DTI Application Form

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ILOCOS SUR PROVINCIAL OFFICE

Judy Chiu Bldg., Mabini St.,


Barangay I, Vigan City, Ilocos Sur

SALES PROMOTION PERMIT APPLICATION FORM

__________________________
(Date)

_________________________________________
(PROMO TITLE)

( ) 1. NAME OF SPONSOR: __________________________________________________________

 ADDRESS: ____________________________________________________________
 TELEPHONE NO.: ______________________________________________________
 AUTHORIZED REPRESENTATIVE: ________________________________________
 DESIGNATION: ________________________________________________________

( ) 2. NAME OF ADVERTISING AGENCY: _______________________________________________

 ADDRESS: ___________________________________________________________
 TELEPHONE NO.: _____________________________________________________
 AUTHORIZED REPRESENTATIVE:________________________________________
 DESIGNATION ________________________________________________________

( ) 3. PROMO PERIOD: _____________________________________________________________

( ) 4. TYPE OF PROMO: (Please check inclusive types within a multi-scheme sales promo application)
DISCOUNT PREMIUM RAFFLE GAMES CONTEST REDEMPTION

( ) 5. COVERAGE: NCR NATIONWIDE OTHERS (specify)


_____________________________________________________________________________
_____________________________________________________________________________

( ) 6. PARTICIPATING ESTABLISHMENT/S:_______________________________________________
_______________________________________________
_______________________________________________
( ) 7. PRODUCTS COVERED:
BRAND SIZES (in metric, enclose English size in parenthesis)
_________________________ _____________________________________________
_________________________ ______________________________________________
_________________________ ______________________________________________
_________________________ ______________________________________________

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( ) 8. ATTACHMENTS: (Basic Sales Promo Permit Application Requirement)

( ) A. COMPLETE MECHANICS
( ) B. REGISTRATION REQUIREMENTS: Certificate of registration for specific products as maybe
covered by the sales promotion application, Business registration documents (for first time
sponsor applicants)
( ) C. AGREEMENT OF PARTICIPATING OUTLETS AND SPONSORS (for joint sponsorships)
( ) D. LEGAL DOCUMENTS OF HIGH–VALUED PRIZES/GIVEAWAYS: As may be required such
as for house and lot (title, blueprint, specifications, model, location plan, cost and area of the
house and lot) or jewelry (certificate of appraisal signed by a legitimate appraiser)
( ) E. MEDIA UTILIZED: (Please check appropriate medium used and submit required attachment)

( ) RADIO AD (Audio Script)


( ) TV/CINEMA AD (Story board)
( ) WEB-BASED ADS (Screenshots of online ads)
( ) EMAIL-BASED ADS (Email transcript)
( ) TEXT-BASED ADS (Text transcript/Spiel)
( ) POSTER (Layout of Artwork)
( ) STREAMER Layout of Artwork)
( ) PRINT AD (compre)
( ) MAILERS (compre)
( ) FLYERS (compre)
( ) OTHERS:__________________________________

 At least one advertising material shall contain the complete mechanics, duration,
coverage and clause “Per DTI-(office) Permit # ____, series of ____”.
 All other Ad materials with incomplete mechanics shall indicate - “See/visit _________
for complete details”, “promo duration”, and “Per DTI-(office)Permit # ____ Series of
____” at the bottom right of the page.

( ) F. OTHERS: (Please refer to list of requirements per scheme)

UNDERTAKING
I/We hereby understand and agree that:

1. DTI-(name of office/agency shall act on this application within fifteen (15) days from
receipt of complete documents.
2. If I/We do not receive any communication from DTI-(name of office/agency) after
submission of complete documents/requirements within the prescribed fifteen (15) days,
the above application shall be deemed approved. However, such presumption of approval
shall not absolve us from violations other than our lack of permit from your Office.

Authorized Representative of:

SPONSOR ADVERTISING AGENCY

__________________________________ __________________________________
SIGNATURE SIGNATURE

__________________________________ __________________________________
PRINTED NAME PRINTED NAME

_________________________________ ______________________________
DATE DATE

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