COVER SHEET

(Company's Full Name)

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

(Contact Person)

(Company Telephone Number)

Month

Day

(Form Type)

Month

Day

(Fiscal Year)

(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 : : : : . . . . . . . . . . . . . . . . . . . . .....:. . . . . . . . . . .

RDS 96-1DS

Page 1 of 3 REGISTRATION DATA SHEET CAPITAL STOCK/INCORPORATORS/DIRECTORS/OFFICERS INFORMATION

(FOR DOMESTIC STOCK CORPORATION ONLY)

SEC NUMBER

FILL UP INSTRUCTIONS:
COMPANY NAME

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 TIN

CAPITAL STRUCTURE
SHARE CODE SHARE TYPE AUTHORIZED PAR P/N VALUE NO. OF SHARES AMOUNT F/N SUBSCRIBED CAPITAL NO. OF AMOUNT SHARES PAID-UP AMOUNT PAID IN

PAID -UP CAPITAL BY ASSET TYPE

CASH

PROPERTY

OTHERS

TOTAL -

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 NO. OF SHARES SUBSCRIBED CAPITAL PAID-UP CAPITAL

SUB-TOTALS

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.

RDS 96-1DS

Page 3 of 3 REGISTRATION DATA SHEET CAPITAL STOCK/INCORPORATORS/DIRECTORS/OFFICERS INFORMATION

(FOR DOMESTIC STOCK CORPORATION ONLY)

SEC NUMBER

FOR SEC TO PROVIDE: MAINTENANCE NO.:

TRANSACTION DATE

FILL UP INSTRUCTIONS:
COMPANY NAME

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

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 CODE NATIONALITY BRD INC'R OFR SHARE CODE SHARE TYPE SUBSCRIBED CAPITAL PAID-UP CAPITAL

NO. OF DIRECTORS:

NO. OF STOCKHOLDERS:

TOTALS

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

TOTAL FOREIGN EQUITY

(Signature over printed name) PROCESSING EXAMINER: DATE REVIEWED:

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

POSITION: DATA CONTROL CLERK: DATE REVIEWED:

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

DATE: DATA ENCODER: DATE ENCODED:

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 COMPANY NAME GENERAL INFORMATION 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.

(
PRINCIPAL OFFICE ADDRESS AREA CODE BUSINESS OFFICE ADDRESS AREA CODE BUSINESS INFORMATION PARTNERSHIP [ [ INDUSTRY CODE ] LIMITED

) DS - DOMESTIC STOCK
POSTAL CODE

( )DN - DOMESTIC NON-STOCK

TEL. NO.

( ) DP - DOMESTIC PARTNERSHIP

CHANGE FROM STOCK TO NON

FAX NO.

POSTAL CODE

TEL. NO.

FAX NO.

TYPE OF ENTERPRISE

[ [ [

] ] ]

N- NO SPECIAL REGISTRATION E - FIA EXPORT D - FIA DOMESTIC

( ) F - FIXED (MM/DD)

[ [ [

] ] ]

H- FIA HOLDING R - FIA REPRESENTATIVE OFF S - SUBIC REGISTERED

[ ]

] GENERAL TERMS OF EXISTENCE YEARS

FISCAL YEAR END (MM/DD)

ANNUAL MEETING (For Domestic Companies only)

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

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 (RELN TYPE) RELN TYPE C V - DISSOLVED COMPANY ( if due to consolidation) - DISSOLVED COMPANY ( if change in company type) SEC NUMBER TIN S - PARENT COMPANY (if registrant is a subsidiary) A - AFFILIATE (of registrant) COMPANY NAME

CERTIFIED CORRECT: PROCESSING ATTORNEY: DATE REVIEWED:

(Signature over printed name) PROCESSING EXAMINER: DATE REVIEWED:

POSITION: DATA CONTROL CLERK: DATE REVIEWED:

DATE:

CHANGE FROM STOCK TO NON ( ) YES

CHANGE IN PRIMARY

( )X YES

FAX NO.

FAX NO.

A HOLDING

[ [ [

] ] ]

F - FINANCIAL INSTITUTION Z - EPZA REGISTERED B - BOI REGISTERED

IA REPRESENTATIVE OFF

UBIC REGISTERED

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

O - OTHERS

COMPANY NAME

DATE: DATA ENCODER: DATE ENCODED: