will not be used for the manufacture of or diverted for purposes

Valid 10 No

END-USER DECLARATION (EUD) personal use

Please fill-out this form legibly and completely

DECLARATION I with

(FuJI Name) residence address at


Further declaring that controlled chemical will not be used for the manufacture of explosives or diverted for illegal purposes

ANNEX B

Valid 10 No

END-USER DECLARATION (EUD) For personal use


with DECLARATION I

(Full Name)


--__--------------shy


that aforecited controlleddeclaring will not be used for the manufacture

or diverted for illegal purposes

name

Valid 10 No ___________



DECLARATION I with

(Full Name) residence address at


--------

ANNEX B Revised PNP FORM 6middotG

Purchaser) of April 2016

Further that controlled chemical will not be used for the manufacture

explosives or for illegal

Valid No

016-t2

c some of the chemicals listed they will be regulated on the concentrations specified in an aqueous solution

Example Aqueous 20 hydrogen peroxide solution is regulated because those with concentration of 13 - 52 hydrogen peroxide are considered as low-risk chemical

d The PNP Chief can update the list and may consult the Research and Development Team the group commissioned by the Secretary of Interior and Local Government as the Chairman of the National Police Commission who shall use available scientific methodology and security information in evaluating and determining the explosive potential of such new chemicals

PNP License or Special Permit Requirements

a Entities who are engaged in the manufacture dealing in andl or purchase of controled chemicals are still required to secure appropriate licenses and permits from the PNP through the Firearms and Explosives Office at Camp Crame to approved by designated authorities

b PNP may issue a Special Permit to Purchase and Move Controlled Chemicals to DTI-certified micro and small enterprises CHEDIDepEDITESDA certified academe DOST-certified analyticalltesting laboratories DOH-certified hospitals and 8arangay-certified if the controlled chemicals to be purchased will not exceed the maximum allowable quantity as defined in the IRR Maximum allowable quantity refers to 10 liters for liquid or 10 kilograms of solid which a user can purchase and consume within a day or it may also refer to a threshold quantity of a substance determined by the PNP

c The application form and requirements are provided herewith in this memorandum circular as Annex B (as listed in Annex of the IRR)

d A Certificate of Good Standing may be to a licensed entity if they have pa~sea the parameters listed in Annex F of the IRR which will grant them privileges such as exemptions for some documentary requirements andor license with longer validity period

e Procedures for processing for licences and permits schedule of and guidelines for the movement and transportation of controlled chemicals as well as inspection of storage facility are specified in the annexes of the IRR

C Reportorial storage transport and handling requirements

a License holders are required to

i Maintain an inventory report controlled chemicals including supporting documents such as delivery receipt sales reports consumption or production reports

ii Submit notarized monthly consumption reports with delivery receipt every 15th

day of the succeeding month to the PNP FEO

iii Avail of one police security escort for every movement and transport of high-risk controlled chemicals at no cost (based on issuance of the PNP on moratorium

