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统一投资申请表
Unified Investment Application Form
in Lao P.D.R.
投资申请表填写指南
(Instruction for filling out Investment Application Form)
? 请仔细阅读每项问题，并且正确回答（印刷体）。
(Please read every question carefully and answer correctly, to the best of your knowledge and legibly (Print or block letters) ? 如果所提供的填写空间有限，请另附纸张。(If the space provided for your answer is not sufficient, please use separate sheets and attach)
? 金额单位为美元 (Please use US dollars as a reference) ? 请随附任何您认为必要的文件。
(Please attach any document(s) that you think is (are) relevant)
? 更多信息请联系我们 (For more information please contact us)-: ?ê (by phone): (856 ?- 21) 219568, 222690, áì? (and) 215636 í-? (or) á3?? (by fax): (856 ?- 21) 215491.
??§?¤ -??--á°--??- -áì? -??--ì?¤ê?- ??′-|‰¤-à|ó′-??--ì?¤-ê?-
Ministry for Planning and Investment Investment Promotion Department
?请递交8份申请表。(Please submit 8 copies of your application form)
?请自留一份备您参考。(An extra copy of your application form should be kept for your reference)
|?ê?ì?-?ì?? ˉ?§?êòˉ??a ˉ?§?§?-ì??
|?-aò2?? ào??ì?? ˉ?§?êòˉ??a ào??2?? ???ê?-????o-
***********
促进管理部参考号. Department for Promotion and Management Reference No.
of Domestic and Foreign Investment
郎布拉邦路，万象01001，老挝.
Luangprabang Road, Vientaine 01001, Lao PDR.
联合投资申请表
用于投资审批、公司注册和税务注册
（表.A.）
Unified Investment Application Form
for Investment approval, Business registration
and
Tax registration
(FORM .A.)
我代表全部股东，就如下事项，向您递交该申请表
On behalf of all shareholders I apply this application form for your consideration for the following approvals
1. 投资许可
Investment License
2. 企业许可
Enterprise License
3. 税务注册
Tax Registration
具体所需信息提供如下
The particular required information are provided as below
必要信息(Part A Essential Information)
I.投资人/申请人相关信息
(Information concerning investors / Applicants)
a.名...................................................... 姓...................................................
First Name ...................................... ……https://www.doczj.com/doc/c0562659.html,st Name........... ................. ...........................
b. 出生日期....................................出生地点...............................................
Date of birth ................................... ..........Place of birth ........................ ...........................
c. 国籍..............................................职业.......................................................... Nationality...................................... .......... Occupation ......................... ...........................
d. 家庭住址................................................................................................................ Home Address ................................ ............................ ........................... ...........................
e. 护照号码............................签发日期.................................................
Passport No .................................... ..........Date of Issued ....................... ...........................
f. 签发地点............................................?有效期至................................................
Place of Issued ............................... ...........Valid Until ........................... ...........................
II.将要注册的信公司的相关信息 (Information concerning the company to be established)
2.1. 有4类企业，3种企业及2种合伙人关系和2种公司(There are 4 types of enterprise;
3 forms of Enterprise and 2 Kinds of partnership and 2 Kinds of Company).
2.1.1. 企业类别 (Type of Enterprise):
私营企业(Private Enterprise)
国有企业 (State Enterprise)
合资企业 (Joint Venture Enterprise)
合作企业 (Cooperative Enterprise)
2.1.2.企业种类 (Forms of Enterprise)
独资企业 (Individual Enterprise)
共同经营企业 (Partnership Enterprise)
公司 (Company)
2.1.
3. 合伙人种类 (Kinds of Partnership)
普通合伙人 (Ordinary Partnership)
有限合伙人 (Limited Partnership)
2.1.4. ˉ?à2??eìò|??:
有限公司包括独资有限公司(Limited Company Including sole limited company) 公众公司 (Public Company)
2.2. 总资本 (Total Capital)
总资本(Total Capital):.....................................................................................$
-运营资本(Working Capital):.....................................................................$
-固定资本(Fixed Capital):................................................................................$
2.3.注册资本(Registered Capital)
注册资本 (Registered Capital): ......................................................................$
不得少于总资本的30%。No less than 30% of the total capital )
固定资产Fixed Assets):....................................................................................$
流动资产 (Current Asset): ...................................................................$
III.公司资产相关信息（注册资本相关）
Informa tion concerning the company’s assets ( By registered capital)
IV. 将要注册的新公司的相关信息
Information concerning the company to be established
A.- 提议的新公司名称(Proposed name of the company to be incorporated)
老挝文名称?
(In Lao language): .......................... ....................................................................................
英文/法文名称
(In English/French):............................................. ...............................................................
