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BOI FORM 501 APPLICATION NO.

:
(for BOI use only)

REPUBLIC OF THE PHILIPPINES


BOARD OF INVESTMENTS

APPLICATION FOR REGISTRATION


UNDER REPUBLIC ACT 9513
(Renewable Energy Act of 2008)

A. APPLICANT
NAME OF ENTITY :
TAX ACCOUNT NO. :
OFFICE ADDRESS :

ZIP CODE : E-MAIL ADDRESS :


TELEPHONE NO. : FAX NO. :
PLANT/FARM ADDRESS :

TELEPHONE NO. : FAX NO. :

NAME OF AUTHORIZED OFFICER/DESIGNATION :


TELEPHONE NO. : FAX NO. :
MOBILE NO. : E-MAIL ADDRESS :

APPLICANTS REPRESENTATIVE TO BOI:


NAME :
ADDRESS :

TELEPHONE NO. : FAX NO. :


MOBILE NO. : E-MAIL ADDRESS :

B. ACTIVITY APPLIED FOR

Under E.O. 226 (Listed in the Investment Priorities Plan (IPP) Energy)

Under R.A 9513 (Renewable Energy Act 2008)


C. AREA OF INVESTMENT APPLIED FOR
Activity as listed in the IPP :
Specific Products/Services :
Attainable Capacity/Year (volume) / (if applicable) :

D. TYPE OF PROJECT

Wind Geothermal Solar


Hydro Biomass ________ Ocean

E. STATUS (If under E.O. 226)

Pioneer Non-Pioneer

F. SOLE PROPRIETORSHIP, PARTNERSHIP, OTHERS


Name Nationality Country of Residence Capital (In Pes

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

BOI Form No. 501, Page 2 of 3


Nationality (indicate
Name & Tax Country of No. of No. of
Identification No. (TIN)
with * if naturalized Value V
Filipino) Residence shares shares

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.

DONE IN THE CITY/PROVINCE OF THIS DAY OF


200 .

Applicant/Authorized Officer

REPUBLIC OF THE PHILIPPINES


CITY/PROVINCE OF ) S.S.
MUNICIPALITY OF )

SUBSCRIBED AND SWORN to before me this day of 200


in the City/Province of affiant exhibited to me his Residence

BOI Form No. 501, Page 3 of 3


Certificate No. issued at on
200 .

NOTARY PUBLIC
Until Dec. 31,

Doc. No. :
Page No. :
Book No. :
Series of :

BOI Form No. 501, Page 4 of 3