Form No. T-RD-APP-01

Republic of the PhilippinesTOURISM INFRASTRUCTURE AND ENTERPRISE ZONE AUTHORITY

Tourism Enterprise Zone Management SectorMAKATI

APPLICATION FORM(DESIGNATION OF TOURISM ENTERPRISE ZONE)

Instructions: This application together with the required supporting documents must be submitted in six (6) sets of hard copies and six (6) sets of soft copies to TEZ Regulation Department subject to the payment of application fee.

FOR TIEZA USE ONLYApplication No.Date FiledApplication Fee: PhPO.R. Number Date of Payment

I. PROPONENT’S INFORMATION Name of Proponent/ ApplicantAddressTINAuthorized RepresentativePositionEmail Address Telephone NoWebsite Fax NoII. SEC REGISTRATION / ARTICLES OF INCORPORATIONSEC Registration No. Primary Purpose (per Articles of Incorporation/Partnership)Year RegisteredAuthorized CapitalizationSubscribed CapitalPaid-Up CapitalIII. PROPONENT’S PARENT COMPANY (if any)Company NameOffice address

TOURISM ESTATE MANAGEMENT FACILITY AND SERVICES (TEMFS) / TEZ OPERATOR/DEVELOPERCompany NameOffice Address

IV. EXISTING BUSINESS REGISTRATION WITH OTHER GOVERNMENT AGENCIES (if any)Office Registration No. Date Registered

Securities and Exchange CommissionBoard of InvestmentsOthers, please specify

V. PROJECT DETAILSProposed Zone NameZone AddressArea ( in square meters) Cost of Land PhPTotal Project Cost PhP US$ (Foreign exchange as of date of application)

ZONE CLASSIFICATION(for mixed use, check all that applies)

ZONE STATUS PURPOSE OF APPLICATION

Cultural and HeritageHealth and WellnessEco-tourismGeneral LeisureMixed-use

Greenfield

Brownfield

New

Expansion of existing TEZ

Note: The TEZ Operator / Developer shall be registered as a Tourism Enterprise (TEMFS) which may avail of incentives under the Tourism Act of 2009 or R.A. 9593.

CHECKLIST OF DOCUMENTARY REQUIREMENTSUPON APPLICATION DOCUMENTS PRO-FORMA NUMBER OF COPIES

1. Duly Accomplished TIEZA Application Form ✔ Six (6) ring-bind copies in A4 paper and Six (6) electronic copies (CD/USB)

2. Project Brief ✔3. SEC Certificate of Registration, Articles of Incorporation and

By-Laws, General Information Sheet (3 years prior to application)

4. Board Resolution or Secretary’s Certificate authorizing the filing and designation and submission of name of a representative

Letter of Authority from Head of National Agency or Local Chief Executive authorizing the filing and designation and submission of name of a representative (In the case of National Government Agency or Local Government Unit applicants)

✔

5. Anti-Graft Certificate pursuant to R.A. 3019 ✔6. Company Profile of the proponent containing basic

data/information on its technical, financial, marketing and management capability to undertake the proposed project; track record of the company or consortium

7. List of directors, principal officers, and major stockholders, including respective bio-data

8. Proof of land ownership and/or Long-Term Lease Agreement(s) for a period of not less than 25 years on the entire area of the proposed TEZ and other documents evidencing development right

9. Vicinity map reflecting various land uses, important verifiable landmarks within the five (5) kilometers radius of the project site

10. Certification from the LGU of the current land use of the proposed area for TEZ under the approved CLUP and Zoning map with the proposed TEZ clearly identified

11. Endorsement letter from the National Historical Institute (NHI) in the case of Cultural and Heritage TEZ, from the Department of Health (DOH) in the case of Health and Wellness TEZ or from the Philippine Retirement Authority in the case of retirement villages/communities(Proponent may submit Memorandum Circular, instructions or affidavit of undertaking if the project is not yet existing)

PRIOR TO DESIGNATION DOCUMENTSUpon receipt of the Notice to Proceed, kindly submit the documents listed below in the following formats specified:

1. Development Plan (Development Plan Components) ✔ Six (6) ring-bind copies in A4 paper and six (6) electronic copies (CD/USB)

2. Resolution of the concerned LGU approving the development plan and endorsing the application for designation of the proposed TEZ

