SEC Forms

COVER SHEET

(Company's Full Name)

(Business Address No. Street City/Town/Province)

(Contact Person)

Month

(Company Telephone Number)

Day

(Form Type)

(Fiscal Year)

Month

Day

(Annual Meeting)

Total No. of Stockholders

(Secondary License Type, If Applicable)

-----------------------------------------------------------------------------To be accomplished by SEC Personnel concerned

File Number

LCU

Document ID

Cashier

. . . . . . . . . . . . . . . . . . . . . . .. .. . . . . : : : STAMPS : : : : . . . . . . . . . . . . . . . . . . . . .....:. . . . . . . . . . .

Page 1 of 3

RDS 96-1DS

REGISTRATION DATA SHEET CAPITAL STOCK/INCORPORATORS/DIRECTORS/OFFICERS INFORMATION (FOR DOMESTIC STOCK CORPORATION ONLY) SEC NUMBER

FILL UP INSTRUCTIONS:

Type or print legibly. Light -shaded boxes are to be filled up by SEC, including the SEC number. For no-par stockds, leave the authorized capital amount and the par value columns blank.

COMPANY NAME

COMPANY TIN

CAPITAL STRUCTURE SHARE CODE

PAID -UP CAPITAL

SHARE TYPE

AUTHORIZED PAR P/N VALUE

NO. OF SHARES

CASH

AMOUNT

SUBSCRIBED CAPITAL NO. OF AMOUNT SHARES

F/N

PROPERTY

PAID-UP

PAID

AMOUNT

IN

OTHERS

TOTAL

BY ASSET TYPE

-

INCORPORATORS / STOCKHOLDERS / DIRECTORS / OFFICERS (Use additional sheets if necessary) NAME (Company Name, if company) (Last Name, First Name, MI, Maiden Surname, if person)

TAXPAYER IDENTIFICATION NUMBER

BIRTH DATE

CODE

NATIONALITY

BRD

INC'R

OFR

SHARE CODE

SHARE TYPE

SUB-TOTALS

NO. OF SHARES

SUBSCRIBED CAPITAL

PAID-UP CAPITAL

-

-

-

Note: For codes to use in filling up the columns, refer to the last page of this form. Refer also to the back of this page for additional instructions.

Page 3 of 3

RDS 96-1DS

REGISTRATION DATA SHEET CAPITAL STOCK/INCORPORATORS/DIRECTORS/OFFICERS INFORMATION (FOR DOMESTIC STOCK CORPORATION ONLY)

SEC NUMBER

FILL UP INSTRUCTIONS:

FOR SEC TO PROVIDE: MAINTENANCE NO.:

TRANSACTION DATE

Type or print legibly. Light -shaded boxes are to be filled up by SEC, including the SEC number.

COMPANY NAME

INCORPORATORS / STOCKHOLDERS / DIRECTORS / OFFICERS (Use additional sheets if necessary) NAME (Company Name, if company) (Last Name, First Name, MI, Maiden Surname, if person)

NO. OF DIRECTORS:

TAXPAYER IDENTIFICATION NUMBER

CODE

NATIONALITY

BRD

NO. OF STOCKHOLDERS:

INC'R

OFR

SHARE CODE

SHARE TYPE

SUBSCRIBED CAPITAL

TOTALS

PAID-UP CAPITAL

-

-

FOREIGN EQUITY BREAKDOWN (Refer to the back of this page for instruction on how to fill-up this section.) NATIONALITY CODE

TOTAL FOREIGN EQUITY

NATIONALITY DESCRIPTION SUBSCRIBED CAPITAL OF -INDIVIDUALS COMPANY (IES) PAID UP CAPITAL OF -INDIVIDUALS COMPANY (IES) TOTAL PAID-UP CAPITAL PERCENTAGE OF FOREIGN EQUITY CERTIFIED CORRECT:

(Signature over printed name)

POSITION:

DATE:

PROCESSING ATTORNEY:

PROCESSING EXAMINER:

DATA CONTROL CLERK:

DATA ENCODER:

DATE REVIEWED:

DATE REVIEWED:

DATE REVIEWED:

