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Affidavit of No Change Page 1-3

The document is an affidavit and application form for renewal of accreditation in the Client Profile Registration System (CPRS) as an exporter with the Bureau of Customs in the Philippines. The affidavit confirms there have been no changes to the company's circumstances or previously submitted documents. The application form requests information about the company, its export performance, finances, employees, and membership in organizations.

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Leo Cj Palmonis
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164 views4 pages

Affidavit of No Change Page 1-3

The document is an affidavit and application form for renewal of accreditation in the Client Profile Registration System (CPRS) as an exporter with the Bureau of Customs in the Philippines. The affidavit confirms there have been no changes to the company's circumstances or previously submitted documents. The application form requests information about the company, its export performance, finances, employees, and membership in organizations.

Uploaded by

Leo Cj Palmonis
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 4

REPUBLIC OF THE PHILIPPINES)

CITY OF ______________ ) S.S

AFFIDAVIT OF NO CHANGE
(On Information on CPRS Application Form)

I, ____________(name)_____________, Filipino, of legal age and


with postal address at ___________(address)_______________________, after
having been duly sworn in accordance with the law do hereby depose and state:

That I am, ________(position)_______, of


________(company)________, with main office at ______________(business
address)___________________________________________.

That, ______(company)_______________, is a registered applicant


of the Client Profile Registration System (CPRS) as Exporter with the Bureau of
Customs;

That in connection with the application for a renewal of CPRS


Accreditation as Exporter with the Bureau of Customs, I hereby confirm that there
are no changes in the circumstances of our company as well as on the documents
earlier submitted where no update is necessary;

That I am executing this affidavit for the purpose of filing a yearly


update on the approved application in compliance with the requirements of the
Bureau of Customs and Philippine Exporters Confederation, Inc.

___________________
AFFIANT

Page 1 / 3
CLIENT PROFILE REGISTRATION SYSTEM (CPRS) INFORMATION

Please fill up all information. Do not leave any information blank. If not applicable,
please indicate not applicable.
Company Name:_________________________________________________________________
TIN Number : _________________________ Website: _________________________________
Office Address:__________________________________________________________________
Warehouse/Plant Address:_________________________________________________________
Product Lines/Services:___________________________________________________________
Export Products for CPRS:_________________________________________________________
With BOC AMO (Account Management Office)accreditation?

_____Yes Imported Materials:___________________________________________ / _____ No

Export Performance for the Past Year (if none, pls. indicate “No Export”)
Products Exported: ____________________________________
Countries of Destination: ________________________________
Value (Pesos):________________________________________
How many times per year: _______________________________
Countries of Export:______________________________________________
For Corporations:
Authorized Capital Stock:__________(based on General Information Sheet as of ______ year)
Paid-Up Capital Stock: ____________(based on General Information Sheet as of ______ year)
Total Assets: ___________________(based on Audited Financial Statement as of ______ year)
For Sole Proprietorship's:
Owner’s Equity:_________________(based on Audited Financial Statement as of ______ year)
Total Assets: ___________________(based on Audited Financial Statement as of ______ year)
No. of Employees:
Office Plant
Regular __________ __________
Contractual __________ __________
Organizations/Associated Membership: ____________________________________________
Trade Fairs Participated (Local & International) : ____________________________________
_____________________________________________________________________
Accomplished by CPRS Authorized Company Officer:
Name of Person: ___________________________________________________________
Signature over printed Name
Position: ___________________________________________________________________
Contact No/s: _________________________ Date:________________________________
NOTES: * This form is to be filled up by Authorized Representative as per the submitted
Secretary's Certificate.

============Only for Member(s) of PHILEXPORT Membership=============


Official Representative(s):
Contact Person 1: _____________________________ Position : _______________________
Mobile No.: ___________________________ Telephone No.: ________________________
Facebook/Messenger/Viber Account: ______________________________________________
Email Address : ______________________________________________________________

Alternate Representative(s):
Contact Person 2: _____________________________ Position : _______________________
Mobile No.: ___________________________ Telephone No.: ________________________
Facebook/Messenger/Viber Account: ______________________________________________
Email Address : ______________________________________________________________
Page 2 / 3

DATA PRIVACY DISCLAIMER

DATA PRIVACY STATEMENT AND CONSENT FORM FOR THE


CLIENT PROFILE REGISTRATION SYSTEM (CPRS) APPLICATION

I understand and agree that by my voluntary engagement of the services of PHILEXPORT,


and by providing my personal information, I am giving consent to PHILEXPORT to collect,
store, access, share and process my personal data, whether manually or electronically,
which will be used for the purpose of Client Profile Registration System (CPRS) application.

I am aware of and understand my rights under the Data Privacy Act of 2012 and that while I
have the right to object, it is still necessary for PHILEXPORT to collect, store, access, share
and process my personal data for the purpose of CPRS application with the Bureau of
Customs.

I am aware that no persons, other than the relevant PHILEXPORT employees, are
authorized to access my personal data held in the database, and that all persons who need
to access and process my information are required to maintain its confidentiality and
compliance with privacy laws.

I also acknowledge and warrant that this waiver frees PHILEXPORT from any complaint, law
suit, or damages in relation to this process.

I confirm that the contents of this consent form have been explained to me in terms that I
understand and that I agree to the provisions stated above. My signature below signifies my
voluntary consent to the above.

________________________________________
Name and signature of Authorized Representative

Company : ___________________________
Position : ___________________________
Date : ___________________________

SUBSCRIBED AND SWORN to before me this ________ day of__________________,(CPRS


Official Representative), exhibiting to me his/her Community Tax Certificate
No.______________________ issued on________________________ at _______________,
Philippines.

NOTARY PUBLIC
Doc. No. _________
Page No. _________
Book No._________
Series No. ________

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