BOI FORM N-501 / APPLICATION NO:
DATE ACCEPTED:
REPUBLIC OF THE PHILIPPINES
BOARD OF INVESTMENTS
APPLICATION FOR REGISTRATION
(SHIPPING)
UNDER BOOK I OF THE OMNIBUS INVESTMENTS CODE OF 1987, AS AMENDED
(EXECUTIVE ORDER NO. 226)
I. PROPONENT
NAME OF ENTITY:
OFFICE ADDRESS:
NAME OF PROJECT:
SEC. REGISTRATION / DATE NO:
IPP CATEGORY: / Regular List / Mandatory List / Export Activities
OWNERSHIP RATIO: / % Filipino / %Foreign
(Nationality)
II. CONTACT DETAILS
AUTHORIZED REPRESENTATIVE TO BOI/POSITION:
( Attached Board Resolution Appointment)
E-MAIL ADDRESS:
LANDLINE/ CELPHONE NO:
OFFICE ADDRESS
HOME WARF:
ROUTE:
III. PROJECT PROFILE
PROJECT COST:
PROJECT DESCRIPTION:
TYPE OF PROJECT:
ð  New: / ð  Expansion:
ð  Start of Commercial Operation: / ð  % Increase in capacity:
ð  Capacity:
STATUS:
Pioneer / Non-Pioneer

Schedule 1: Project Cost (PhP’000)

Activity / Related Expenses / Schedule
(Month/Year) / Pre-operating Stage / Start of Commercial Operation / Total
Secure necessary license/permit/registration from the government/training costs / Pre-operating expenses
Site Preparation & Development
Building Construction
Acquisition, Installation of Machineries & Equipment, Furniture and Fixtures
Vessel Cost
Other Cost / Vessel’s acquisition cost/ other cost
Hiring and Training of Personnel
Start of Commercial Operations / Working Capital
(3 months)
TOTAL PROJECT COST

Schedule 2: Net Value Added [(Cost of Services- Cost of Purchases)/Cost of Services]

Yr-1 / Yr-2 / Yr-3 / Yr-4 / Yr-5
Total Cost of Services* PhP’000
Total Cost of Purchases**
NVA (%)

*Cost of services include Operating Expenses and Selling Expenses

**Total Cost of purchases includes fuel, depreciation and supplies

Schedule 3: Job Generation

Number of Personnel / Annual Payroll (P’000)
Classification / Y1 / Y2 / Y3 / Y4 / Y5 / Y1 / Y2 / Y3 / Y4 / Y5
Direct Labor
Indirect Labor
Selling/Admin
Managers
Supervisors
Total

Schedule 4: Project Financing

/ Amount (PhP '000) / % /
Equity
Bank Loan
Others (specify)
Total / 100

Schedule 5: Current Stockholders’ Profile (as of filing date)

Name / Nationality / Capital Stock (PhP) / % Ownership
Subscribed / Paid-up
1.
2.
3.
4.
5.
Total
NAME / POSITION / PROFILE (brief info about the stockholder, e.g., business affiliation and/or experience )
1.
2.
3.
4.
5.

Schedule 6: Projected Revenue

Year / Nature of Service / No. of Trips per year or Total Volume of cargo/ passenger / Revenue per trip or Rate per cargo/passenger (P’000) / Value*
(P ‘000)
1
2
3
4
5
Total

Assumption used:

Schedule 7: Route and Target Market

Route:

Market Category
1.
2.
3…

Schedule 8 Justification for Pioneer Status (if applicable)

Schedule 9: Status of Licensing, Permits, Consents

Licenses / Permits (indicate applicable only) / Number / Date Issued
SEC Registration
MARINA Accreditation
MARINA Endorsement
Builder’s Certificate/Shipbuilding Contract
Seaworthiness/ Safety and Valid Class and Statutory Certificate (as required by MARINA)
Vessel’s Registration under the Philippine Flag

Schedule 10: Vessel Specification

Name of Vessel
Kind of vessel
Capacity
Port of Registry
Classification
Length
Breadth
Depth
Gross Tonnage
Deadweight
Type and No. of Main Engine
Speed
Date of Construction
Date of Delivery
Date Build/Launch
Ship Builder

Schedule 11: List of Equipment

Description / Type of Machine / AHTN 3 Code / Check R if 4 / Check Rif 5 / Check Rif 6 / Source (Write LS if Locally Sourced or I if Imported) / End-use 7 / Qty
(No. of units) / Unit Cost (Php) / Total Cost (Php)
Total:
3 ASEAN Harmonized Tariff Nomenclature
4 Already acquired
5 Already installed
6 For acquisition
7 Application or manufacturing stage where the equipment will be used

Schedule 12: Financial Projections

Income Statement (10 years projection): (preferably in Excel format) presented in two sets: (i) Projections WITH Income Tax Holiday (ITH); and, (ii) Projections WITHOUT Income Tax Holiday.

·  Assumptions used in Financial Projections

ATTACHMENTS:

a.  Perspective View of the Vessel.

b.  Schematic Diagram showing Forward-Backward Linkages.

c.  Schematic diagram showing the Business Model of the activity being registered (clearly indicate how/where the proponent will source its food, supplies, equipment as well as earn revenues and make profit).

d.  SEC Certificate of Registration, Articles of Incorporation and By-Laws, General Information Sheet (GIS)

e.  Audited Financial Statements (for the past 3 years, if applicable)

f.  Secretary’s Certificate authorizing representative

g.  List of BOI-registered Projects showing compliance with the Terms & Conditions, Status of Operation and Incentives Availed

h.  MARINA Accreditation and Endorsement and Other documents i.e. Shipbuilding Contract, Shipbuilder Certificate, other docs showing the vessel specification

i.  Publisher’s Affidavit of Publication of Notice

The applicant has read the Omnibus Investment Code of 1987 and the Rules and Regulations adopted by the BOI and commits itself to abide by the provisions thereof.

DONE IN THE CITY OF ______THIS ______DAY OF ______20__.

Applicant/Authorized Officer

REPUBLIC OF THE PHILIPPINES

CITY/PROVINCE OF ______) S.S.

MUNICIPALITY OF ______)

SUBSCRIBED AND SWORN to before me this ______day of ______20__ in the City/Province of ______affiant exhibited to me his CTC No. ______issued on ______at _____City.

NOTARY PUBLIC

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