of 3








Page 3 of 3

ANNEXA





































ANNEX B

ANNEXG FORMS


Purchasers License

6-A2 shy


Permit







Form 6-E OF BALANCE


Form DECLARATION





REPRESENTATIVE




Company Name




Warehouse Address



I














D Business Permit











_________________________ _







RECOMMEND

RECOMMEND

DAPPROVAL

DISAPPROVAL


DISAPPROVED




ANNEX B








___________________________










under RA No


1







Company Name





Warehouse Address



















ANNEX B











DISAPPROVED

and

ANNEX B














Name of Company







REMARKSBY FEORCSU












0 DISAPPROVED


ANNEX B





PEEX-07-____

AUTHORIZATION















ANNEX B




D D D

Manufacturer

Dealer

Purchaser


DATE





KIND QTY

UTHORIZED I PERMIT






SBR NO Amount Date

Very truly yours


FEO PROCESSING

RECOMMENDS

D APPROVAL

D DISAPPROVAL


D APPROVED

D DISAPPROVED


II

ANNEX B



Manufacturer

Dealer

D Purchaser



__________________c_____


--~--------------------



~~cc____ ________________c_c_ - __-l-__c_____



RECOMMEND

APPROVAL

DISAPPROVAL

ANNEX B

FEO PROCESSING



I LICENSE

I

I I

-~-f--


f---shy

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED



-_____

ANNEX B


Manufacturer

Dealer

Purchaser

_-__-------_




-------------+---------~



RECOMMEND

o APPROVAL

DISAPPROVAL


ANNEX B

FEO PROCESSING

I _OJ I




I

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--

RECOMMEND

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DISAPPROVAL


APPROVED

DISAPPROVED


I


KIND QUANTITY

(FOR DISPOSAL)



ANNEX B



Manufacturer

D Dealer

D Purchaser





RECOMMEND

APPROVAL

DISAPPROVAL

APPROVED

DISAPPROVED


ANNEX B



REMARKS





ANNEX B

PROCESSING


LICENSE I

i i

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I

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


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I

ANNEX B



Manufacturer

Dealer

D Purchaser


Company Name

Purposeuse




r---------------------~----------____1

r----------~ ------~-_+_------___i

--------------1-----------1



RECOMMEND

APPROVAL

DISAPPROVAL

ANNEX B

FEO PROCESSING



LICENSE (DATE) I BY

t---

i

~-

i

f--- shy

i

RECOMMEND

APPROVAL

DISAPPROVAL


RECOMMEND

APPROVED

DISAPPROVED


NatureLine of

ANNEX B



Manufacturer

o Dealer

Purchaser


Company Name

Office Storage

No Purposeuse

------~------





Indicate


RECOMMEND

APPROVAL

DISAPPROVAL

AIJNEX B

I FES PROCESSING

I QIY I I I D I


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DISAPPROVAL


APPROVED

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ANNEX B



0 Manufacturer

Dealer

Purchaser

DATE


Quezon City





)

1_

KIND

__



I

r-shy

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RECOMMEND

APPROVAL

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APPROVED

DISAPPROVED


ANNEX B


PERSONAL DATA SHEET

2X2 PICTURE

I PERSONAL DATA



III FAMilY HISTORY



I I I I I I I l

NEMPlOYMENTRECORDS


information leavin


ANNEX B






SIGNATURE

RIGHT THUMBARK

ANNEX B






Sir



On Hand

infuIltcd

Total


PPEPI No

SoldUsed

Total

Balance


-




Purchasing Officer

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No








of 3

ANNEXA





































ANNEX B

ANNEXG FORMS


Purchasers License

6-A2 shy


Permit







Form 6-E OF BALANCE


Form DECLARATION





REPRESENTATIVE




Company Name




Warehouse Address



I














D Business Permit











_________________________ _







RECOMMEND

RECOMMEND

DAPPROVAL

DISAPPROVAL


DISAPPROVED




ANNEX B








___________________________










under RA No


1







Company Name





Warehouse Address



















ANNEX B











DISAPPROVED

and

ANNEX B














Name of Company







REMARKSBY FEORCSU












0 DISAPPROVED


ANNEX B





PEEX-07-____

AUTHORIZATION















ANNEX B




D D D

Manufacturer

Dealer

Purchaser


DATE





KIND QTY

UTHORIZED I PERMIT






SBR NO Amount Date

Very truly yours


FEO PROCESSING

RECOMMENDS

D APPROVAL

D DISAPPROVAL


D APPROVED

D DISAPPROVED


II

ANNEX B



Manufacturer

Dealer

D Purchaser



__________________c_____


--~--------------------



~~cc____ ________________c_c_ - __-l-__c_____



RECOMMEND

APPROVAL

DISAPPROVAL

ANNEX B

FEO PROCESSING



I LICENSE

I

I I

-~-f--


f---shy

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED



-_____

ANNEX B


Manufacturer

Dealer

Purchaser

_-__-------_




-------------+---------~



RECOMMEND

o APPROVAL

DISAPPROVAL


ANNEX B

FEO PROCESSING

I _OJ I




I

~

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1-------

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--

- -shy --_

i

--

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


I


KIND QUANTITY

(FOR DISPOSAL)



