1. Unit 6-D 6th floor, Washington Tower Condominium
The Asiaworld City, E. Aguinaldo Blvd.
Parañaque City, Philippines
Tel: +63 2 459-2133
Website: www.ekonek.com
marketing@ekonek.com
VASP ENROLLMENT FORM
Value Added Service Provider
□ PEZA Expanded □
AFAB/CDC/
□ PEZA e-IPS □ PEZA ELSE AEDS SBMA e-TAPS BOC e2m
(Electronic Import (Electronic Import (Automated Export (Electronic Transit Customs Systems
Permit System) Permit System) Documentation Admission Permit □ e-manifest
System) System)
□ Import/Transit
□ CDC EEDS □ AFAB/SBMA AEDS □
SBMA GMS
□ PSAD – E-ACTS □ Export
(Enhanced Automated
(Electronic Export (Automated Export (GatePass
Cargo Transfer □ OLRS
Declaration System) Documentation System) Management System)
System)
Client Type □ Importer/Exporter □ Broker/Forwarder □ Airline/Shipping Line □ CBW/CY-CFS
*Company Name/ Broker/ Forwarder:
*Address:
*Telephone No: Fax:
*Tax Identification No (TIN): *PEZA/AFAB/CLARK/SUBIC or BOC Reg. No.
*Responsible Officer: Position Title:
*Telephone No: Mobile No: *E-mail:
*Officer for Billing Purposes: Position Title:
*Billing Address:
*Telephone No: Fax:: *E-mail:
*Email(s) to be used in e-broadcasting:
Authorized User (Please list additional authorized users in a separate sheet, sign the list and attach it as part of the Enrollment Form)
*User's Full Name: User's Email:
By submitting this document, I hereby agree to the non-repudiation of e-documents (e.g., declarations,
entries, etc.) lodged through the VASP System of E-Konek Pilipinas, Inc. as accredited Value Added
Service Provider. I also commit to pay directly or through my logistics provider whatever market-based
fees E-Konek Pilipinas, Inc. shall charge for services rendered.
___________________________________________ _______________________
Signature over Printed Name of Responsible Officer Date
E-mail to lmisa@ekonek.com ; marketing@ekonek.com ; ekonek.help@ekonek.com or
Fax to (02) 879-4207 or (02) 879-8310;
To be accomplished by E-Konek Pilipinas, Inc.
Date Received: Status:
Username Issued: Account Reference:

2. Unit 6-D 6th floor, Washington Tower Condominium
The Asiaworld City, E. Aguinaldo Blvd.
Parañaque City, Philippines
Tel: +63 2 459-2133
Website: www.ekonek.com
marketing@ekonek.com