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Order - of - Payment - 1 FDA

This document is an order of payment from the Philippines Food and Drug Administration for AMBFEL PHARMACY. It provides details of the pharmacy such as the owner Jaime Bilango Diwas Jr., address, and qualified personnel Juliet Cuyahin. It specifies an application fee of 2,000 pesos for a 2-year license as well as additional legal research and service fees, totaling 2,020 pesos due. It notes an additional 15 pesos if paying online through Bancnet.

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Sheron Biase
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376 views2 pages

Order - of - Payment - 1 FDA

This document is an order of payment from the Philippines Food and Drug Administration for AMBFEL PHARMACY. It provides details of the pharmacy such as the owner Jaime Bilango Diwas Jr., address, and qualified personnel Juliet Cuyahin. It specifies an application fee of 2,000 pesos for a 2-year license as well as additional legal research and service fees, totaling 2,020 pesos due. It notes an additional 15 pesos if paying online through Bancnet.

Uploaded by

Sheron Biase
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 Health
Food And Drug Administration
Civic Drive, Filinvest Corporate City 
Alabang, Muntinlupa City

Order of Payment
General Information
Account Code: 3000003747510
Product Center: Drugs
Authorization: License To Operate
Type: Initial
Primary Activity: Drugstore
LTO No. (If applicable): Not Applicable
Expiry (If applicable): Not Applicable
 
Establishment Information
Company Name: AMBFEL PHARMACY
Owner: JAIME BILANGO DIWAS JR.
Declared Capital: Not Applicable
Site Address (if NO. 6, PUROK 1, AMBIONG, Baguio, Benguet, Cordillera
applicable): Administrative Region (CAR), 2600
Office Address (if
Not Applicable
applicable):
Plant Address (if
Not Applicable
applicable):
List of Warehouses (if applicable):
Address
  
Details of the Approving Authority
Fullname: DIWAS, JAIME,JR. BILANGO
Designation: Owner (for sole proprietorships)
NO.6, PUROK 1, AMBIONG BAGUIO CITY, N/A, Baguio,
Mailing Address:
Benguet, Cordillera Administrative Region (CAR), 2600
  
Details of the Qualified Personnel
Fullname Designation TIN Email Government ID
Professional
CAGA, Regulatory
Company
JULIET 473-578-979-000 [email protected] Commission: 0069415
Pharmacist
CUYAHIN (1993-06-21)
(2019-06-21)
  
Payment Details
Application Fee: 2,000.00
Number of Years Applied: 2
Surcharge (if any): 0.00
Legal Research Fund
20.00
(LRF):
Total Amount: Php 2,020.00

If payment is made using Bancnet Online Bills Payment Facility (www.bancnetonline.com), an


additional Php15.00 should be included to the amount due.

BancNet Payment: Php 2,035.00  

Remarks: Initial

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