ANNEX B



Manufacturer

D Dealer

D Purchaser





RECOMMEND

APPROVAL

DISAPPROVAL

APPROVED

DISAPPROVED


ANNEX B



REMARKS





ANNEX B

PROCESSING


LICENSE I

i i

i i

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r--- shy

-~~--

---------shy

I

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


i

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ANNEX B



Manufacturer

Dealer

D Purchaser


Company Name

Purposeuse




r---------------------~----------____1

r----------~ ------~-_+_------___i

--------------1-----------1



RECOMMEND

APPROVAL

DISAPPROVAL

ANNEX B

FEO PROCESSING



LICENSE (DATE) I BY

t---

i

~-

i

f--- shy

i

RECOMMEND

APPROVAL

DISAPPROVAL


RECOMMEND

APPROVED

DISAPPROVED


NatureLine of

ANNEX B



Manufacturer

o Dealer

Purchaser


Company Name

Office Storage

No Purposeuse

------~------





Indicate


RECOMMEND

APPROVAL

DISAPPROVAL

AIJNEX B

I FES PROCESSING

I QIY I I I D I


LICENSE - shy

I i

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i i I

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r----shy

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j

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APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B



0 Manufacturer

Dealer

Purchaser

DATE


Quezon City





)

1_

KIND

__



I

r-shy

-

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I

~

1----

1 -shy -- I




ANNEX B

PROCESSING




i- shy

I

i------~---

i

Ifshy --shyi

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f- shy

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B


PERSONAL DATA SHEET

2X2 PICTURE

I PERSONAL DATA



III FAMilY HISTORY



I I I I I I I l

NEMPlOYMENTRECORDS


information leavin


ANNEX B






SIGNATURE

RIGHT THUMBARK

ANNEX B






Sir



On Hand

infuIltcd

Total


PPEPI No

SoldUsed

Total

Balance


-




Purchasing Officer

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

ANNEXA





































ANNEX B

ANNEXG FORMS


Purchasers License

6-A2 shy


Permit







Form 6-E OF BALANCE


Form DECLARATION





REPRESENTATIVE




Company Name




Warehouse Address



I














D Business Permit











_________________________ _







RECOMMEND

RECOMMEND

DAPPROVAL

DISAPPROVAL


DISAPPROVED




ANNEX B








___________________________










under RA No


1







Company Name





Warehouse Address



















ANNEX B











DISAPPROVED

and

ANNEX B














Name of Company







REMARKSBY FEORCSU












0 DISAPPROVED


ANNEX B





PEEX-07-____

AUTHORIZATION















ANNEX B




D D D

Manufacturer

Dealer

Purchaser


DATE





KIND QTY

UTHORIZED I PERMIT






SBR NO Amount Date

Very truly yours


FEO PROCESSING

RECOMMENDS

D APPROVAL

D DISAPPROVAL


D APPROVED

D DISAPPROVED


II

ANNEX B



Manufacturer

Dealer

D Purchaser



__________________c_____


--~--------------------



~~cc____ ________________c_c_ - __-l-__c_____



RECOMMEND

APPROVAL

DISAPPROVAL

ANNEX B

FEO PROCESSING



I LICENSE

I

I I

-~-f--


f---shy

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED



-_____

ANNEX B


Manufacturer

Dealer

Purchaser

_-__-------_




-------------+---------~



RECOMMEND

o APPROVAL

DISAPPROVAL


ANNEX B

FEO PROCESSING

I _OJ I




I

~

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1-------

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- -shy --_

i

--

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


I


KIND QUANTITY

(FOR DISPOSAL)



