Year
Year
Year
Average annual production
Average annual production employment
Total annual man hours for workers of the
exempted business
Number of units produced annually or
services rendered
Annual sales value (billed) for said units
4.
If Applicant does not accept the applicability of Section 16 of the Act, submit supporting data, or any
other evidence supporting that the products or services are not substantially similar.
Section IV: For Informational Purposes Only
A. Educational level of employees and numbers required:
Education
Current
12-Month Projection
High school
Associate’s degree
Undergraduate
Graduate
PhD
B. Are the Applicant’s operations related to, or will be related to scientific research and development?
□ Yes □ No
If the response is in the affirmative, provide the following information:
Current
12-Month Projection
Specialization
Amount of employees
Payroll
Amount of employees
Payroll
Total
C. Principal marketing outlets for products or services to be rendered:
Purchaser
Product
Parent Company
Their Party (name)
City/ Country
Export %
This Application must be signed by an authorized officer of the Applicant. All the information submitted in this
Application is subject to verification, and additional information may be requested as needed for its consideration.
The submission of false information in this Application will be grounds for denying the granting of a decree and
Applicant may be civil and criminally liable in accordance with applicable statutes.
Name (Print)
Authorized Signature
5