BOI FORM 501-Energy APPLICATION NO. :(Revised as of 01 December 2014) DATE ACCEPTED :

REPUBLIC OF THE PHILIPPINESBOARD OF INVESTMENTS

APPLICATION FOR REGISTRATION OF ENERGY PROJECT *A. APPLICANTNAME OF ENTITY :OWNERSHIP : % Filipino % Foreign (Nationality)TAX ACCOUNT NO. :SEC REGISTRATION : No. : Date :OFFICE ADDRESS :

ZIP CODE :TELEPHONE NO. : FAX NO. :

AUTHORIZED OFFICER:NAME :DESIGNATION :LANDLINE NO. : FAX NO. :MOBILE NO. : E-MAIL ADDRESS :

APPLICANT’S REPRESENTATIVE TO BOI:NAME :ADDRESS :

LANDLINE NO. : FAX NO. :MOBILE NO. : E-MAIL ADDRESS :

B. ACTIVITY/ AREA OF INVESTMENT APPLIED FORIPP Category : Regular List Mandatory ListActivity as listed in the IPP :

Under E.O. 226 (Listed in the Investment Priorities Plan (IPP) – Energy)Type of Project: New Expansion Modernization ExistingStatus: Non-Pioneer Pioneer Basis for Pioneer Status:

Under R.A 9513 (Renewable Energy Act 2008) New Investment Additional Investment Existing Investment

Name of Project :Specific Products/Services :Capacity/Year (in MW, if electricity generation)Project Location :Start of Commercial Operation :C. ENERGY SOURCE/ FUEL

Biomass Hydro Wind GasGeothermal Solar Coal Others, Specify

*This Form applies to power and non-power energy projects, (e.g., bio-fuels, etc.)

ENERGY PROJECT REPORT 1) PROJECT DESCRIPTION

Attachment: Business Model of the activity being registered (clearly indicating among others, all revenue-Business Model of the activity being registered (clearly indicating among others, all revenue-generating activities of the enterprise, including the activities proposed for BOI registration)generating activities of the enterprise, including the activities proposed for BOI registration)

2) PROJECT LOCATION - Provide description and Google map of the project site3) PROPOSED MARKET/CLIENTS - Provide list of targeted clients and their energy requirements

Attachment: Proof of Assured Market: Copy of Power Supply Agreement, Purchase Orders or Letters of Intent, etc.

4) PRODUCTION AND TECHNOLOGY: a. Energy Source/ Raw Materials

(The Table below applies to development of biomass energy resources and non-power applications, e.g., bio-fuels, etc; Add rows, if necessary)

Description Cost per Unit of Raw MaterialRaw Material Usage Rate per

kWh Generated/ Unit of Finished Product

Supplier

Indicate applicable units of measure, e.g., metric tons, liters, etc. Add rows, if necessaryNet Value Added: Applicable if applying under E.O. 226:

Y1 Y2 Y3 Y4 Y5Costs in (PhP):

Total Production Imported Raw Material Local Raw Material

Net Value Added (NVA) -% NVA -to be computed by BOI Y1 is the first year (12-month period) of commercial operations

b. Machinery and Equipment (Add rows, if necessary)Equipment Country Source End-use Qty (No. of units) Unit Cost (PhP) Total Cost (PhP)

Total: (A)End Use is the application or processing step where the equipment will be usedBreakdown of Machinery & Equipment Costs, as to source and status of acquisition

Status of Acquisition Cost of Locally Sourced (PhP) Cost of Imported (PhP) Total Cost (PhP)

Already acquiredFor acquisition

Total: (A)c. Process: Provide Process Flow Chart, with Description of Each Process

5) PROJECT TIMETABLE/COST:Activity Schedule (Mo.& Yr) Related Expenses Cost (in PhP)

Obtaining licenses, permits, registration Pre-operating expenseProject Site preparation & development Hiring of Contractors Civil works

LandLand improvementsBuildingLeasehold Improvements Other expenses

Acquisition & installation of mach. & equipment Machinery & equipment: (A)Start of commercial operation Working capital (__ mos.)

Total Project Cost (B)Working capital normally covers the first three to four months of commercial operationsYearly Investment Requirement (For projects with a gestation period of more than one year)Add columns, if necessary

Pre-Operating Period TotalYearInvestment Requirement (PhP) (B)

BOI Form No. 501, Page 2 of 6

Total Investment Requirement should tally with the Total Project Cost6) PROJECT FINANCING

Sources of Funds Amount in PhP % to TotalEquity Loan

Total Financing (B)Total Financing should tally with the Total Project CostAttachment: Proof of financial close; or information on status of loan application Provide also information on: Collateral for the loan; and, Whether or not the applicant enterprise needs sovereign/ government guarantee for the proposed project.

