Republic of the PhilippinesDepartment of Agriculture

BUREAU OF ANIMAL INDUSTRY

Visayas Avenue, Diliman Quezon City
TIN: 300000746316

LATEST

APPLICATION FOR LICENSING OF ANIMAL FEED 1"x1" ID PICTURE

ESTABLISHMENT (APPLICANT)

Under R.A. 1556, the Livestock and Poultry Feeds Act and R.A. 10611, the Food Safety Act of 2013

Date

Name of Establisment:
Office Address:
Telephone No.: Mobile No: Email address:
Plant Address:
Warehouse Address:

Nature of Bussiness: Business Organization:

(Please see at the back) (Please see at the back)

Product Lines:
(poultry, swine, gamecocks, pet foods, etc.)

Rated Capacity in MT (per 8-Hr Shift/Day): No. of Shifts Per Day:

Animal Nutritionist / Veterinary Consultant:
Membership to any livestock and allied organizations:
Coordinates:
Latitude:
Longtitude:
Signature Over Printed Name of Applicants or Authorized Representative

Designation

SUBSCRIBED AND SWORN to before me this day of 20 . The Affiant

exhibited to me his/her Government issued ID (PRC, Driver's license, Voters ID, TIN, Passport, UMID) No. on
valid until 20 .

Doc No.
Page No. Doc Stamp
Book No.
Series of
Notary Public

RAFVDABCO

Region

RECOMMENDING APPROVAL:
(To be filled-up by BAI-AFVDBCD Staff/Deputized AFVDABCO)
License to Operate No.
Valid Until:
LTO Fee:
Official Receipt No.: APPROVED:
Date Issued:
Remarks

