Business Clearance Form — Barangay Bolbok

Republic of the Philippines · Province of Batangas

Barangay Bolbok

Batangas City, Batangas · Tel: 043 980 0831 · contact@bolbok.gov.ph

BB-FORM-001

Rev. 01 · 2026

Business Clearance — Application Form

Control No.: Date Filed:

Business Owner / Applicant Information

Last Name

First Name

Middle Name

Contact Number

Email Address

Home Address

Business Information

Business / Trade Name

Type of Business

Nature of Business

Business Address in Barangay Bolbok

DTI / SEC / CDA Registration No.

TIN

No. of Employees

Type of Application

New Business

Renewal

Amendment / Change of Business Name

Change of Location

Valid ID Presented

Type of ID

ID Number

I hereby certify that all information stated above is true and correct. I understand that Barangay Business Clearance is required prior to the issuance of a City Business Permit and that any false declaration shall subject me to applicable penalties under existing laws.

Applicant's Signature over Printed Name

Date: __________________________

Punong Barangay / Authorized Official

Barangay Bolbok, Batangas City

For Office Use Only

OR Number

Amount Paid

Received By

* Processing time: 1–2 working days. Attach required documents: DTI/SEC registration, ID, and proof of business address.