3. Verified survey return and the consolidated technical descriptions of the land area of the proposed TEZ (contiguous)

4. Environmental Compliance Certificate issued by the Department of Environment and Natural Resources (DENR) (for pending application: submit copy of the stamped received application form and necessary attachments)

5. Audited Financial statements for three (3) years for existing companies

6. Filled-out Cost-Benefit Analysis (CBA) Form 7. DAR Conversion Order of the proposed TEZ from agriculture

to non-agriculture purpose or HLURB Certificate of land use

8. Other requirements as may be prescribed by the TIEZA Board

APPLICANT’S NOTARIZED UNDERTAKING

In applying for TIEZA registration, the Applicant herewith makes the following undertaking:

1. That Applicant will operate on a sound and efficient basis and contribute to the objectives of the TEZ and to the development of the national economy in general;

2. That Applicant is economically, technically, and financially sound;

3. That Applicant will engage in good faith in creating a market for its products and services.

4. That Applicant will install an accounting system and submit separate books of accounts adequate to identify the investments, revenues, costs and profits or losses of the project, tourism enterprises or activities covered by this application;

5. That Applicant shall submit periodic reports and other information that the Authority may require on its activities;

6. That Applicant has read Republic Act 9593 and its Implementing Rules and Regulations, and commits to abide by the provisions thereof and amendments thereto;

7. That Applicant shall start and operate the project covered by this application upon approval of the development plan by the TIEZA Board;

8. That, pursuant to the provisions of Sec. 3 and Sec. 14 of R.A. 3019 (Anti-Graft and Corrupt Practices Act), the Applicant has not given or promised to give and will not give any gift or considerations to any TIEZA officer or employee in connection with the filing and processing of this application;

9. That no Board member or TIEZA official has an investment or any other financial interest, direct or indirect, in the applicant’s enterprise;

10. That there exists no dummy relationship between the stockholders and/or principal officers of the Applicant and any foreign individuals/business entity;

11. That the Applicant attests to and warrants the veracity, genuineness and authenticity of the documents submitted for purposes of its application for designation of tourism enterprise zone; and

12. That the Applicant commits to the faithful implementation of its development plan as approved by the TIEZA Board.

Done in the City/Province of __________________________________ this ______________ day of _____________________, 20 _________________________

________________________ Affiant

________________________ Designation

Republic of the Philippines )City/Province of ) S.S.

Subscribed and sworn to before me this ________________ day of ________, 20_____ in the City/Province of ________________________. Affiant exhibited to me his Residence Tax Certificate No. A. ___________________ issued at __________________, on _______, 20____.

________________________ Notary Public

Until December 31, 20 ____

Doc. No. __________Page No. __________Book No. __________Series of 20 ________

PROJECT BRIEF OUTLINE (Pro-forma)I. OVERVIEW OF THE PROPOSED TEZ

1. Tourism potential or touristic value of the TEZ in compliance with Sections 2, 3 and 4 of the TIEZA Guidelines for the designation and supervision of the Tourism Enterprise Zones

2. PROJECT LOCATION AND AREA2.1.Total area to be developed (in sq. m.)2.2.Access to Project Site / Location Map including directions going to the proposed TEZ2.3.Maps

Vicinity map reflecting existing land use (Zoning Map) Map showing important verifiable landmarks and tourism developments within 5km-radius of

project site including transportation and utilities infrastructure Site development plan

II. PROJECT PLAN AND COMPONENTS

1. Brief description of the overall design theme2. Leisure/recreational facilities properly labeled and identified as existing/to be developed within the

proposed TEZ3. Brief description of proposed infrastructure including utilities by TEZ proponent 4. Market Study which includes brief description of:

3.1.Relevant market trends3.2.Proposed market/promotion strategies 3.3.Carrying capacity of the proposed TEZ

5. Summary of potential economic impacts6. Proposed investments by TEZ locators7. Description of initiatives taken to involve stakeholders

III. CONTROL ON THE PROPOSED TEZ

Discussion on the proponent’s right to use, develop and manage the site into a TEZ

IV. SERVICES AND MANPOWER REQUIREMENT

Construction Phase (Direct and Indirect) Operational Phase (Direct and Indirect)

Kindly state the projected number of employees at the start of operation up to the next six (6) years. Indicate also which years correspond to Year 1, Year 2, Year 3 and the like (e.g. Year 1- 2013; Year 2-2014; and so on.)