ANNEX B



Manufacturer

D Dealer

D Purchaser





RECOMMEND

APPROVAL

DISAPPROVAL

APPROVED

DISAPPROVED


ANNEX B



REMARKS





ANNEX B

PROCESSING


LICENSE I

i i

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APPROVAL

DISAPPROVAL


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DISAPPROVED


i

I

ANNEX B



Manufacturer

Dealer

D Purchaser


Company Name

Purposeuse




r---------------------~----------____1

r----------~ ------~-_+_------___i

--------------1-----------1



RECOMMEND

APPROVAL

DISAPPROVAL

ANNEX B

FEO PROCESSING



LICENSE (DATE) I BY

t---

i

~-

i

f--- shy

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RECOMMEND

APPROVAL

DISAPPROVAL


RECOMMEND

APPROVED

DISAPPROVED


NatureLine of

ANNEX B



Manufacturer

o Dealer

Purchaser


Company Name

Office Storage

No Purposeuse

------~------





Indicate


RECOMMEND

APPROVAL

DISAPPROVAL

AIJNEX B

I FES PROCESSING

I QIY I I I D I


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DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B



0 Manufacturer

Dealer

Purchaser

DATE


Quezon City





)

1_

KIND

__



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r-shy

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I

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1 -shy -- I




ANNEX B

PROCESSING




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RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B


PERSONAL DATA SHEET

2X2 PICTURE

I PERSONAL DATA



III FAMilY HISTORY



I I I I I I I l

NEMPlOYMENTRECORDS


information leavin


ANNEX B






SIGNATURE

RIGHT THUMBARK

ANNEX B






Sir



On Hand

infuIltcd

Total


PPEPI No

SoldUsed

Total

Balance


-




Purchasing Officer

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

ANNEX B

ANNEXG FORMS


Purchasers License

6-A2 shy


Permit







Form 6-E OF BALANCE


Form DECLARATION





REPRESENTATIVE




Company Name




Warehouse Address



I














D Business Permit











_________________________ _







RECOMMEND

RECOMMEND

DAPPROVAL

DISAPPROVAL


DISAPPROVED




ANNEX B








___________________________










under RA No


1







Company Name





Warehouse Address



















ANNEX B











DISAPPROVED

and

ANNEX B














Name of Company







REMARKSBY FEORCSU












0 DISAPPROVED


ANNEX B





PEEX-07-____

AUTHORIZATION















ANNEX B




D D D

Manufacturer

Dealer

Purchaser


DATE





KIND QTY

UTHORIZED I PERMIT






SBR NO Amount Date

Very truly yours


FEO PROCESSING

RECOMMENDS

D APPROVAL

D DISAPPROVAL


D APPROVED

D DISAPPROVED


II

ANNEX B



Manufacturer

Dealer

D Purchaser



__________________c_____


--~--------------------



~~cc____ ________________c_c_ - __-l-__c_____



RECOMMEND

APPROVAL

DISAPPROVAL

ANNEX B

FEO PROCESSING



I LICENSE

I

I I

-~-f--


f---shy

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED



-_____

ANNEX B


Manufacturer

Dealer

Purchaser

_-__-------_




-------------+---------~



RECOMMEND

o APPROVAL

DISAPPROVAL


ANNEX B

FEO PROCESSING

I _OJ I




I

~

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1-------

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--

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--

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


I


KIND QUANTITY

(FOR DISPOSAL)



