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COVER SHEET

SEC Registration Number

(Companys Full Name)

I A
(Business Address: No. Street City/Town/Province)

(Contact Person)

(Company Telephone Number)

Month

Day

(Form Type)

Month

Day
(Annual Meeting)

(Fiscal Year)

(Secondary License Type, If Applicable)

Dept. Requiring this Doc.

Amended Articles Number/Section Total Amount of Borrowings

Total No. of Stockholders To be accomplished by SEC Personnel concerned

Domestic

Foreign

File Number

LCU

Document ID

Cashier

STAMPS Remarks: Please use BLACK ink for scanning purposes.

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