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APPENDIX I-3
Registration/Request for Issuance of Investment Certificate

(for cases associated with establishment of enterprise)

SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness


REGISTRATION/REQUEST FOR ISSUANCE OF INVESTMENT CERTIFICATE


To: [01]

[02] Name of investor:

Hereby registers establishment of an economic organization in order to implement an investment project with the following contents:

I. Contents of registration of establishment of the enterprise:

[03] 1. Name of the enterprise:
[04] 2. Address of the head office:
[05] Branch/Representative Office (if any):
[06] 3. Type of enterprise being registered for establishment:
[07] 4. Legal representative of the enterprise:
[08] 5. Business lines:
[09] 6. Capital of the enterprise:
[10] 7. Legal capital:

II. Contents of the investment project:

[11] 1. Name of the investment project:
[12] 2. Location for implementation of the project; proposed area of land to be used:
[13] 3. Objectives and scale of the project:
[14] 4. Proposed investment capital for implementation of the project:
[15] Of which: Capital contribution for implementation of the project:
[16] 5. Duration of operation:
[17] 6. Schedule for implementation of the project:
[18] 7. Recommendations [of the investor] on entitlement to investment incentives:

III. The investor undertakes:

1. [To be responsible for] the accuracy of the contents of the investment application file; and
2. To comply strictly with the provisions of the law of Vietnam and of the Investment Certificate.

                                                                                                  Dated:................

[19]                                                                                               INVESTOR
[20] Documents attached:

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