ANNEX B



Manufacturer

D Dealer

D Purchaser





RECOMMEND

APPROVAL

DISAPPROVAL

APPROVED

DISAPPROVED


ANNEX B



REMARKS





ANNEX B

PROCESSING


LICENSE I

i i

i i

shy

r--- shy

-~~--

---------shy

I

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


i

I

ANNEX B



Manufacturer

Dealer

D Purchaser


Company Name

Purposeuse




r---------------------~----------____1

r----------~ ------~-_+_------___i

--------------1-----------1



RECOMMEND

APPROVAL

DISAPPROVAL

ANNEX B

FEO PROCESSING



LICENSE (DATE) I BY

t---

i

~-

i

f--- shy

i

RECOMMEND

APPROVAL

DISAPPROVAL


RECOMMEND

APPROVED

DISAPPROVED


NatureLine of

ANNEX B



Manufacturer

o Dealer

Purchaser


Company Name

Office Storage

No Purposeuse

------~------





Indicate


RECOMMEND

APPROVAL

DISAPPROVAL

AIJNEX B

I FES PROCESSING

I QIY I I I D I


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REMARKS





ANNEX B

PROCESSING


LICENSE I

i i

i i

shy

r--- shy

-~~--

---------shy

I

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


i

I

ANNEX B



Manufacturer

Dealer

D Purchaser


Company Name

Purposeuse




r---------------------~----------____1

r----------~ ------~-_+_------___i

--------------1-----------1



RECOMMEND

APPROVAL

DISAPPROVAL

ANNEX B

FEO PROCESSING



LICENSE (DATE) I BY

t---

i

~-

i

f--- shy

i

RECOMMEND

APPROVAL

DISAPPROVAL


RECOMMEND

APPROVED

DISAPPROVED


NatureLine of

ANNEX B



Manufacturer

o Dealer

Purchaser


Company Name

Office Storage

No Purposeuse

------~------





Indicate


RECOMMEND

APPROVAL

DISAPPROVAL

AIJNEX B

I FES PROCESSING

I QIY I I I D I


LICENSE - shy

I i

--r shy ---~-

- _shyi

i

-shy

i i I

--~--

-shy

_---shy

r----shy

I- shy

_- r shy -shy

j

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B



0 Manufacturer

Dealer

Purchaser

DATE


Quezon City





)

1_

KIND

__



I

r-shy

-

shy

I

~

1----

1 -shy -- I




ANNEX B

PROCESSING




i- shy

I

i------~---

i

Ifshy --shyi

----- I

f- shy

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B


PERSONAL DATA SHEET

2X2 PICTURE

I PERSONAL DATA



III FAMilY HISTORY



I I I I I I I l

NEMPlOYMENTRECORDS


information leavin


ANNEX B






SIGNATURE

RIGHT THUMBARK

ANNEX B






Sir



On Hand

infuIltcd

Total


PPEPI No

SoldUsed

Total

Balance


-




Purchasing Officer

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

ANNEX B

PROCESSING


LICENSE I

i i

i i

shy

r--- shy

-~~--

---------shy

I

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


i

I

ANNEX B



Manufacturer

Dealer

D Purchaser


Company Name

Purposeuse




r---------------------~----------____1

r----------~ ------~-_+_------___i

--------------1-----------1



RECOMMEND

APPROVAL

DISAPPROVAL

ANNEX B

FEO PROCESSING



LICENSE (DATE) I BY

t---

i

~-

i

f--- shy

i

RECOMMEND

APPROVAL

DISAPPROVAL


RECOMMEND

APPROVED

DISAPPROVED


NatureLine of

ANNEX B



Manufacturer

o Dealer

Purchaser


Company Name

Office Storage

No Purposeuse

------~------





Indicate


RECOMMEND

APPROVAL

DISAPPROVAL

AIJNEX B

I FES PROCESSING

I QIY I I I D I


LICENSE - shy

I i

--r shy ---~-

- _shyi

i

-shy

i i I

--~--

-shy

_---shy

r----shy

I- shy

_- r shy -shy

j

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B



0 Manufacturer

Dealer

Purchaser

DATE


Quezon City





)