V. PROJECT COST

Estimated Amount of Investment(This already includes the development cost of both the TEZ and the RTEs within the said TEZ. Acquisition cost of land, however, should not be included in this development cost.)

PhP $

Horizontal Development Cost of the Tourism Estate Manager(Horizontal development pertains to the basic infrastructure utilities and facilities that the tourism estate manager should set up to make the TEZ ready for immediate use and occupancy by prospective investor enterprises. This includes but is not limited to earthworks, base preparation, internal road network, curbs and gutter, sidewalk, drainage system, water distribution system, sewer system, STP, electrical system, common parking, landscaping, streetlights, street furniture, signage, and fences.)

PhP $

RTE 1 PhP $RTE 2 PhP $RTE 3 PhP $RTE 4 PhP $RTE 5 PhP $

Total PhP

* You may use a separate sheet for additional RTEs.

Possible sources of financing of the Tourism Estate Manager for the development of the zone

Sources AmountEquityLoansOthersTOTAL

VI. PROJECT DURATION AND SCHEDULE

Construction and Development Phase Timetable of the proposed and existing tourism enterprises (indicate 1. Date of Start of Construction, 2. Date of Completion, and 3. Date of Full Commercial Operation)

ANTI-GRAFT CERTIFICATE

I, ____________________________________, of legal age, President/General Manager/Chief Executive Officer of _______________________________________________with postal address at _____________________________________________________________________, swearing under oath, hereby depose and state:

That pursuant to the provisions of Section 3 and 14 of R.A. 3019 (Anti-Graft and Corrupt Practices Act), the applicant enterprise, ______________________________________________ has not given or promised to give, and will not give any gift to any officer/employee of the TIEZA in connection with the filing and processing of this application, nor will it give such gift to any of said officers or employees after approval of its application

That based on the records of the applicant, no Board Member or Officer of the TIEZA has an investment or other financial interest, direct or indirect, in the applicant.

________________________ Affiant

Subscribed and sworn to before me this _________ day of __________, 20_____ in the City/Province of __________________________. Affiant exhibited to me his Driver’s License/Passport ID No. A. _________________, issued at _________________, on _____________ 20 _________.

________________________ Notary Public Until December 31, 20 _____

Doc. No. ___________Page No. ___________Book No. ___________Series of 20 _________

SECRETARY‘S CERTIFICATE

I, _____________________, of legal age, Filipino, with business address at ________________, swearing under oath, hereby depose and state:

That I am the duly elected Corporate Secretary of _______________________________ __________ (the “Applicant-Company”), a domestic corporation duly organized and existing under the laws of the Republic of the Philippines with principal office at ________________________________; and

That at a duly convened meeting of the Board of Directors of the Applicant Company held on _______________________, the following resolutions were unanimously approved:

“Whereas the Company wishes to apply for the designation / registration of its _______________________ Project with the Tourism Infrastructure and Enterprise Zone Authority (“TIEZA”);

“Now, therefore, be it resolved, as it is hereby resolved, that, the Board authorize the Company to proceed with its application for the registration of its ___________________ Project with TIEZA; and

“Resolved, further, as it is hereby resolved, that the Board authorizes the Company’s ___________________ to be designated representative of the Company in all dealings (Position & Name) and transactions with TIEZA in relation to the designation / registration of the Company’s _______________ Project with the TIEZA.”

That the foregoing is a true and correct copy of the resolution appearing in the minutes of the Applicant-Company and is, as of this date, in full force and effect.

In witness whereof, I have hereunto set my hand at ______________ this ______ day of _________ 20 ______.

_____________________________ Corporate Secretary

SUBSCRIBED AND SWORN to before me this ________ day of ________ 20 ___. Affiant exhibited to me his Driver’s License/Passport ID No. ________ issued at _______ on _________________, 20 ____.

