HOW TO APPLY OTB STATION

OFF-TRACK BETTING STATION (OTB) APPLICATION FORM

DATE OF APPLICATION: ___________

NAME OF APPLICANT: _________________________________________________

ADDRESS OF OTB SITE:_________________________________________________

NAME OF OTB SITE (IF ANY):_________________________________

TEL. NOS.                                                                                 

RESIDENCE:  ____________    ADDRESS: ______________________

OFFICE:         _____________  ADDRESS: ______________________

CELLPHONE:_______________________________

OTB SITE:    ________________________________

NATURE OF EXISTING BUSINESS ON THE OTB SITE (Please Check):

CANTEEN___  RESTAURANT___  VIDEOKE___  BAR___  VACANT SPACE___

OTHERS:_________________________________________________________

LOCATION / SITE STATUS:        OWNED____ LEASED____ (if any)

                                              MONTHLY RENTAL__________

                                              LEASE PERIOD ______________

LOT AREA (sq.m.) ___________           

FLOOR AREA (sq.m.)_________   PARKING (no.) ________ TOILETS __________

TEL. LINES (no.) ____________   Name of Tel. Company ____________________

CABLE LINES (no.) _________     Name of Cable Company ___________________

OTHER INFORMATION:

_________________________________________________________

_________________________________________________________

                                                                                                ACCOMPLISHED PAPER REQUIREMENTS

(To be checked by OIC)

__SKETCH MAP OF PROPOSED SITE

__PICTURES OF OTB SITE (INSIDE/OUT)

__LATEST ID PICTURE OF APPLICANT (2x2)

__PROOF OF BILLING (ELECTRIC, TEL.,ETC)

__BUSINESS REGISTRATION CERTIFICATE

__LEASE CONTRACT

__WRITTEN CONSENT FROM LESSOR 

Signature of Authorized Representative         
           Sign Over Printed Name