SBSR Boat

SRLD Form A-2
Revised 2000
MARITIME INDUSTRY AUTHORITY
SBSR LICENSING DATA SHEET
(For Boatbuilding Only)
INSTRUCTION: Type or print legibly and check appropriate boxes. Light-shaded portion to be filled up by MARINA
NAME OF COMPANY/ENTERPRISE FOR MARINA USE ONLY
DOC. CONTROL NUMBER

PRINCIPAL OFFICE ADDRESS ☐☐☐☐ ☐☐☐☐☐
TYPE OF APPLICATION
TEL. NO/S. FAX NO/S. E-MAIL ADDRESS
☐ NEW ☐ ANNUAL
☐ RENEWAL
BUSINESS/ SHIPYARD ADDRESS
Date ☐☐ ☐☐ ☐☐☐☐
TEL. NO/S. FAX NO/S. E-MAIL ADDRESS Filed MM DD YYYY
CONTACT PERSON SEC/ DTI NUMBER

Date ☐☐ ☐☐ ☐☐☐☐
Inspected MM DD YYYY
BOATYARD INFORMATION
TYPE OF ORGNIZATION SPECIALIZATION Date ☐☐ ☐☐ ☐☐☐☐
Approved MM DD YYYY
☐ Corporation Equity Participation Hull Material
☐ Partnership % Filipino ☐ FRP –hull License No. ☐☐☐ ☐☐☐

% Foreign ☐Wooden-hull
☐ Proprietorship ☐Aluminum-hull VALIDITY PERIOD
☐Others
FROM ☐☐ ☐☐ ☐☐☐☐
AFFILIATION Type of Boat MM DD YYYY
☐ PHILSAR ☐ INAMASA ☐ Banca
☐ PMBA ☐ BIAP ☐ CMIP ☐ Dive Boat TO ☐☐ ☐☐ ☐☐☐☐
☐ OTHERS, please specify ☐ Pleasure Craft MM DD YYYY
☐ Lifeboat BOATYARD CLASSIFICATION
☐ Others ☐ CLASS A
II. FACILITY PROFILE ☐ CLASS B
☐ CLASS C
AREA SIZE STATUS
(in sq. m.) CONDITION MODE OF ACQUISITION
☐ Owned
☐ Leased
Launching Area VALIDITY OF LEASE CONTRACT:
FROM ☐☐ ☐☐ ☐☐☐☐
MM DD YYYY
Molding/ Lamination
Area
TO ☐☐ ☐☐ ☐☐☐☐
MM DD YYYY
Construction Area
Others
YARD MACHINERIESE/ EQUIPMENT NUMBER STATUS/ CONDITION

Air Compressor
SBSR Licensing Date Sheet Page 1 of 5
SRLD Form A-2
Revised 2000
Blowers
Drilling Machine & Equipment
Gas-Cutting Outfits
Generating Set
Grinding Machine & Equipment
Molding Pattern
Paint Outfit & Equipment
Pneumatic Machine & Equipment
Polishing Machine & Equipment
Pumps/ Pressure Tank
Sawing Equipment (Jig saw, Bench saw, etc.)
Welding Machine & Equipment
Others
III. MANPOWER
NUMBER
TECHNICAL PERSONNEL PERMANENT CONTRACTUAL TEMPORARY
Naval Architect & Marine Engineer
Mechanical Engineer
Electrical Engineer
Marine Engineer
Civil Engineer
Chemical Engineer
Industrial Engineer
Electronic Engineer
Safety Engineer
Draftsman
Metallurgist
Others
SUB-TOTAL
NUMBER

SRLD Form A-2
Revised 2000
UNSKILLED PERMANENT CONTRACTUAL TEMPORARY
WORKERS
SUB – TOTAL
NUMBER
MANAGERIAL PERSONNEL
PERMANENT CONTRACTUAL TEMPORARY
Proprietor
General Manager
President
Vice President
Others
SUB-TOTAL
NUMBER
SKILLED WORKERS
PERMANENT CONTRACTUAL TEMPORARY
Welder
Cutter
Pipefitter
Carpenter
Electrician
Caulker
Mold Loftsman
Mechanic
Mechanist
Planner/ Estimator
Painter
Rigger
Others
SUB-TOTAL
NUMBER
ADMINISTRATIVE PERSONNEL PERMANENT CONTRACTUAL TEMPORARY
Accountant
SRLD Form A-2
Revised 2000
HRD
Secretary
Computer Operator
Liaison Officer
Clerk
Others
SUB – TOTAL
GRAND TOTAL
IV. FINANCIAL ASPECT (As of ☐☐-☐☐-☐☐)