DATE ENCODED:

INSTRUCTIONS FOR FILLING UP THE FOLLOWING COLUMNS: PAR/NO PAR (P / N) FILIPINO / FOREIGN VALUE INDICATOR (F/N) OWNED P - PAR INDICATOR -N - NO PAR F - FILIPINO N - NON-FILIPINO / FOREIGNER

WITH PAID-IN SURPLUS? Y - YES N - NO

BOARD (BRD) INDICATOR -C - CHAIRMAN M - MEMBER N - NEITHER

OFFICER (OFR) INDICATOR -PRE - PRESIDENT CEO - CHIEF EXECUTIVE OFFICER CFO - CHIEF FINANCIAL OFFICER COO - CHIEF OPERATING OFFICER COS - CORPORATE SECRETARY

LEG - LEGAL COUNSEL AUD - EXTERNAL AUDITOR GOV - GOVERNMENT REPRESENTATIVE OTH - OTHERS N - NONE

REGISTRATION DATA SHEET GENERAL / BUSINESS / COMPANY RELATIONSHIP INFORMATION (FOR DOMESTIC COMPANIES ONLY) SEC NUMBER FILL UP INSTRUCTIONS

Type or print legibly. Light-shaded boxes are to be filled up by the SEC. Check appropriate boxes. FILL UP ONLY THOSE ITEMS FOR WHICH AMENDMENTS OR CHANGES ARE TO BE MADE. Refer to the back of this page for additional instructions.

COMPANY NAME GENERAL INFORMATION

(

) DS - DOMESTIC STOCK

( )DN - DOMESTIC NON-STOCK

CHANGE FROM STOCK TO NON

( ) DP - DOMESTIC PARTNERSHIP

PRINCIPAL OFFICE ADDRESS AREA CODE

POSTAL CODE

TEL. NO.

FAX NO.

POSTAL CODE

TEL. NO.

FAX NO.

BUSINESS OFFICE ADDRESS AREA CODE BUSINESS INFORMATION PARTNERSHIP

TYPE OF ENTERPRISE LIMITED

[

]

[

] GENERAL

INDUSTRY CODE

TERMS OF EXISTENCE

[

]

N- NO SPECIAL REGISTRATION

[

]

H- FIA HOLDING

[

]

E - FIA EXPORT

[

]

R - FIA REPRESENTATIVE OFF

[

]

D - FIA DOMESTIC

[

]

S - SUBIC REGISTERED

FISCAL YEAR END (MM/DD)

ANNUAL MEETING (For Domestic Companies only)

YEARS

( )

TYPE OF NON STOCK CORPORATION (Refer to the back of this page for the classification)

F - FIXED (MM/DD)

TOTAL CONTRIBUTION (of domestic non-stock companies)

[

]

% OF FOREIGN M

COMPANY RELATIONSHIP - List all companies related to the registrant. (Use additional sheets, if necessary) RELATIONSHIP TYPE

C

- DISSOLVED COMPANY ( if due to consolidation)

(RELN TYPE)

V

- DISSOLVED COMPANY ( if change in company type)

RELN TYPE

CERTIFIED CORRECT:

SEC NUMBER

S - PARENT COMPANY (if registrant is a subsidiary) A - AFFILIATE (of registrant) TIN

(Signature over printed name)

COMPANY NAME

POSITION:

DATE:

PROCESSING ATTORNEY:

PROCESSING EXAMINER:

DATA CONTROL CLERK:

DATE REVIEWED:

DATE REVIEWED:

DATE REVIEWED:

CHANGE FROM STOCK TO NON ( ) YES

CHANGE IN PRIMARY

( )X YES

FAX NO.

FAX NO.

A HOLDING

[

]

F - FINANCIAL INSTITUTION

IA REPRESENTATIVE OFF

[

]

Z - EPZA REGISTERED

UBIC REGISTERED

[

]

B - BOI REGISTERED

TING (For Domestic Companies only) V - VARIABLE ____________________ % OF FOREIGN MEMBERSHIP (Of non-stock companies)

O - OTHERS

COMPANY NAME

DATE: DATA ENCODER: DATE ENCODED: