Republic of the Philippines

P ro v in ce O f Lagu na
C ITY OF CA LA MB A
The Premiere City of Growth, Leisure and National Pride

GENERAL INSTRUCTIONS:
1. For NEW BUSINESS, please fill-out Sections A-C.
2. For RENEWAL and RETIRING BUSINESSES, Kindly fill-up Section C.
3. For AMENDMENT of Business Data, fill-up amendment Section and applicable fields for revision.

UNIFIED APPLICATION FORM FOR BUSINESS PERMIT

TRANSACTION TYPE: FORM OF OWNERSHIP: MODE OF PAYMENT: DATE OF APPLICATION:
NEW SINGLE PROPRIETORSHIP ANNUALLY TRANSACTION NUMBER:
RENEWAL PARTNERSHIP SEMI-ANNUALLY BUSINESS PLATE NUMBER:
AMENDMENT CORPORATION QUARTERLY
BUSINESS ACCOUNT NUMBER (BAN)
FULL RETIREMENT ONE-PERSON CORPORATION PAYMENT OPTIONS:
PARTIAL RETIREMENT COOPERATIVE CASH
ASSOCIATION/ FOUNDATION CHEQUE
ONLINE PAYMENT
AMENDMENT/S: (If there are any changes or amendments from the previous business registration, please check the box/es and attach copies of supporting documents.)
Ownership Form of Ownership Business Name Business Address Nature of Business Additional Line

FROM TO

A. BUSINESS INFORMATION AND REGISTRATION

Do you have tax incentives from any Government Entity? Yes (Please specify the entity and attach a copy of your certificate)
DTI /SEC/CDA Registration No. PEZA /BOI Registration No. Tax Identification Number (TIN)
DTI /SEC/CDA Registration Date PEZA /BOI Registration Date BIR Certificate Registration No.
Business Name:

Trade Name / Franchise (If applicable):

Name of Taxpayer: Name of President / Officer in Charge:
(for Sole Proprietorship only) (for Corporation, OPC, Partnership, Association & Cooperatives only)
LAST NAME LAST NAME
FIRST NAME FIRST NAME
MIDDLE NAME SUFFIX MIDDLE NAME SUFFIX

GENDER Male Female EMAIL ADDRESS GENDER Male Female EMAIL ADDRESS

MOBILE NO. TELEPHONE NO. MOBILE NO. TELEPHONE NO.

House / Building / Block & Lot No. Street / Subdivision / Village House / Building /Block& Lot No. Street / Subdivision / Village
OWNER’S MAIN
RESIDENTIAL Barangay City / Municipality Province Zip Code
OFFICE Barangay City / Municipality Province Zip Code
ADDRESS ADDRESS

B. BUSINESS OPERATION
Total Floor Area House No. / Bldg. No / Blk & Lot No. Name of Building / Street Name / Purok
BUSINESS ADDRESS
(in square meters)
Area intended for Subdivision / Village Name Barangay
MAIN BRANCH
Business (in sqm.)
Male Female Total
Total Number YES
Is the place OWNED? NO Property Identification Number (PIN)
of Employees
Total Number of Employees If leased,
Lessor’s Address
Residing within the LGU Lessor’s Full Name:
Van Truck Motorcycle WEBSITE please indicate site below Social Media Account/s: please indicate below
No. of Delivery
Marketing Platform
Vehicles

C. DECLARATIONS
TOTAL CAPITAL INVESTMENT (Please attach Declared Total Capital Investment which includes Net working Capital + PP&E + Goodwill & Intangibles)
No. of CAPITALIZATION / CURRENT GROSS SALES/ RECEIPTS
NATURE/ LINE OF BUSINESS PRODUCTS/ SERVICES PSIC Code
Units PREVIOUS GROSS SALES RECEIPTS Essential Non-Essential

DEED OF UNDERTAKING/ WAIVER

I, ________________________________________, of legal age, and business registrant of Calamba City, undertake to comply with all statutory and regulatory requirements necessary to my
license/permit application both on prerequisite and post-inspection bases. I hereby authorize access to the premises of my establishment for city inspector/s to conduct the incidental/mandatory
ocular inspection pursuant to law/ordinance.
Likewise, I declare under penalty of perjury, that all information declared in this application are true and correct to the best of my personal knowledge and hereby attest to the authenticity of all the
attached documents. I also acknowledge that all personal data and account transaction information records with the City Government of Calamba may be processed, profiled or shared to requesting
parties or for the purpose of any court, legal process examination/inquiry/investigation of any legal authority consistent and within the limits of the provisions of Data Privacy Act of 2012 and its
Implementing Rules and Regulations.

Accordingly, I hereby recognize the right of the City Government of Calamba to issue suspension or revocation of my permit/license or execute foreclosure after due process in case of non-
compliance on my part of any requirement, refusal to be inspected, and violation of pertinent law or any of the terms and conditions of my permit/license.

SIGNATURE OF APPLICANT/ OWNER OVER PRINTED NAME

DESIGNATION/ POSITION/ TITLE

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UAFberna2025 BPT-001-0124 Rev 5
APPROPRIATE DEPARTMENT SHALL FILL-UP THIS SECTION

TAXPAYER’S NAME Date of Application (MM/DD/YYYY)

BUSINESS NAME Business Account Number (BAN)

1. VERIFICATION OF DOCUMENTS: NEW RENEWAL WITH POSITIVE FINDINGS __________________________________

COMPLIANCE
DESCRIPTION OFFICE/AGENCY Remarks Evaluated by
Y N NR

Assessment of Application and Business Permits and Tricycle

requirements Franchising Office

Verification of Business Record City Treasury Management Office

Zoning Clearance
City Planning and Development
Zoning Ordinance (When Applicable) Office

Occupancy Permit
Mechanical Building Regulatory Services Office
Electrical

Validation of the Proof of Ownership or

City Assessor’s Office
Authority to Use

Sanitary Permit/ Health Clearance City Health Department

City Environment and Natural

City Environment Certificate
Resources Office

Security & Traffic Clearance Public Order and Safety Office

Cultural Affairs, Tourism and Sports

Department of Tourism Accreditation
Development Office

Valid Fire Safety Inspection Certificate Bureau of Fire Protection

* NR – Not Required

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