7) PROJECTED PRODUCTION & SALES SCHEDULE:a) For Power ApplicationsYear 1 2 3 4 5No. Turbine Generators/ PV Modules Capacity (MW) Total Rated Capacity (MW)Operating Hours per YearSales (kWh)Selling Price (PhP/kWh)Sales Value (PhP)If applicable:Carbon Emission Reductions (CERs) (in MT CO2)Price of CER (Equivalent in PhP /MT CO2)Gross CER Revenue (PhP)Total Revenues (PhP)Y1 is the first year (12-month period) of commercial operationsb) For Non-Power Applications, e.g., bio-fuels, etc.

Year 1 2 3 4 5Total Production Volume (indicate unit of measure) Sales Volume (indicate unit of measure)Selling Price (PhP per unit of measure))Total Sales Value (PhP)If applicable:Carbon Emission Reductions (CERs) (in MT CO2)Price of CER (Equivalent in PhP /MT CO2)Gross CER Revenue (PhP)Total Revenues (PhP)

Indicate unit of measure (e.g., metric tons, liters, etc.) Projected annual production volume should not exceed the production capacity per year being applied for BOI registrationAssumptions Used in the Projections:o Y1 is the first year (12-month period) of commercial operationso No. of shifts per dayo No. of Operating days per yearo Basis for the selling price(s)o Others

8) JOB GENERATION Employee Type No. of employees Annual Payroll (PhP’000)

Y1 Y2 Y3 Y4 Y5 Y1 Y2 Y3 Y4 Y5Direct LaborIndirect LaborAdministrative/Sales

Total:Y1 is the first year (12-month period) of commercial operations

9) FINANCIAL PROJECTIONS (preferably in Excel format):Provide 2 sets of Projected Income Statements for 15 years*, with itemized Cost of Sales, Manufacturing Overhead and Operating Expenses including breakdown on government share, real property taxes, licensing and business permits, etc. 1 Set WITH Corporate Tax Incentives* , 1 Set WITHOUT Corporate Tax Incentives , i.e., with corporate tax rate of 30% from Year 1 (Year 1 is the first 12-months of

commercial operations)------------*Notes:If under E.O 226: with ITH period depending on the type and status of registration; and with corporate tax rate of 30% after the ITH period;

BOI Form No. 501, Page 3 of 6

If Under RA 9513 i.e., with 7-year ITH and corporate tax rate of 10% (instead of 30%) from year 810) JUSTIFICATION FOR PIONEER STATUS (if applying for pioneer status under EO 226)11) IF THE APPLICATION FOR REGISTRATION COVERS EXPANSION or MODERNIZATION/UPGRADING

OF AN EXISTING PROJECT; or ADDITIONAL INVESTMENTS:a) For Power Applications

Actual Generation & Sales (Volume & Value) for the past three (3) years Year

No. of Turbine Generators/ PV ModulesCapacity (MW) Total Rated Capacity (MW)Operating Hours per YearProduction (kWh)Sales (kWh)Selling Price (PhP/kWh)Sales Value (PhP)

b) For Non-Power Applications, e.g., bio-fuels, etc. Actual Production & Sales (Volume & Value) for the past three (3) years

Year Installed Capacity

Production Volume

Sales Volume (No. of units)

Average Selling Price (PhP per Unit) Total Sales Value (PhP)

Domestic Export Domestic Export Domestic Export Total

Indicate unit of measure (e.g., metric tons, liters, etc.)YEARo Foreign Exchange Rate Used (in PhP

per USD)o No. of shifts per dayo No. of Operating days per yearAttachment: Plant and machinery Lay-out providing distinction as to the existing/currently installed facilities vis-a-vis proposed facilities covered by the application for BOI registration12) FOR MODERNIZATION PROJECTS

Compliance to 25% Substantial Reduction of Total Cost of Production/ServiceProduction/

Generation Cost Before Modernization

Production/ Generation Cost

After Modernization

Reduction of Cost Production/ Service

    Cost Difference Percentage(A) (B) A-B = (C) C / TCS

Total Raw Materials         Local         Imported        

Direct Labor        Manufacturing Overhead:         

Utilities:         Electricity

Water Communication Total Utilities Other Manufacturing Overhead:

Indirect Labor         Factory Supplies         Insurance Expenses         Depreciation & Amortization         Repairs & Maintenance         Others

Total Other Manufacturing OverheadTotal Cost of Sales (TCS)       (25% minimum)

Matrix of Machines and Equipment (Existing & Replacement) (Add rows, if necessary)Processing

Step/ Existing Machines & Equipment Replacement Machines & Equipment

under Modernization Program

BOI Form No. 501, Page 4 of 6

Stage Machine Type/Model

Age/ Year Acquired Qty Actual

Prodn Capacity End-Use Quantity Production Capacity Expected Efficiency

13) PROJECT PROPONENTSFOR SOLE PROPRIETORSHIP

Name Nationality Country of Residence Capital (In Pesos)

FOR CORPORATION/PARTNERSHIPSAuthorized Capital PhPStockholders (Add rows, if necessary)

NameNationality (indicate

with * if naturalized Filipino)

Country of Residence

Subscribed Capital Paid-Up Capital % Ownership

No. of Shares Value No. of Shares Value

Total:Directors (Add rows, if necessary)