1_

KIND

__



I

r-shy

-

shy

I

~

1----

1 -shy -- I




ANNEX B

PROCESSING




i- shy

I

i------~---

i

Ifshy --shyi

----- I

f- shy

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B


PERSONAL DATA SHEET

2X2 PICTURE

I PERSONAL DATA



III FAMilY HISTORY



I I I I I I I l

NEMPlOYMENTRECORDS


information leavin


ANNEX B






SIGNATURE

RIGHT THUMBARK

ANNEX B






Sir



On Hand

infuIltcd

Total


PPEPI No

SoldUsed

Total

Balance


-




Purchasing Officer

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

ANNEX B



Manufacturer

Dealer

D Purchaser


Company Name

Purposeuse




r---------------------~----------____1

r----------~ ------~-_+_------___i

--------------1-----------1



RECOMMEND

APPROVAL

DISAPPROVAL

ANNEX B

FEO PROCESSING



LICENSE (DATE) I BY

t---

i

~-

i

f--- shy

i

RECOMMEND

APPROVAL

DISAPPROVAL


RECOMMEND

APPROVED

DISAPPROVED


NatureLine of

ANNEX B



Manufacturer

o Dealer

Purchaser


Company Name

Office Storage

No Purposeuse

------~------





Indicate


RECOMMEND

APPROVAL

DISAPPROVAL

AIJNEX B

I FES PROCESSING

I QIY I I I D I


LICENSE - shy

I i

--r shy ---~-

- _shyi

i

-shy

i i I

--~--

-shy

_---shy

r----shy

I- shy

_- r shy -shy

j

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B



0 Manufacturer

Dealer

Purchaser

DATE


Quezon City





)

1_

KIND

__



I

r-shy

-

shy

I

~

1----

1 -shy -- I




ANNEX B

PROCESSING




i- shy

I

i------~---

i

Ifshy --shyi

----- I

f- shy

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B


PERSONAL DATA SHEET

2X2 PICTURE

I PERSONAL DATA



III FAMilY HISTORY



I I I I I I I l

NEMPlOYMENTRECORDS


information leavin


ANNEX B






SIGNATURE

RIGHT THUMBARK

ANNEX B






Sir



On Hand

infuIltcd

Total


PPEPI No

SoldUsed

Total

Balance


-




Purchasing Officer

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

ANNEX B

FEO PROCESSING



LICENSE (DATE) I BY

t---

i

~-

i

f--- shy

i

RECOMMEND

APPROVAL

DISAPPROVAL


RECOMMEND

APPROVED

DISAPPROVED


NatureLine of

ANNEX B



Manufacturer

o Dealer

Purchaser


Company Name

Office Storage

No Purposeuse

------~------





Indicate


RECOMMEND

APPROVAL

DISAPPROVAL

AIJNEX B

I FES PROCESSING

I QIY I I I D I


LICENSE - shy

I i

--r shy ---~-

- _shyi

i

-shy

i i I

--~--

-shy

_---shy

r----shy

I- shy

_- r shy -shy

j

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B



0 Manufacturer

Dealer

Purchaser

DATE


Quezon City





)

1_

KIND

__



I

r-shy

-

shy

I

~

1----

1 -shy -- I




ANNEX B

PROCESSING




i- shy

I

i------~---

i

Ifshy --shyi

----- I

f- shy

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B


PERSONAL DATA SHEET

2X2 PICTURE

I PERSONAL DATA



III FAMilY HISTORY



I I I I I I I l

NEMPlOYMENTRECORDS


information leavin


ANNEX B






SIGNATURE

RIGHT THUMBARK

ANNEX B






Sir



On Hand

infuIltcd

Total


PPEPI No

SoldUsed

Total

Balance


-




Purchasing Officer

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

NatureLine of

ANNEX B



Manufacturer

o Dealer

Purchaser


Company Name

Office Storage

No Purposeuse

------~------





Indicate


RECOMMEND

APPROVAL

DISAPPROVAL

AIJNEX B

I FES PROCESSING

I QIY I I I D I


LICENSE - shy

I i

--r shy ---~-

- _shyi

i

-shy

i i I

--~--

-shy

_---shy

r----shy

I- shy

_- r shy -shy

j

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B



0 Manufacturer

Dealer

Purchaser

DATE


Quezon City





)

1_

KIND

__



I

r-shy

-

shy

I

~

1----

1 -shy -- I




ANNEX B

PROCESSING




i- shy

I

i------~---

i

Ifshy --shyi

----- I

f- shy

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B


PERSONAL DATA SHEET

2X2 PICTURE

I PERSONAL DATA



III FAMilY HISTORY



I I I I I I I l

NEMPlOYMENTRECORDS


information leavin


ANNEX B






SIGNATURE

RIGHT THUMBARK

ANNEX B






Sir



On Hand

infuIltcd

Total


PPEPI No

SoldUsed

Total

Balance


-




Purchasing Officer

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

AIJNEX B

I FES PROCESSING

I QIY I I I D I


LICENSE - shy

I i

--r shy ---~-

- _shyi

i

-shy

i i I

--~--

-shy

_---shy

r----shy

I- shy

_- r shy -shy

j

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B



0 Manufacturer

Dealer

Purchaser

DATE


Quezon City





)

