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DOLE PTO Application

This document is an application for internal combustion engine installation from the Department of Labor and Employment in the National Capital Region of the Philippines. It requests information such as the name and address of the establishment, owner/manager, type of machinery to be installed, whether the installation is permanent or temporary, machinery details including name, type, dimensions, cycle, and accessories. The manager must sign the application along with their tax identification number.

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norlyn esguerra
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3K views

DOLE PTO Application

This document is an application for internal combustion engine installation from the Department of Labor and Employment in the National Capital Region of the Philippines. It requests information such as the name and address of the establishment, owner/manager, type of machinery to be installed, whether the installation is permanent or temporary, machinery details including name, type, dimensions, cycle, and accessories. The manager must sign the application along with their tax identification number.

Uploaded by

norlyn esguerra
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Labor and Employment


National Capital Region

APPLICATION FOR INTERNAL COMBUSTION ENGINE INSTALLATION

1. Name of Establishment ____________________________________________________


2. Address _________________________________________________________________
3. Name of Owner/Manager and his Address _____________________________________
_______________________________________________________________________
4. What machinery is to be installed ____________________________________________
________________________________________________________________________
5. Installation permanent or temporary __________________________________________
_______________________________________________________________________
6. Machinery Data:

a) Name ________________________________________________________________
b) Type and Model _______________________________________________________
c) Bore __________________________ d) Stroke ______________________________
e) No. of Cyl _____________________ f) Cycle ________________________________
g) D.P. __________________________ h) R.P.I.M. _____________________________
f) Kind of I.C.E. ___________________ j) Engine Weight ________________________

7. Name and Signature of Person to supervise the installation:


_______________________________________________________________________
and___________________________________________________________________
(Board of Mechanical Engineering License, if any)
8. Other accessories or equipment _____________________________________________
_______________________________________________________________________
_______________________________________________________________________

____________________________________
(Name and Signature of Manager)
____________________________________
Tax Identification Number

Application Fee ___________ I.C.E. _________


Plan Fee ________________________________
O.R. No. ________________ Date ___________
Date Received ___________________________
Received by: ____________________________

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