Name Nationality Country of Residence

Principal Officers) (Add rows, if necessary)Name Nationality Designation

Attachment for enterprises which are not newly-incorporatedfor enterprises which are not newly-incorporated: : Copy of Latest General Information Sheet (GIS) Copy of Latest General Information Sheet (GIS) Copy of Audited Financial Statements (past 3 Years)

a. BACKGROUND ON THE APPLICANT ENTERPRISEIncluding but not limited to applicant enterprise’s and its stockholders’ previous and current businesses other than the proposed project being applied for BOI registration.

b. AFFILIATES (if applicable), (Add columns/rows, if necessary)Applicant Enterprise

Parent Company

Affiliate 1 Affiliate 2

Business ActivitiesNon-Power ProjectsPower Projects/ CapacitiesLocation of Power ProjectsBOI Reg’n No./ DateLaw Governing the BOI Registration Start of Commercial Operations

Name of Stockholders Nationality % Ownership % Ownership % Ownership % Ownership

c. EXISTING ENERGY PROJECTS OF APPLICANT ENTERPRISE (Add columns, if necessary)Project 1 Project 2 Project 3 Project 4

Business ActivitiesPower ProjectsLocation of Power ProjectsCapacity of Power ProjectsStart of Commercial OperationsBOI Reg’n No./ Date (if applicable)Law Governing the BOI Registration

OTHER ATTACHMENTS: (Provide also e- copy of the Application Form, Project Report including Financial Projections preferably in word 2003 or Excel 2003 format a. Copy of SEC Certificate of Registration, Articles of Incorporation/Partnership and By-Laws, Copy of SEC Certificate of Registration, Articles of Incorporation/Partnership and By-Laws, (the primary/secondary purpose should cover the activity being registered

with the BOI); or Copy of DTI Certificate of Registration (for sole proprietor)b. Secretary’s Certificate re: applicant enterprise’s Board Resolution authorizing its officer/ official representative to transact with BOI, execute and sign all documents in

behalf of the applicant enterprise pertaining to the application for BOI registration. (Use BOI format) c. Copy of Environmental Compliance Certificate/ Certificate of Non-Coverage, whichever is applicable for the project; or information on status of application d. If incentives are to be governed by EO 226 If incentives are to be governed by RA 9513 Letter of Intent to register with the BOI the Renewable Energy

project to avail of the incentives set forth under EO 226 Letter of Intent to register with BOI the RE project to avail of the incentives set forth

under R.A. 9513, pursuant to the MOA between DOE and BOI DOE Endorsement Copy of DOE Certificate of Registration

BOI Form No. 501, Page 5 of 6

Copy of RE Operating/Service Contracte. Other documents that maybe required by the Board during the course of the evaluation of the project.

The applicant has read the Republic Act 9513 (Renewable Energy Act of 2008), and the Rules and Regulations adopted by the DOE and BOI/ Omnibus Investment Code of 1987 and the Rules and Regulations adopted by the BOI and commits itself to abide by the provisions thereof.DONE IN THE CITY/PROVINCE OF THIS DAY OF

20 .

Applicant/Authorized OfficerREPUBLIC OF THE PHILIPPINESCITY/PROVINCE OF ) S.S.MUNICIPALITY OF )

SUBSCRIBED AND SWORN to before me this day of 20 in the City/Province of affiant exhibited to me his Residence Certificate No. issued at on

20 . NOTARY PUBLIC

Until Dec. 31, Doc. No. :Page No. :Book No. :Series of :

SAMPLE FORMAT (Use separate sheet) SECRETARY’S CERTIFICATE

I, (name of Corporate Secretary), of legal age, Filipino, being the duly elected and qualified Corporate Secretary of (name of applicant enterprise), a corporation duly organized and existing under the laws of the Philippines, with office address at (office address of applicant enterprise), under oath, do hereby certify that at the special meeting of the Board of Directors of the Corporation held on (date of special meeting), the following resolution was unanimously adopted:

RESOLVED, that (name of officer of enterprise), (position of officer) be as it hereby, authorized to transact, execute and sign all documents in behalf of the Corporation pertaining to its application for registration with the Board of Investments (BOI) for purposes of availing the applicable incentives under the Renewable Energy Act of 2008 (Republic Act No. 9513)/ Omnibus Investments Code of 1987 (Executive Order No. 226) as amended for the (proposed project activity) as Renewable Energy Developer/ (New)(Expanding)(Existing) Producer/Operator of _________ , which is covered by the Mandatory/ Regular List of the 20___ Investment Priorities Plan (IPP) of the BOI.

IN WITNESS WHEREOF, I have hereunto affixed my signature this __________ day of _____________, 20___ at __________________________.Corporate Secretary

Subscribed and Sworn to before me this __________________ at _______________, affiant exhibited to me his CTC No. ____________________ issued on ___________________ at ___________________.Notary Public Doc. No. _______Page No. _______Book No. _______

BOI Form No. 501, Page 6 of 6

Series of _______

BOI Form No. 501, Page 7 of 6