Boi Form 501: Application No.
Boi Form 501: Application No.
Boi Form 501: Application No.
:
(for BOI use only)
A. APPLICANT
NAME OF ENTITY :
TAX ACCOUNT NO. :
OFFICE ADDRESS :
Under E.O. 226 (Listed in the Investment Priorities Plan (IPP) Energy)
D. TYPE OF PROJECT
Pioneer Non-Pioneer
G. CORPORATION
1. CAPITAL STRUCTURE
Voting Non-Voting
CAPITAL STOCK
No. of Shares Total Value (PhP) No. of Shares Total Value (Ph
AUTHORIZED:
SUBSCRIBED:
Filipino
Foreign (specify
nationality)
a.
b.
c.
TOTAL SUBSCRIBED:
PAID-UP:
2. STOCKHOLDERS
Subscribed Capital Paid-Up Cap
3. DIRECTORS
Subscribed Capital Paid-Up Capital
Country of
Name Nationality No. of No. of
Residence Value Value
Shares Shares
4. PRINCIPAL OFFICERS
Name Designation
The applicant has read the Republic Act 9513 (Renewable Energy Act of 2008), and the Rules and
Regulations adopted by the DOE and BOI and commits itself to abide by the provision thereof.
Applicant/Authorized Officer
NOTARY PUBLIC
Until Dec. 31,
Doc. No. :
Page No. :
Book No. :
Series of :