Request for Refund of Performance Bond, ROASD-569, Revision-0

Page No. Page 1 of 2 REQUEST FOR REFUND OF Form No. ROASD-569 PERFROMANCE BOND Revision No. 0 Effectivity Jun. 22, 2026 PART A. GENERAL INSTRUCTIONS 1. Please use this form to request for the refund of the posted Performance Bond. 2. Only requests with correct and complete information as well as proper attachments will be processed. 3. Print your application form and all documentary requirements on an A4-size paper. 4. Original documents must be submitted to the Remote Operations and Ancillary Services Department (ROASD) Office. Applications with incomplete information / requirements will not be accepted. Note: For any inquiries regarding your refund, you may contact ROASD through an email to [email protected] PART B. REQUIRED ATTACHMENTS / SUPPORTING DOCUMENTS This form must be accompanied by the following supporting documents: 1. Notarized Resolution of the Board pertaining to the refund of the performance bond; 2. Certified True Copy of the Latest General Information Sheet or its foreign equivalent with beneficial owner page 3. Certified True Copy of Articles of Incorporation and By-Laws 4. Certificate of no outstanding balances in regulatory fee, and remaining performance Bond issued by the Accounting Department 5. Certificate of no unpaid administrative fee, authorization fee, demerits or cash penalties issued by the ROASD 6. Release, Waiver, and Quitclaim signed by all directors 7. Original Official Receipt issued for posting of performance bond 8. Photocopies of government-issued identification cards of all directors with three (3) wet signatures in blue ink 9. Certificate of Tax Clearance from the Bureau of Internal Revenue 10. Certificate of Non-Operation issued by CMED 11. Proof of OGEL IDs surrendered 12. Proof of Certificate/s surrendered 13. Other documents specific to the requesting company Note: ROASD reserves the right to request additional documentation as deemed necessary. PART C. DETAILS NAME OF COMPANY: TYPE OF LICENSE / AUTHORIZATION: Bank Bank Account Type Bank Address Account Name Account Number Amount of Performance Bond PART D. NAME OF DECLARANT (to be filled out by Authorized Representative/Appointed Representative) PRINTED NAME: POSITION TITLE: CONTACT NUMBER: EMAIL ADDRESS: ________________________________________ SIGNATURE OVER PRINTED NAME

Page No. Page 2 of 2 REQUEST FOR REFUND OF Form No. ROASD-569 PERFROMANCE BOND Revision No. 0 Effectivity Jun. 22, 2026