1_

KIND

__



I

r-shy

-

shy

I

~

1----

1 -shy -- I




ANNEX B

PROCESSING




i- shy

I

i------~---

i

Ifshy --shyi

----- I

f- shy

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B


PERSONAL DATA SHEET

2X2 PICTURE

I PERSONAL DATA



III FAMilY HISTORY



I I I I I I I l

NEMPlOYMENTRECORDS


information leavin


ANNEX B






SIGNATURE

RIGHT THUMBARK

ANNEX B






Sir



On Hand

infuIltcd

Total


PPEPI No

SoldUsed

Total

Balance


-




Purchasing Officer

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

ANNEX B



0 Manufacturer

Dealer

Purchaser

DATE


Quezon City





)

1_

KIND

__



I

r-shy

-

shy

I

~

1----

1 -shy -- I




ANNEX B

PROCESSING




i- shy

I

i------~---

i

Ifshy --shyi

----- I

f- shy

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B


PERSONAL DATA SHEET

2X2 PICTURE

I PERSONAL DATA



III FAMilY HISTORY



I I I I I I I l

NEMPlOYMENTRECORDS


information leavin


ANNEX B






SIGNATURE

RIGHT THUMBARK

ANNEX B






Sir



On Hand

infuIltcd

Total


PPEPI No

SoldUsed

Total

Balance


-




Purchasing Officer

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

ANNEX B

PROCESSING




i- shy

I

i------~---

i

Ifshy --shyi

----- I

f- shy

RECOMMEND

APPROVAL

DISAPPROVAL


APPROVED

DISAPPROVED


ANNEX B


PERSONAL DATA SHEET

2X2 PICTURE

I PERSONAL DATA



III FAMilY HISTORY



I I I I I I I l

NEMPlOYMENTRECORDS


information leavin


ANNEX B






SIGNATURE

RIGHT THUMBARK

ANNEX B






Sir



On Hand

infuIltcd

Total


PPEPI No

SoldUsed

Total

Balance


-




Purchasing Officer

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

ANNEX B


PERSONAL DATA SHEET

2X2 PICTURE

I PERSONAL DATA



III FAMilY HISTORY



I I I I I I I l

NEMPlOYMENTRECORDS


information leavin


ANNEX B






SIGNATURE

RIGHT THUMBARK

ANNEX B






Sir



On Hand

infuIltcd

Total


PPEPI No

SoldUsed

Total

Balance


-




Purchasing Officer

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

ANNEX B






SIGNATURE

RIGHT THUMBARK

ANNEX B






Sir



On Hand

infuIltcd

Total


PPEPI No

SoldUsed

Total

Balance


-




Purchasing Officer

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

ANNEX B






Sir



On Hand

infuIltcd

Total


PPEPI No

SoldUsed

Total

Balance


-




Purchasing Officer

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

-------------------









aUin





(a)


(e)




Name of C EMD

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

--------------------


Rank Designation









atin (address)



----------------~~--~----------------



Cal (bt


(cl







As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No




As of April 2016




















(date of issuance)

FEO



ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

ANNEX B

COMPANY

DECLARATION (EUD)


No Pack Size

DECLARATION

I

on behalf of









------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

------




with DECLARATION I

(Full Name)




Valid 10 No



DECLARATION I with




ANNEX B

Valid 10 No



with DECLARATION I

(Full Name)


--__--------------shy




name

Valid 10 No ___________



DECLARATION I with



--------





Valid No

--------





Valid No

Memorandum Circular No. 2016-025

Documents

Transcript of Memorandum Circular No. 2016-025