,

S.E.C. FORM NO. F-I04For Representative Officeof a Foreign Corporation

APPLICATION OF A FOREIGN CORPORATION TO ESTABLISH AREPRESENTATIVE OFFICE IN THE PHILIPPINES

(Name of Corporation)

here by applies for a license to transact business in the Philippinesas a representative office under Section 125 of Batas PambansaBIg. 68 and Foreign Investments Act of 1991 (RA 7042, asamended), and submits the following statements andaccompanying documents:

1. The applicant is a corporation formed and organized underthe laws of on for a term of

2. The location of its principal office is at _

(complete address on home country)

3. _________ with(Nationality)(Name of Resident Agent)

residence or office address at -----------------is its resident agent in the

Philippines, authorized to accept summons and legal processes inall legal proceedings, and all notices affecting the corporation.

4. The corporation shall hold office in __________ and operate in _

(Specify place in the Philippines)

5. The purpose(s) of said corporation which it intends topursue in the transaction of its business in the Philippines is / are

(Please use additional sheet if necessary)

,

6. The names and addresses of the present directors andofficers of the corporation are as follows:

NAME ADDRESSES

7. The authorized capital stock of the corporation isroughly equivalent to

P and the aggregate number of shareswhich the corporation has authority to issue is

(Itemized by classes & series, if any)

8. The outstanding capital stock of the corporation isand the

aggregate number of shares which the corporation has issued is__________ (itemized by classes & series, if any) all of which areof a par value of _

9. The amount actually paid In the treasury of the foreigncorporation is _

10. That we hereby authorize the Securities and ExchangeCommission and the Bangko Sentral ng Pilipinas to examine andverify the deposit in the in the

of said corporation in the(Name of Bank)

amount of which is equivalent to(P ) at the current

rate of exchange, representing the actual remittance of theapplicant. This authority is valid and inspection of said depositmay be made even after the issuance of the license of the company.

11. That we undertake to change our corporate name asherein provided, or as amended thereafter, immediately uponreceipt of notice or directive from the Commission that another

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corporation, partnership or person has acquired a prior right to theuse of that name or that the name has been declared misleading,deceptive, confusingly, similar to a registered name, or contrary topublic morals, good custom or public policy.

Done this __ day of ,201_ at _

(Signature over printed name of the resident agent)

SUBSCRIBED AND SWORN TO____ ,200_ affiant exhibiting toCertificate No issued

before me,me his/herat

this __ day ofCommunity Tax

on

Doc. No.Page No.Book No.Series of 200 _

NOTARYPUBLIC

NOTE:• All documents executed abroad should be authenticated by the Philippine

Embassy or Consulate in the country where executed.• Submit six (6) copies• List of Requirements:

1) Application Form2) Name Verification Slip3) Certified copy of Board Resolution authorizing the establishment of an office in the

Philippines; designating the resident agent to whom summons and other legal processesmay be served in behalf of the foreign corporation; and stipulating that in the absence ofsuch agent or upon cessation of its business in the Philippines, may be served to SEC anysummons or legal processes as if the same is made upon the corporation at its homeoffice.

4) Financial statements for the immediate preceding year at the time of filing of theapplication, certified by an independent Certified Public Accountant of the home office(audited) and authenticated before the Philippine consulate/embassy.

5) Certified copies of the Articles of Incorporation/Partnership with an English translationthereof if in a foreign language.

6) Proof of inward remittance such as bank certificate of inward remittance in the amount ofUS$30,OOO.OO

7) Resident Agent's Acceptance ofAppointment ( not necessary if agent is the signatory in theapplication form)

8) Affidavit executed by the President or Resident Agent stating that the applicant is solventand in sound financial condition.

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