SEC Forms

COVER SHEET
(Company's Full Name)
(Business Address No. Street City/Town/Province)
(Contact Person)
(Company Telephone Number)
Month
Day
(Form Type)
Month
Day
(Fiscal Year)
(Annual Meeting)
Total No. of Stockholders
(Secondary License Type, If Applicable)
-----------------------------------------------------------------------------To be accomplished by SEC Personnel concerned
File Number
LCU
Document ID
Cashier
. . . . . . . . . . . . . . . . . . . . . . .. .. . . . . : : : STAMPS : : : : . . . . . . . . . . . . . . . . . . . . .....:. . . . . . . . . . .
RDS 96-1DS
Page 1 of 3 REGISTRATION DATA SHEET CAPITAL STOCK/INCORPORATORS/DIRECTORS/OFFICERS INFORMATION

(FOR DOMESTIC STOCK CORPORATION ONLY)
SEC NUMBER
FILL UP INSTRUCTIONS:
COMPANY NAME
Type or print legibly. Light -shaded boxes are to be filled up by SEC, including the SEC number. For no-par stockds, leave the authorized capital amount and the par value columns blank.
COMPANY TIN
CAPITAL STRUCTURE
SHARE CODE SHARE TYPE AUTHORIZED PAR P/N VALUE NO. OF SHARES AMOUNT F/N SUBSCRIBED CAPITAL NO. OF AMOUNT SHARES PAID-UP AMOUNT PAID IN
PAID -UP CAPITAL BY ASSET TYPE
CASH
PROPERTY
OTHERS
TOTAL -
INCORPORATORS / STOCKHOLDERS / DIRECTORS / OFFICERS (Use additional sheets if necessary)

NAME (Company Name, if company) (Last Name, First Name, MI, Maiden Surname, if person) TAXPAYER IDENTIFICATION NUMBER BIRTH DATE CODE NATIONALITY BRD INC'R OFR SHARE CODE SHARE TYPE NO. OF SHARES SUBSCRIBED CAPITAL PAID-UP CAPITAL
SUB-TOTALS
Note: For codes to use in filling up the columns, refer to the last page of this form. Refer also to the back of this page for additional instructions.
RDS 96-1DS
Page 3 of 3 REGISTRATION DATA SHEET CAPITAL STOCK/INCORPORATORS/DIRECTORS/OFFICERS INFORMATION

(FOR DOMESTIC STOCK CORPORATION ONLY)
SEC NUMBER
FOR SEC TO PROVIDE: MAINTENANCE NO.:
TRANSACTION DATE
FILL UP INSTRUCTIONS:
COMPANY NAME
Type or print legibly. Light -shaded boxes are to be filled up by SEC, including the SEC number.
INCORPORATORS / STOCKHOLDERS / DIRECTORS / OFFICERS (Use additional sheets if necessary)

NAME (Company Name, if company) (Last Name, First Name, MI, Maiden Surname, if person) TAXPAYER IDENTIFICATION NUMBER CODE NATIONALITY BRD INC'R OFR SHARE CODE SHARE TYPE SUBSCRIBED CAPITAL PAID-UP CAPITAL
NO. OF DIRECTORS:
NO. OF STOCKHOLDERS:
TOTALS
FOREIGN EQUITY BREAKDOWN (Refer to the back of this page for instruction on how to fill-up this section.)
NATIONALITY CODE NATIONALITY DESCRIPTION SUBSCRIBED CAPITAL OF -INDIVIDUALS COMPANY (IES) PAID UP CAPITAL OF -INDIVIDUALS COMPANY (IES) TOTAL PAID-UP CAPITAL PERCENTAGE OF FOREIGN EQUITY CERTIFIED CORRECT: PROCESSING ATTORNEY: DATE REVIEWED:
INSTRUCTIONS FOR FILLING UP THE FOLLOWING COLUMNS: PAR/NO PAR (P / N) FILIPINO / FOREIGN VALUE INDICATOR (F/N) OWNED P - PAR INDICATOR -N - NO PAR F - FILIPINO N - NON-FILIPINO / FOREIGNER
TOTAL FOREIGN EQUITY
(Signature over printed name) PROCESSING EXAMINER: DATE REVIEWED:

WITH PAID-IN SURPLUS? Y - YES N - NO
POSITION: DATA CONTROL CLERK: DATE REVIEWED:

BOARD (BRD) INDICATOR -C - CHAIRMAN M - MEMBER N - NEITHER OFFICER (OFR) INDICATOR -PRE - PRESIDENT CEO - CHIEF EXECUTIVE OFFICER CFO - CHIEF FINANCIAL OFFICER COO - CHIEF OPERATING OFFICER COS - CORPORATE SECRETARY
DATE: DATA ENCODER: DATE ENCODED:

