Amo Application Form Word

Republic of the Philippines
Department of Finance
BUREAU OF CUSTOMS
1099 Manila
INTELLIGENCE GROUP
ACCOUNT MANAGEMENT OFFICE (AMO)
APPLICATION FOR ACCREDITATION AND REGISTRATION

(Corporation / Partnership / Cooperative)
I, , of legal
age,
with postal address at
___________________________________________________________________after having
been duly sworn in accordance with law,
hereby depose and say that:
1. I am the of
duly authorized to file this application for accreditation and
registration with the Bureau of Customs, as evidence by written
authority from the company.
2. I hereby present the following information for accreditation with the

Bureau of Customs;
2.1. Name of the Firm:

a. Head Office Address:
_____________________________________________________
Year/s of Stay in the Premises:
Nature of ( )share
Occupation: ()owned ( )leased d
( )others ________________________
b. Warehouse Address:
______________________________________________________
Nature of Occupation: ()owned ( )leased ( )shared
( )others ________________________
c. Branch Office Address: N/A

______________________________________________________
N/A
Nature of ( )share
Occupation: ( )owned ( )leased d
( )others ________________________
d. Contact Number/s:
e. Facsimile Number/s:
f. Email Address*1:
g. Number of Employees:____________________________________
h. Nature of Company:
2.2. List of Officers / Directors (Please attach Personal Profile or
Resume)
_________________________________________________________
3. I hereby attached herewith the following documents:
1
*Mandatory Field since Notice of Denial / Approval will be send via Email
( ) BCOR evidencing payment of application fee
( ) Corporate Secretary Certificate for designated signatories, in the
import entries with sample original signatures
( ) Original copy of NBI Clearance issued within three (3) months
prior to the date of application of responsible officers and
majority stockholders.
( ) Two (2) valid government issued I.Ds., with picture of
applicant ( ) Latest General Information Sheet, if a
corporation
( ) Personal Profile of applicant and responsible officers, duly
signed ( ) Company Profile with pictures of office and/or
warehouse premises
( ) Proof of lawful occupancy of office and warehouse
premises:________________
( ) Printed CPRS
( ) Previous Certificate of Accreditation/Registration, if applicable
( ) License/Permit/Accreditation from concerned agency, when applicable,
i.e., food (LTO & CPR), rice (NFA), sugar (SRA), etc.
( ) Indorsement from the Collector concerned, if applicable
4. List of Importable Items with clear description in technical and tariff,

terms, estimated volumes and values for the next twelve (12)
months
(Use separate sheet if necessary).
Commodity Tariff Heading Technical Volume Value

(General Terms) Description
USD
Bento 392490 90 Bento Box 20,000.00kg 6,000.00
USD
Cutleries wooden 441990 90 Wooden cutleries 20,000.00kg 7,000.00
USD
Plastic lid 392350 00 Plastic sipping lid 15,000.00kg 6,000.00
USD
Cutleries 392410 99 Cornstarch Cutleries 20,000.00kg 6,000.00
USD
TOTAL USD 25,000.00
TOTAL PHP 1,450,000.00
REPUBLIC OF THE PHILIPPINES )
___________________________) S.S.
SWORN UNDERTAKING
I hereby certify under oath that all the above information are true and
correct; all documents submitted in support of tis application are true copies
of the original, subject to verification; any misrepresentation and/or
manifestation of fraud in this application shall be a ground for the
disapproval of my application, and blacklisting of our firm and the
undersigned as the applicant.
As specified in Section 2.2. of CMO No. 4-2014, I Hereby undertake to

(a) to receive notice by e-mail; (b) to strictly abide with existing rules and
regulations on the Statement of Full Description of Imported Articles covered
by entry declarations; (c) to notify the BOC-AMO of any changes in the
information contained in the application for accreditation; and (d) to obtain
knowledge of the contents of a declaration, and to attest to the veracity
thereof.
I fully understand that failure to comply with the undertaking will result
in the cancellation and revocation of the accreditation as importer, without
prejudice to the imposition of any other criminal sanction for violation of the
Tariff and Customs Code of the Philippines, and other customs laws and
regulations.
AFFIX 2x2 picture

of Proprietor /
Applicant
Latest photo, which should Not be more
than three (3) Months old
Very truly yours,
APPLICANT’S NAME &

SIGNATURE
SUBSCRIBED AND SWORN to before me this _______ day

of
______________
In Manila, Philippines, affiant exhibiting to me his /
her
___________________________
Issued at ____________________________ on ________________________________
NOTARY PUBLIC
Doc No. __________

Page No.__________
Book No.__________
Series of__________

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Republic of the Philippines

APPLICATION FOR ACCREDITATION AND REGISTRATION

2. I hereby present the following information for accreditation with the

2.1. Name of the Firm:

c. Branch Office Address: N/A

4. List of Importable Items with clear description in technical and tariff,

Commodity Tariff Heading Technical Volume Value

As specified in Section 2.2. of CMO No. 4-2014, I Hereby undertake to

AFFIX 2x2 picture

Very truly yours,

APPLICANT’S NAME &

SUBSCRIBED AND SWORN to before me this _______ day

Doc No. __________

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