MM DD YY
CAPITALIZATION
AUTHORIZED CAPITALIZATION PAID UP CAPITALIZATION % SHARE OF FILIPINO EQUITY
ASSETS & LIABILITIES
TOTAL ASSETS TOTAL LIABILITIES NET WORTH
GROSS REVENUE FROM OPERATION
10% VAT AS OF ☐☐-☐☐-☐☐ TOTAL VAT PAYMENT MADE BALANCE

MM DD YY
V. BOATYARD OPERATIONS DATA AS OF YEAR ☐☐☐☐
Fill in the following items for each boat CONSTRUCTED during the period. Continue on separate sheet, if
necessary.
NAME OF BOAT OWNER CLASS
☐ Foreign ☐ Domestic
TYPE OF BOAT
☐ Dive Boat ☐ Lifeboat ☐ Workboat ☐ Passenger ☐ Fishing

☐ Pleasure ☐ Banca ☐ Others, please specify
CAPACITY CONTRACT COST CONSTRUCTION TIME
☐☐☐, ☐☐☐.☐☐ GRT Date ☐☐-☐☐-☐☐☐☐

Started MM DD YYYY
☐☐☐, ☐☐☐.☐☐ DWT
Date ☐☐-☐☐-☐☐☐☐
Completed MM DD YYYY
HULL MATERIAL
☐ Steel ☐ Wood ☐ Fiberglass ☐ Aluminum ☐ Ferro-cement ☐ Others, please specify

SRLD Form A-2
Revised 2000
VI. SHIPYARD’S FUTURE PLANS, PROJECTS & OTHERS IN TERMS OF THE FOLLOWING
FACILITY
MANPOWER
OPERATIONS
TECHNOLOGY
OTHERS
I, hereby certify to the best of knowledge and information, that the data given above are true and correct.
REPRESENTATIVE OF THE INSPECTED MARINA INSPECTION TEAM

ENTERPRISE
SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME
DESIGNATION DESIGNATION
DATE DATE

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SRLD Form A-2

DOC. CONTROL NUMBER

CONTACT PERSON SEC/ DTI NUMBER

☐ Partnership % Filipino ☐ FRP –hull License No. ☐☐☐ ☐☐☐

YARD MACHINERIESE/ EQUIPMENT NUMBER STATUS/ CONDITION

Drilling Machine & Equipment

Grinding Machine & Equipment

Paint Outfit & Equipment

Pneumatic Machine & Equipment

Polishing Machine & Equipment

Pumps/ Pressure Tank

Sawing Equipment (Jig saw, Bench saw, etc.)

Welding Machine & Equipment

Naval Architect & Marine Engineer

SBSR Licensing Date Sheet Page 2 of 5

IV. FINANCIAL ASPECT (As of ☐☐-☐☐-☐☐)

ASSETS & LIABILITIES

TOTAL ASSETS TOTAL LIABILITIES NET WORTH

GROSS REVENUE FROM OPERATION

10% VAT AS OF ☐☐-☐☐-☐☐ TOTAL VAT PAYMENT MADE BALANCE

☐ Dive Boat ☐ Lifeboat ☐ Workboat ☐ Passenger ☐ Fishing

CAPACITY CONTRACT COST CONSTRUCTION TIME

☐☐☐, ☐☐☐.☐☐ GRT Date ☐☐-☐☐-☐☐☐☐

☐ Steel ☐ Wood ☐ Fiberglass ☐ Aluminum ☐ Ferro-cement ☐ Others, please specify

SBSR Licensing Date Sheet Page 4 of 5

REPRESENTATIVE OF THE INSPECTED MARINA INSPECTION TEAM

SBSR Licensing Date Sheet Page 5 of 5

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