New Renewal CIC

RF FVDB-01 Application for Licensing of Animal Feed EstablishmentsRevision No. 02 September 19, 2019
 INSTRUCTIONS
I. WHERE TO APPLY
Application form (RF FVDB-01) for the issuance of License to Operate (LTO) is available at the Office of the Animal Feeds, Veterinary Drugs and Biologics Control Division
(AFVDBCD), Visayas Avenue, Diliman, Quezon City, at any Regional Office of the Department of Agriculture, Regulatory Division or could be downloaded from the BAI
website (www.bai.gov.ph). The application form shall be accomplished in triplicate, notarized and submitted to the BAI-AFVDBCD or DA-RFOs for processing together
with the documents stated below.
II. DOCUMENTS REQUIRED:
A. COMMERCIAL MIXED FEED (COMMERCIAL FEED TRADER/TOLL) / FEED INGREDIENT MANUFACTURERS
*1. Duly accomplished and notarized Application Form # RF FVDB-01. For items not applicable, please write NA;
2. For business organization: (select only what is applicable)
a. For Sole Proprietorship: Photocopy of Registration from the Department of Trade and Industry (DTI);
b. For Corporations: Photocopy of Registration and Articles of Incorporation and By-Laws from the Securities and Exchange Commission (SEC);
c. For Cooperatives: Photocopy of Registration from the Cooperative Development Authority (CDA);
3. Nature of Business: Please indicate the nature of operation: - a) Commercial Mixed Feed Manufacturer, b) Toll Feed Manufacturer, c) Commercial Feed Trader
d) Feed Ingredient Manufacturer, e) Non-Commercial Mixed Feed Manufacturer, f) Feed Importer, g) Feed Exporter, h) Feed Indentor, i) Feed Supplier,
j) Feed Dealer, k) Feed Distributor, l) Feed Repacker and, m) Feed Retailer; PLEASE USE ONE APPLICATION FOR EACH NATURE OF BUSINESS
*4. Photocopy of Environmental Compliance Certificate (ECC) from the Environmental Management Bureau (EMB) or Permit to Operate (PTO)
from the Laguna Lake Development Authority (LLDA). For plants outside Metro Manila, a corresponding valid PTO issued by the Department of Environment
and Natural Resources (DENR) Provincial Office (PENRO);
*5. Photocopy of Business/Mayor's Permit for the current year;
6. Copy of plant lay-out, and latest pictures of the feed plant with the owner or authorized representative, one taken inside and
one taken outside the feed mill;
*7. For Toll Feed Manufacturer or Commercial Feed Trader: Copy of Memorandum of Agreement between the concerned parties;
*8. Joint Affidavit of Undertaking of Owner with Licensed Agriculturist (Animal Nutritionist) or Veterinarian, and Chemist (RF FVDB-30) and photocopy of valid PRC ID;
*9. For Manufacturers contracting the services of an independent Quality Control Laboratory: photocopy of valid BAI-Laboratory Recognition Certificate and
Memorandum of Agreement (MOA) between the concerned parties;
10. Site inspection of office, plant and warehouse and validation of submitted documents;
11. Sketch or location map of the establishment or facility;
*12. Payment of LTO Fee (based on rated capacity per 8-Hour Shift per day in Metric Ton).
a. Less than 25.0 MT - Php 450.00
b. 25.1 to 50.0 MT - 540.00
c. 50.1 to 100.0 MT - 630.00
d. More than 100.0 MT - 720.00
B. NON-COMMERCIAL MIXED FEED MANUFACTURER
*1. Duly accomplished and notarized Application Form # RF FVDB-01. For items not applicable, please write NA;
2. For business organization: (select only what is applicable)
a. For Sole Proprietorship: Photocopy of Registration from the Department of Trade and Industry (DTI);
b. For Corporations: Photocopy of Registration and Articles of Incorporation and By-Laws from the Securities and Exchange Commission (SEC);
c. For Cooperatives: Photocopy of Registration from the Cooperative Development Authority (CDA);
*3. Photocopy of Business/Mayor's Permit for the current year;
*4. Photocopy of valid PTO or ECC from the DENR;
*5. Affidavit of animal population;
*6. Joint Affidavit of Undertaking of Owner with Licensed Agriculturist (Animal Nutritionist) or Veterinarian, and Chemist (RF FVDB-30) and photocopy of valid PRC ID;
7. Site inspection of office, plant and warehouse and validation of submitted documents;
*8. Payment of LTO Fee. Php 180.00
C. FEED IMPORTER/EXPORTER/INDENTOR
*1. Duly accomplished and notarized Application Form # RF FVDB-01. For items not applicable, please write NA;
2. For business organization: (select only what is applicable)
a. For Sole Proprietorship: Photocopy of Registration from the Department of Trade and Industry (DTI);
b. For Corporations: Photocopy of Registration and Articles of Incorporation and By-Laws from the Securities and Exchange Commission (SEC);
c. for Cooperatives: Photocopy of Registration from the Cooperative Development Authority (CDA);
3. Sketch or location map of the establishment or facility;
*4. Photocopy of Business/Mayor's Permit for the current year;
5. Site inspection of office, plant and warehouse and validation of submitted documents;
*6. Payment of LTO Fee. Php 480.00
D. FEED SUPPLIER/REPACKER
*1. Duly accomplished and notarized Application Form # RF FVDB-01. For items not applicable, please write NA;
2. Site inspection of office and warehouse and validation of submitted documents;
3. For Repackers: authorization from the manufacturer, trader or importer to repack their products, tags or labels of the product to be repacked;
*4. Photocopy of Business/Mayor's Permit for the current year;
*5. Payment of LTO Fee. Supplier Php 240.00
Repacker 120.00
E. FEED DISTRIBUTOR/DEALER/RETAILER
*1. Duly accomplished and notarized Application Form # RF FVDB-01. For items not applicable, please write NA;
*2. Photocopy of Business/Mayor's Permit for the current year;
*3. Payment of LTO Fee.
a. Feed Dealer Php 240.00
b. Feed Distributor 120.00
c. Feed Retailer. 60.00
III. CHANGE IN CIRCUMSTANCES (CIC)
1. Official letter re change of address/ownership/business name;
2. Duly accomplished and notarized application form RF FVDB-01 reflecting changes;
3. Surrender original LTO certificate and submission of documents to be replaced;
*IV. ATTENDANCE TO ORIENTATION SEMINAR
Certificate of attendance to be attached as one of the requirements (both initial/renewal)
V. DISPLAY OF LTO CERTIFICATE
The LTO Certificate shall be displayed conspicuously in the place of business (feedmill or store) readily visible to the public.
VI. EXPIRATION
The LTO automatically expires on the 31st of December every year. Application for renewal shall be filed on or before January 21st of the following year. Failure to renew on or
before the deadline shall be subjected to surcharges under DA Administrative Order No 33, Series of 2000. The original Certificate of LTO shall remain valid every after renewal of LTO.
All Applications together with required documents should be submitted in color-coded folders with ear tags.
* To be submitted annually as requirements for renewal of LTO

RF FVDB-01 Application for Licensing of Animal Feed EstablishmentsRevision No. 02September 19, 2019