REPUBLIC OF THE PHILIPPINES

CITY GOVERNMENT OF MANILA

OFFICE OF THE MAYOR
BUREAU OF PERMITS

UNIFIED APPLICATION FORM FOR RENEWAL OF BUSINESS PERMIT (ONLINE)

Date of Receipt: 2022-01-14

NEW ✔ RENEWAL ADDITIONAL
Tracking Number:
PAYMENT: ANNUALLY BI-ANNUALLY QUARTERLY Business ID Number: 117-00-2015-0604079

IMPORTANT: Please ensure that all required fields (*) are properly filled out with complete information.

A. BUSINESS INFORMATION AND REGISTRATION

Please choose one *

✔ Sole Propreitorship One Person Corporation Partnership Corporation Cooperative

✔ Male Female Male Female

DTI/SEC/CDA Registration No. * 04561621 Tax Identification No. (TIN) * 717-674-810-000

Business Name * KARL & KYLLE STORE

Trade Name/Franchise (if applicable)

Business Address * 244 SANDICO ST., TONDO

House/Bldg. No. Name of Building Lot No. Block No. Street

Barangay 39 TONDO I / II NCR, CITY OF MANILA, FIRST DISTRICT 1010

Barangay Subdivision City/Municipality Province Zip Code

Telephone No * 023546945 Mobile No * 639120407473 Email Address * wcsenanin@yahoo.com

For Sole Proprietorship

Name of Owner * MARTINEZ NELON TESORO

Surname Given Name Middle Name Suffix

For Corporations/Cooperative/Partnerships

Name of President/Officer in Charge *

Surname Given Name Middle Name Suffix

For Corporation * Filipino Foreign

B. BUSINESS OPERATION

Business Area (in sq.m)/Total Floor Area (in sq.m) * 10.00

Total No. of Employees in Establishment * 2 Male 0 Female

No. of Employees residing within Manila * 2

No. of Delivery Vehicles (if applicable) 0 Van 0 Truck 0 Motorcycle

Main Office Address/Taxpayer's Address *

SANDICO ST 244
House/Bldg. No. Name of Building Lot No. Block No. Street

Barangay 39 TONDO I / II NCR, CITY OF MANILA, FIRST DISTRICT 1010

Barangay Subdivision City/Municipality Province Zip Code

Owned * Yes ✔ No

If Yes, Tax Declaration No./Property Identification No. *

If No, Lessor Name * Monthly Rental * 0.00

Do you have tax incentives from any Government Entity? * Yes (Pls attach a copy of your certificate) ✔ No

Business Activity (Pls check one) * Main Office Branch Office Admin Office Only

Warehouse ✔ Others (Pls specify)

Philippine Standard
Line of Business Products/Services No. of Units Last Year's Gross Sales
Industrial Code (If available)

SARI SARI STORE

I DECLARE UNDER PENALTY OF PERJURY that all information in this application are true and correct based on my personal

knowledge and submitted authentic documents online to the BUREAU OF PERMITS. Any false or misleading information supplied, or

production of fake/falsified documents shall be grounds for appropriate legal action against me and AUTOMATICALLY REVOKES THE

PERMIT. I hereby agree that all personal data (as defined under the Data Privacy Law of 2012 and its Implementing Rules and

Regulations) and account transaction information or records with the City/Municipal Government may be processed, profiled or shared to

requesting parties or for the purpose of any court, legal process, examination, inquiry and audit or investigation of any authority.

NELON TESORO MARTINEZ

SIGNATURE OF APPLICANT / OWNER OVER PRINTED NAME

DESIGNATION / POSITION / TITLE