LEG - LEGAL COUNSEL AUD - EXTERNAL AUDITOR GOV - GOVERNMENT REPRESENTATIVE OTH - OTHERS N - NONE
REGISTRATION DATA SHEET GENERAL / BUSINESS / COMPANY RELATIONSHIP INFORMATION (FOR DOMESTIC COMPANIES ONLY)
SEC NUMBER FILL UP INSTRUCTIONS COMPANY NAME GENERAL INFORMATION Type or print legibly. Light-shaded boxes are to be filled up by the SEC. Check appropriate boxes. FILL UP ONLY THOSE ITEMS FOR WHICH AMENDMENTS OR CHANGES ARE TO BE MADE. Refer to the back of this page for additional instructions.
(
PRINCIPAL OFFICE ADDRESS AREA CODE BUSINESS OFFICE ADDRESS AREA CODE BUSINESS INFORMATION PARTNERSHIP [ [ INDUSTRY CODE ] LIMITED
) DS - DOMESTIC STOCK
POSTAL CODE
( )DN - DOMESTIC NON-STOCK

TEL. NO.
( ) DP - DOMESTIC PARTNERSHIP
CHANGE FROM STOCK TO NON
FAX NO.
POSTAL CODE
TEL. NO.
FAX NO.
TYPE OF ENTERPRISE
[ [ [
] ] ]
N- NO SPECIAL REGISTRATION E - FIA EXPORT D - FIA DOMESTIC

( ) F - FIXED (MM/DD)
[ [ [
] ] ]
H- FIA HOLDING R - FIA REPRESENTATIVE OFF S - SUBIC REGISTERED

[ ]
] GENERAL TERMS OF EXISTENCE YEARS
FISCAL YEAR END (MM/DD)
ANNUAL MEETING (For Domestic Companies only)
TYPE OF NON STOCK CORPORATION (Refer to the back of this page for the classification)
TOTAL CONTRIBUTION (of domestic non-stock companies)
% OF FOREIGN M
COMPANY RELATIONSHIP - List all companies related to the registrant. (Use additional sheets, if necessary) RELATIONSHIP TYPE (RELN TYPE) RELN TYPE C V - DISSOLVED COMPANY ( if due to consolidation) - DISSOLVED COMPANY ( if change in company type) SEC NUMBER TIN S - PARENT COMPANY (if registrant is a subsidiary) A - AFFILIATE (of registrant) COMPANY NAME
CERTIFIED CORRECT: PROCESSING ATTORNEY: DATE REVIEWED:
(Signature over printed name) PROCESSING EXAMINER: DATE REVIEWED:
POSITION: DATA CONTROL CLERK: DATE REVIEWED:
DATE:
CHANGE FROM STOCK TO NON ( ) YES
CHANGE IN PRIMARY
( )X YES
FAX NO.
FAX NO.
A HOLDING
[ [ [
] ] ]
F - FINANCIAL INSTITUTION Z - EPZA REGISTERED B - BOI REGISTERED
IA REPRESENTATIVE OFF
UBIC REGISTERED
TING (For Domestic Companies only) V - VARIABLE ____________________ % OF FOREIGN MEMBERSHIP (Of non-stock companies)
O - OTHERS
COMPANY NAME
DATE: DATA ENCODER: DATE ENCODED:

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COVER SHEET

(Company's Full Name)

(Business Address No. Street City/Town/Province)

(Company Telephone Number)

Total No. of Stockholders

(Secondary License Type, If Applicable)

-----------------------------------------------------------------------------To be accomplished by SEC Personnel concerned

Page 1 of 3 REGISTRATION DATA SHEET CAPITAL STOCK/INCORPORATORS/DIRECTORS/OFFICERS INFORMATION

PAID -UP CAPITAL BY ASSET TYPE

INCORPORATORS / STOCKHOLDERS / DIRECTORS / OFFICERS (Use additional sheets if necessary)

Page 3 of 3 REGISTRATION DATA SHEET CAPITAL STOCK/INCORPORATORS/DIRECTORS/OFFICERS INFORMATION

FOR SEC TO PROVIDE: MAINTENANCE NO.:

INCORPORATORS / STOCKHOLDERS / DIRECTORS / OFFICERS (Use additional sheets if necessary)

TOTAL FOREIGN EQUITY

(Signature over printed name) PROCESSING EXAMINER: DATE REVIEWED:

POSITION: DATA CONTROL CLERK: DATE REVIEWED:

DATE: DATA ENCODER: DATE ENCODED:

( )DN - DOMESTIC NON-STOCK

CHANGE FROM STOCK TO NON

N- NO SPECIAL REGISTRATION E - FIA EXPORT D - FIA DOMESTIC

H- FIA HOLDING R - FIA REPRESENTATIVE OFF S - SUBIC REGISTERED

] GENERAL TERMS OF EXISTENCE YEARS

FISCAL YEAR END (MM/DD)

ANNUAL MEETING (For Domestic Companies only)

TOTAL CONTRIBUTION (of domestic non-stock companies)

CERTIFIED CORRECT: PROCESSING ATTORNEY: DATE REVIEWED:

(Signature over printed name) PROCESSING EXAMINER: DATE REVIEWED:

POSITION: DATA CONTROL CLERK: DATE REVIEWED:

CHANGE FROM STOCK TO NON ( ) YES

F - FINANCIAL INSTITUTION Z - EPZA REGISTERED B - BOI REGISTERED

DATE: DATA ENCODER: DATE ENCODED:

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