B.业务领域 (Business Sector)
?农业(Agri-business) ?制造业(Manufacturing)
?能源 (Energy) ?矿业 (Mining)
?旅游 (Tourism) ?酒店(Hotel)
?运输 (Transportation) ?电信 (Telecom)
?建筑(Construction) ?贸易 (Trading)
?咨询 (Consultancy) ?服务(Services)
经营范围描述 ( Descriptions of Business Activities)
…………………………………………………………………………………………
…………………………………………………………………………………………
…………………………………………………………………………………………
C. 运用的会计准则
The Accounting Principle to be Applied
传统式 (Conventional) 扩展式 (Extended)
D. 新公司预选地址
The proposed location where the company is to be established
总部(Head office):
省 (Province)......................... ................................ 地区 (District) ....................................
村(Village) ............................ ................................ 单位(Unit) ..........................................
房屋号(House No)..........................路/街 (Road/Street) .....
电话 (Phone No). .................. ................................ 传真 (Fax No).....................................
电子邮件(E?mail).............. ................................ ............. ..............................................
分支机构Branch office (如有/ If any):
省 (Province)......................... ................................ 地区 (District) ....................................
村(Village) ............................ ................................ 单位(Unit) ..........................................
房屋号(House No)..........................路/街 (Road/Street) .....
电话 (Phone No). .................. ................................ 传真 (Fax No).....................................
电子邮件(E?mail).............. ................................ ............. ..............................................
生产地址 (Production site):
省 (Province)......................... ................................ 地区 (District) ....................................
村(Village) ............................ ................................ 单位(Unit) ..........................................
房屋号(House No)..........................路/街 (Road/Street) .....
电话 (Phone No). .................. ................................ 传真 (Fax No).....................................
电子邮件(E?mail).............. ................................ ............. ..............................................
库房仓储地址（如果与生产地址不同）
(Warehouse/stock if different from production site):
省 (Province)......................... ................................ 地区 (District) ....................................
村(Village) ............................ ................................ 单位(Unit) ..........................................
房屋号(House No)..........................路/街 (Road/Street) .....
电话 (Phone No). .................. ................................ 传真 (Fax No).....................................
电子邮件(E?mail).............. ................................ ............. ..............................................
E.投资许可上显示的人员的姓名
Names of Persons to be Appeared on an Investment License
V.股东信息
Information concerning the shareholders
VI.管理相关信息
Information concerning the Management
C.对当地人的培训计划
Training Plan for Local Staff
?国内培训(Domestic Training)
?工作中培训(On the Job Training)
?海外培训 (Overseas Training)
?教育支持 (Educational Supports)
?其他 (Others)…
VII. 投资计划信息
Information Concerning the Investment Plans
A.针对20 /01/01经营业绩（美元） (Performa Balance Sheet as of 01/01/20 (i)
USD)
B.收入预期(美元)
@: Profit Tax rate (10%, 15%, 20%, 35%) depending on investment zone and
activities as specified in the Investment Law
D.预期现金流
E.所需土地要求（平方米或公顷）
Land Requirement expressed in m2 or ha
1.办公用For Office………………………………………………………
2.厂房用/运营用For Factory/Operation…………………………………………..
3.用于其它建设/For other construction……………………………………..…VIII. 产品/服务/市场相关信息
Information Concerning Products/Services/Market
a.提供产品/服务的特征描述，如型号、尺寸、质量、标准等等(Provide some
characteristics of the products/services, e.g. type, size, quality, standard, etc.)
.... .........................................................................................................................
.... .........................................................................................................................
.... .........................................................................................................................
.... .........................................................................................................................
.... .........................................................................................................................
.... ………………………………………………………………………………..
b.描述生产/交货/分销程序
(Describe the Production/Delivery/Distribution procedures)
.... .........................................................................................................................
.... .........................................................................................................................
.... .........................................................................................................................
.... .........................................................................................................................
.... .........................................................................................................................
.... ……………………………………………………………………………….
c.描述目标市场(Describe Targeted Markets)
.... .........................................................................................................................
.... .........................................................................................................................
.... .........................................................................................................................
.... .........................................................................................................................
.... .........................................................................................................................
.... ………………………………………………………………………………
IX. 输入相关信息
Information Concerning the Inputs Requirements
X.欲进口的机械/厂房/设备相关信息
Information about Machinery/Plant/Equipment to be Imported
If this table is insufficient, new sheets should be provided
XI. 执行进度信息
Information about Implementation Schedule
?注册公司(Register the company)在 (within): 天以内(days).
?解决场地(Settlement of Location)在 (within): 天以内(days).
?开工建设Construction Startup在 (within): 天以内(days).
?完成机械设备安装
?在 (within): ?天以内(days) (Complete installation of Machinery)
?试运营在 (within): ?天以内(days)
(Test run)
?开幕式在 (within): ?天以内(days)
(Official opening)
?全面运营在 (within): ?天以内(days)
(Full operation)
我保证，我在本表格中的声明是基于我的最充分的了解，是真实、完整和正确的。
(I certify that the statements made by me in this form are true, complete and correct to the best of my knowledge.)
感谢您的考虑和审批
(Your consideration and approval will be highly appreciated)
此致,
Yours sincerely,
日期/date,..-..-..-..-..-..-..-..-..-..-..-..-..-..-..-..-..-..-..-..
全名签字/signature and full name