Notary Public Until December 31, 20 ____

Doc. No. __________Page No. __________Book No. _________Series of__________

DEVELOPMENT PLAN COMPONENTS (Pro-forma)

The Comprehensive Development Plan of a TEZ must take into account the priorities and policies of the National Government and fall within the parameters of the programs established by the National Tourism Development Plan as well as by the Department of Tourism or Provincial/Municipal Development Plans, and it must contain at least:

I. Executive Summary1.1. Brief Description of the project;1.2. Goals and Objectives;1.3. Estimated value of investment for the development of the proposed TEZ (excluding the cost of

land);1.4. Location and property description of the proposed TEZ1.5. Estimated job generation;1.6. Sources of Financing (equity, loans and others);1.7. Size of the Area being applied as TEZ (the size of the area should be consistent with the Proof of

Ownership that the applicant will provide as well as the coverage of the Environmental Compliance Certificate or ECC)

II. Components

2.1. Company profile of the proponent/applicant intending to acquire TEZ status:

2.2. Situational Analysis: Tourism attractions/resources and focal points Market trends (Present visitation behavior (in terms of initial arrival, average, length of stay,

type of tourist (domestic/international/same day) Tourism resources/attractions and critical areas within and near the proposed TEZ Existing hospitality/travel services (amenities, accommodation) Present perception/image of destination Tourism branding of the host location

2.2.4. TEZ Development Framework

Physical Developmenta. Vision for the TEZ developmentb. Strategic factors that will ensure project success

Control authorities: for administrative offices, production, and service facilities/ utilities (for the operation of the TEZ)

Proposed investments within the TEZ by the developer/operator and identified partner locatorsa. Tourism enterprises/ locators b. Service facilities/utilitiesc. Internal circulation roads and open spaces/ green areas/ parksd. Land set aside for residential, institutional, and other non-tourism related land uses

Detailed design plans, and civil and architectural plans in the TEZ

Timetable of Development Unless a different period is required and duly approved by the Board, the development of the whole TEZ must be completed within a maximum period of five (5) years:

Horizontal Development Phase and Amount of Investment per Phase

Schedule of Developmen

t

Percent Completion of

the Development

Estimated Amount of Investment per Phase

Activities Involved(e.g. construction of the hotel, fencing, earthworks)

Phase I 30%Phase II 30%Phase III 20%Phase IV 10%Phase V 10%

* Indicate only the relevant horizontal development per phase. No need to provide for the entire five phases if the horizontal development can be completed before that.

Compliance with Development StandardsIn order to determine whether the project is technically viable, the study must include discussions on the following in compliance with the relevant rules and regulations pertaining to tourism developments (e.g. National Building Code, EIS, PD135, etc..):o Infrastructure requirementso Setback requirementso Sewerage disposal systemo Surface water disposalo Safety and securityo Site coverage densityo Landscapingo Visual securityo Roadso Vehicle parkingo Waste water treatmento Ventilation requirements

2.2.5. Ecological and Environmental Plans Energy efficiency and climate change mitigation Conservation and similar sustainable development initiatives by TEZ proponent Studies undertaken to establish carrying capacity in TEZ Key administrative mechanisms to mitigate negative effects Disaster risk reduction mitigation measures

2.2.6. Competitiveness and Financial SustainabilityDetailed discussion on: Key information from financial plan (e.g. NPV, IRR) on TEZ developments Capacity to enhance current and/or future visitor experience and satisfaction in the are Financial sustainability of zone operator Operational feasibility of activities proposed by zone operator Extent of utilization of the public-private partnership as a strategy

2.2.7. Economic Consideration Summary of potential economic impacts of developing TEZ Financial projections for the next 10 years (Annual net income and net profit margin) CBA discounting period Discount rate used Year used as reference to compute Present Values Key assumptions and considerations in CBA Firm level benefits Benefits to society; Direct effects Total Benefits to society Estimated forgone National Government revenue Projection of regional and national economic indicators relevant to the project; Estimated market demand; Production and sales forecast both in the domestic and foreign markets;

Expected impact on the present tourism market Potential contribution to local economic development Services and Manpower Requirement: number of jobs that the investor plans to generate

during each stage of the project

DIRECT INDIRECT/ OUTSOURCEDConstruction PhaseOperations PhaseYear:123456

2.2.8. Cultural Consideration The proposed project must be such that it respects the local culture, generate

employment and boosts the people’s sense of cultural and national pride Social aspects of the project. Initiatives to recognize and respect local culture and Indigenous People’s rights;

2.2.9. Community and Stakeholder Acceptability Identification of future consequences of the tourism development plan related to

individuals, community organizations, and social macro-systems; Suggested mechanisms to mitigate negative socio-cultural impacts; Corporate Social Responsibility efforts.

2.2.10. Marketing / Promotion Plan and Strategies