Republic of the Philippines
Department of Labor and Employment
Cordillera Administrative Region
Cabinet Hill, Baguio City
FM-OM-06-04
REV 0 01/08/2015
APPLICATION FOR LICENSE TO OPERATE A
PRIVATE RECRUITMENT AND PLACEMENT AGENCY
TYPE OF APPLICATION: New Renewal
NAME OF AGENCY: ________________________________________________________________________
ADDRESS OF AGENCY: ______________________________________________________________________
TIN No. ____________________ TEL/FAX Nos. __________________________________________________
TYPE OF BUSINESS ORGANIZATION: (Please check)
[ ] Sole Proprietorship [ ] Partnership [ ] Corporation
Date of Registration: __________________________ Reg. No. ________________________________
COMPREHENSIVE DESCRIPTION OF OPERATION:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
FINANCE:
Total Assets: _________________________________ Bank Statement _______________________________
Total Liabilities: ______________________________ Date of Statement _____________________________
Networth: ________________________________________________________________________________
Paid Up Capital: ____________________________________________________________________________
Date of Statement: _________________________________________________________________________
MANAGEMENT AND STAFF:
NAME DESIGNATION ADDRESS
In witness whereof, I have hereunto affixed my signature this __________ day of
__________________, 20___ in ___________________.
_______________________________________
(Applicant’s Name and Signature)
SUBSCRIBED AND SWORN to before me this ______ day of ______________, 20____ in _________________, Applicant
exhibiting to me his/her Residence Certificate No. _________ issued at _______________________ on
_______________________.
NOTARY PUBLIC
Doc. No. __________
Page No. __________
Book No. __________
Series of __________
CHECKLIST OF REQUIREMENTS
Filing fee of PhP5,000.00
Two (2) copies of duly accomplished and notarized application form
Certified copy of the Certificate of Registration of firm or business name from the
Department of Trade and Industry (DTI) in case of single proprietorship; or a certified copy
of the Articles of Partnership or Incorporation duly registered with the Securities and
Exchange Commission (SEC), in the case of a partnership or a corporation
Documentary proof of ownership or lease of an office space with a floor area of at least
Fifty (50) square meters for the exclusive use of the agency. In case of lease, the contract
must be for a period of One (1) year with an option for renewal
Updated NBI clearance of the applicant owner, or partners in the case of a partnership, or
in case of corporation, its officers and directors
Proof of minimum networth of PhP1,000,000.00 in case of sigle proprietorship or proof of
minimum paid up capital of PhP1,000,000.00 in case of partnership or corporation
An affidavit of undertaking that the applicant shall:
- not support or engage in acts involving illegal recruitment, trafficking of persons,
violation of Anti-Child Labor Law or crimes involving moral turpitude or similar acts;
- ensure that DOLE Standard Recruitment are adhered to by the parties;
- not collect any fees whatsoever from the applicants; and
- assume full responsibility for all acts of its officers, employees and representatives in
connection with recruitment and placement activities
Designate an Office Manager and an Office Secretary or Clerk who must be knowledgeable
in the preparation and review of documents
Certificate of participation/attendance of agency’s management representative to a pre-
application seminar
Note: No application shall be accepted, unless all the requirements have been complied with.
For renewal of license, applicant must submit renewal of application not earlier than 60 days but
not later than 30 days before its expiration and must submit placement reports.
FEES, CASH AND SURETY BONDS:
Filing Fee PhP5,000.00
License Fee PhP15,000.00 (valid for 3 years)
Replacement for Loss License PhP1,000.00
Penalty Fee PhP10,000.00
Cash Bond PhP50,000.00
Surety Bond PhP100,000.00
