CPRS FORM 001 Rev 1

Client Profile Registration System (CPRS)

EXPORTER PROFILE INFORMAT

(for Sole / Single Proprietorship)
DATA ITEM

INFORMATION

Scanned Photo /

Mandatory
(Please submit your photo or logo in JPEG form)

Nature of Business / Mandatory

(Pls. refer to your BIR Certificate of Registration Form 2303)

Business Name /
First Name /

Mandatory

Middle Name /
Last Name /

Mandatory

Mandatory

Mandatory

Country of Citizenship /

Mandatory

Business Address
Address /
City /

Mandatory

Mandatory

Zip Code /
Country /

Mandatory

Mandatory

Contact Information
Phone /

Mandatory

Alternate Phone /
Mobile Phone /
Fax /

Optional

Optional

Optional

Email /

Mandatory

URL/Website /

Optional

Warehouse / Transit Shed Code /

Optional

Tax Identification Number /

Mandatory
(Pls. refer to your BIR Certificate of Registration Form 2303)

Social Security Number /

Passport Number /
Driver's License /
PRC ID No. /

Optional

Optional

Optional

Optional

Primary VASP CCN No. /

Mandatory

Secondary VASP CCN No. /

VA0000000051

Optional

PEZA-BOI Registration Number

(if applicable)/CARR Code / Optional
DTI Reference No./

Mandatory

This is to certify that all information in this page are true and correct.
Approved for CPRS registration by:
__________________________
Signature over Printed Name of Authorized Company Officer

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CPRS Exporter Profile Information

Company Name:

______________________________

Related domestic & foreign companies

Related company 1 /

Optional

Related company 2 /

Optional

Related company 3 /

Optional

Primary Broker / Mandatory (Please check In-House or Licensed Broker)

___In House
TIN

111-111-111-111

(Default)

Code

BR0000722111

(Default)

___Primary Licensed Broker ( Please attach Broker's Certificate of Registration)

TIN /

Mandatory

Code/

Mandatory

Plant/Warehouse Addresses/
Address /
City /

Mandatory

Mandatory

Zip Code /
Country /

Mandatory

Mandatory

Principal Officers/
First Name /

Last Name /
Position /

Mandatory to indicate at least one (1) Principal Officer

Mandatory

Middle Name /

TIN /

Mandatory to indicate at least one (1) Plant Address

Mandatory

Mandatory

Mandatory

Mandatory

Photo /

Mandatory
(Please submit in JPEG Form)

Signature /

Mandatory
(Original Signature)

Address
Address /
City /

Mandatory

Mandatory

Zip Code /
Country /
Phone /

Mandatory

Mandatory

Mandatory

Alternate Phone /
Mobile /
Fax /

Optional

Optional

Optional

Email /

Mandatory

Note: You may photocopy this page for multiple information entry .

This is to certify that all information in this page are true and correct.
Approved for CPRS registration by:
__________________________
Signature over Printed Name of Authorized Company Officer

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CPRS Exporter Profile Information

Responsible Officers/
First Name /

Last Name /

TIN /

______________________________

Mandatory to indicate at least one (1) Responsible Officer

Mandatory

Middle Name /

Position /

Company Name:

Mandatory

Mandatory

Mandatory

Mandatory

Area of Responsibility /

Mandatory

Photo /

Mandatory
(Please submit in JPEG Form)

Signature /

Mandatory
(Original Signature)

Address
Address /
City /

Mandatory

Mandatory

Zip Code /
Country /
Phone /

Mandatory

Mandatory

Mandatory

Alternate Phone /
Mobile /
Fax /

Optional

Optional

Email /

Mandatory

Major Suppliers /
TIN /

Optional

Mandatory to indicate at least one (1) Major Supplier

Mandatory

Name /

Mandatory

Address
Address /
City /

Mandatory

Mandatory

Zip Code /
Country /
Phone /

Mandatory

Mandatory

Mandatory

Alternate Phone /
Mobile /
Fax /

Optional

Optional

Optional

Email /

Mandatory

Note: You may photocopy this page for multiple information entry.
This is to certify that all information in this page are true and correct.
Approved for CPRS registration by: ______________________________
Signature over Printed Name of Authorized Company Officer

Page 3 / 4

CLIENT PROFILE REGISTRATION SYSTEM (CPRS) INFORMATION

Company Name: ___________________________________________________________

Office Address:

____________________________________________________________

Warehouse/Plant Address: _____________________________________________________

Product Lines/Services:

_____________________________________________________

Export Products for CPRS:

_____________________________________________________

With BOC AMO (Account Management Office)

accreditation?

________Yes Imported Materials:___________________________________________

________ No
Exports from the Previous Year:
Products Exported: ____________________________________
Value (Pesos):________________________________________
How many times per year: _______________________________
Countries of Export:____________________________________
No. of Employees:
Office
__________
__________

Plant
__________
__________

Office
Size in sqm. __________

Plant
__________

Regular
Contractual
Size of Office/Plant:

Organizations/Associated Membership:________________________________________________
Accomplished By:
Name of

Person:

Position:

_________________________________________________________________

Contact No/s:

_______________________________________________________________

Date:
NOTES:

_______________________________________________________________

_________________________________________________________________
* This form is to be filled up by Authorized Representative as per the submitted
Secretary's Certificate.
* The form is to be attached to the revised CPRS Application Form (if with changes) or
the Affidavit of No Change and included among the pages to be notarized.

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

Secretary), 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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