Registry Of Establishments - Republic Of The Philippines

DOLE‐BWC‐IP‐3   

 

 

 

 

 

 

 

 

Series of ___________ 

Republic of the Philippines

 

 

 

 

 

 

 

 

 

 

 

Application No. ______ 

DEPARTMENT OF LABOR AND EMPLOYMENT 

 

National Capital Region 

 

 

 

 

Registry of Establishments 

 

 

1a. Business Name: ________________________________________________________    EIN   

1b. Registered Name: ______________________________________________________ 

1c. Tax Identification Number (TIN): ___________________________________________ 

 

 

 

2. Address: _________________________________________________________________ 

                           

 

Floor/Bldg. No./Street/Subdivision               Brgy./City/Municipality                      Province                   Zip Code                                              GEO CODE

 

3. Telephone No. 

4. Fax No. 

5. E‐mail Address: 

6. Name of Manager/Owner 

 

7. Main Economic Activity: ____________________________________________________                 PSIC 

     Major Products/Goods or Services: ___________________________________________                 Code 

 

8. Legal Org

anization (Check Appropriate Box) 

9. Economi

c Organization (Check Appropriate Box)

                    

                

 

 

                     Single Proprietorship 

                     Single Establishment 

                     Partnership 

                     Branch Only 

                     Government Corporation 

                     Establishment and main office 

                     Private Corporation 

                     Main Office only 

                     Others. Specify _________________________ 

                     Ancillary unit (except main office) 

 

 

10. Total Employment: _________                                            Regular: ____________                      Non‐Regular: _________ 

                        Male: ____________            Alien Workers: ______________        Minors: Below 15 years old: ___________ 

                        Female: __________                                                                                           16 ‐ below   18 years old: ________ 

 

 

11. Total Number of Subcontractors: ____________________ 

12. Total Number of Subcontracted Employees: 

___________ 

 

13. Technical Information (Check and enumerate as possible)

                      Machinery, Equipment and Other Devices in Use 

 

                                 Circular saw           Machine Drill Press              Boiler          Pressure Vessel           Internal Combustion Engine 

 

                                       Engine Diesel                       Gasoline                                        Others, specify _______________________ 

                      Materials Handling Equipment 

 

                         

     Power Trucks             Hand Trucks             Conveyors             Forklift            Cranes          Others, specify _______ 

                         

 

                      Chemical or Substances Used or Handled: ___________________________________ 

 

For Updating purposes, accomplish also: 

14. If name of Establishment has been changed, state former name: _____________________________________________

15. If location of Establishment has been changed, state former address: __________________________________________

                        

                      _______________________________________________________________                                   

 

 

                            Floor/Bldg. No./Street/Subdivision           Brgy./City/Municipality            Province             Zip Code                                     GEO CODE

 

CERTIFICATION

 

This is to certify as to the accuracy of the data provided in this form: 

Name/Signature of Person Accomplishing the Form:

Position: 

Fax No.:

Telephone No.: 

E‐mail Address:

 

 

Date Filed: ____________________ 

Date Approved: ____________ 

Approved by: