ANNUAL REPORT

(For Single Proprietorship)

Of

5 JS MARINE SPORT
_____________________________________________________________________

(Name of Authorized Operator)

WATER TRANSPORTATION
_____________________________________________________________________

(Kind of Service)

BAGUNG BAYAN, MARIBAGO, LAPU-LAPU CITY

_____________________________________________________________________

(Office Address)

TO THE

REPUBLIC OF THE PHILIPPINES

MARITIME INDUSTRY AUTHORITY

FOR THE

YEAR ENDING DECEMBER 31, 2020

(1 – C)
 (DO NOT FOLD)

GENERAL RULES FOR REPORTING

THIS AUTHORITY WILL NOT ACCEPT FILING OF ANNUAL REPORTS WHICH ARE NOT PROPERLY
ACCOMPLISHED IN ACCORDANCE WITH THESE RULES AND REGULATIONS.

MAKE A SEPARATE AND COMPLETE REPORT FOR EACH KIND OF SERVICE

Make out report in ink

Answers to inquiries must be complete. If not applicable

write “Not Applicable”

Special and unusual entries and all discrepancies must be

explained by noted

Where in formation asked for is not given, state reasons

for omitting.

The report should be made out in duplicate, the original copy to be submitted to the concerned
MARINA Regional Office (MRO) and one copy retained by the company in its files for reference, in case
correspondence with regard to it becomes necessary.

This report must be filed in the respective MRO on or before JUNE 30 of each year.

THE FORMAT OF THIS AUTHORIZED FORM OF ANNUAL REPORT SHALL NOT BE ALTERED NOR
TAMPERED WITH IN ANY FORM OR MANNER BY ANY INDIVIDUAL OR JURIDICAL ENTITY. CPC GRANTEES
ARE WARNED THAT ANNUAL REPORTS FILED IN ANY OTHER FORM NOT AUTHORIZED BY THIS AUTHORITY
WILL NOT BE ACCEPTED FOR FILING

MARITIME INDUSTRY AUTHORITY

(2 – C)
 ANNUAL REPORT
1. Name of Proprietor: _____________________________
2. Business Address: _____________________________
3. Other Business: _____________________________

4. Person/s who prepared the Annual Report

Name Title/Position Address Telephone Number

5. VESSELS WITH VALID PA/CPC/SP OPERATED DURING THE YEAR:

Total No. of Vessels: ______ Total GRT: __________ Total DWT:________
Category/
Owned Type of
Bareboat Gross Deadweight Operation
Vessel Name
Chartered/ Tonnage (GT) (DWT) (Liner/
Lease Tramper)
Purchased
Tours and
Cruise
Tours and
Cruise
Tours and
Cruise
Tours and
Cruise
Tours and
Cruise

(The owner/operator may use separate sheet if the vessels operated are more than ten)
6. MANPOWER – Fill in the different manpower categories listed below:

Monthly average number of administrative and support personnel whose wages are:

Minimum Wage Above Minimum but below Above P1,500

(3 – C)
 P1, 000

Reserved personnel/,Manpower for the period:

Licensed Officer Regular Crew Apprentice
Deck
Engine

7. OPERATIONS DATA OF VESSELS OPERATED DURING THE PERIOD

Vessel Name:_____________ GRT___________ DWT____________
Utilization Rate:
Commission Days

Non-commissionable Days

● Drydocked
●
● Afloat Repairs
●
Number of Days laid up

Total No. of Days

MILEAGE PERFORMANCE
Nautical miles run for the period

Number of voyages for the period

(4 – C)
 VESSEL MANPOWER – Average monthly manpower of the vessel
Licensed Officer Regular Crew Apprentice

Deck

Engine

Note: This page must be accomplished per vessel

INCOME STATEMENT BY VESSEL – For each vessel operated during the period.
INCOME STATEMENT FOR M/V ____________
For the period ____________
Last This
Year Year
OPERATING REVENUE
Passenger revenue
Freight revenue
Other operating revenue

Total operating revenue __________ ___________

LESS: VESSEL OPERATING EXPENSES

(5 – C)
 Fuel
Lubricants
Vessel Depreciation
Repairs and maintenance
Stevedoring and wharf labor 0 0
Salaries and wages
Insurance Expense
Pilotage 0 0
Port Charges
Taxes and License
Miscellaneous Expenses
Other Operating expenses

Total vessel operating expenses

NET INCOME FROM VESSEL OPERATION ___________ ___________

INCOME STATEMENT ____________

For the period ____________
Last This

(6 – C)
 Year Year
OPERATING REVENUE
Passenger revenue
Freight revenue
Other operating revenue

Total operating revenue __________ ___________

LESS: VESSEL OPERATING EXPENSES

Fuel
Lubricants
Vessel Depreciation
Repairs and maintenance
Stevedoring and wharf labor
Salaries and wages
Insurance Expense
Pilotage
Port Charges
Taxes and License
Miscellaneous Expenses
Other Operating expenses

Total vessel operating expenses

GENERAL AND ADMINISTRATIVE EXPENSE

Salaries and wages
Office Supplies
Light, water and telephone
Bad debts
Depreciation expense

(7 – C)
 Insurance expense
Employees Benefit
Miscellaneous expense
Other General and administrative expense _________ __________

Total General and administrative expense _________ __________

NET INCOME LOSS FROM OPERATION

(ADD/LESS OTHER INCOME/ (EXPENSE)
Interest income
Others

NET INCOME _________ __________

BALANCE SHEET
As of __________
Last This
Year Year
CURRENT ASSETS
Cash
Receivables
Spare parts, materials and supplies
Prepaid Expense

Total current assets

PROPERTY AND EQUIPMENT (NET)
OTHER ASSETS _________ __________

TOTAL ASSETS _________ __________

(8 – C)
LIABILITIES
Payables
Other current liabilities

Total Current Liabilities

Long Term Liabilities _________ _________

TOTAL LIABILITIES

OWNERS EQUITY
Capital, _________
Less: Drawings ___________ ___________
Add: Net Income for the period ___________ __________

TOTAL OWNERS EQUITY __________ __________

TOTAL LIABILITIES AND OWNERS EQUITY __________ __________

SCHEDULE OF PREPAYMENTS
As of ___________

Recipient Amount

(9 – C)
 SPARE PARTS, MATERIALS AND SUPPLIES
Inventory of all items of spare parts, materials and supplies properly classified at the end of
every operating period.

Item Amount

(10 – C)
 SCHEDULE OF ACCOUNTS AND NOTES PAYABLE
As of ______________

NAME OF CREDITOR DATE OF AMOUNT

MATURITY

(11 – C)
SCHEDULE OF ACCRUED EXPENSE
As of ___________

Item Amount

(12 – C)
 SCHEDULE OF PROPERTY & EQUIPMENT

HISTORICAL COST APPRAISAL INCREMENT

PROPERTY ASSUMED
ACCUMULATED
NET
ACCUMULATED NET APPRAISAL
ACQUISITION CAPITALIZED ESTIMATED SCRAP/ BOOK LATEST APPRAISAL
EQUIPMENT DATE START OF
COST IN EXPENSES IN SERVICE SALVAGED
DEPRECIATION
VALUE YEARS OF INCREMENT IN
DEPRECIATION IN INCREMENT IN
ACQUIRED OPERATION IN
P 000 P 0000 LIFE VALUE IN APPRAISAL P 000
P 000 P 000 P 000
P 000 P 000

VESSELS

(13 – C)
(14 – C)
 (1) (2) (3) (4) (5) (6) (7) (8) (9)

VOYAGE DATE ROUTE PORT LEG CARGO CARRIED FREIGHT PASSENGER PASSENGER
NO. STARTED & CARRIED REVENUE
END OF CU. M. M.T.
VOYAGE

Leg 1 1 class

2 class

3 class

Leg 2 1

CARGO AND PASSENGER TRAFFIC REPORT

for all types of vessels
How to accomplish:

On a per vessel basis, the above column numbers shall refer to:

(1) Trip number

(2) Duration of one round trip
(3) Authorized route
(4) Link covered by route
(5) Cargo carried in terms of cu. m. cargoes carried in terms of weight (m.t.) shall be likewise reflected in
terms of cu. m. in this column. Put in another way, the same cargo in column 6 shall be reflected

(15 – C)
 in column 5 expressed in cu. m.

(6) Cargo carried in terms of m.t. cargoes carried in terms of volume (cu.m.) shall be likewise reflected in
terms of m.t. in this column. Put in another way, the same cargo in column 5 shall be reflected

in column 6 expressed in m.t.

(7) Revenue per link
(8) Passenger by class, i.e., number of class accommodation.
(9) Passage revenue corresponding to reflected number by class accommodation in column 8.

GENERAL REMARKS
State hereunder any strike, accident or injury to any person or damage to any property, the causes and
results thereof, or any other occurrence of materials importance during the period covered by this report.

ANNUAL TONNAGE FEE

1. Has the utility paid the annual tonnage fee(s) to the MARINA corresponding to the year
which this report is filed? ________ (Yes or No)

Amount Paid P _____________________

Number and date of official receipt _____________________

2. If the utility had any unpaid annual tonnage fee(s), state the amount and year below:

YEAR AMOUNT
____________________ P ____________________
____________________ P ____________________
____________________ P ____________________
(16 – C)
 ____________________ P ____________________

INDEPENDENT ACCOUNTANTS SUPERVISION

I/ We have examined the Balance sheet, of ____________ as of December 31, 20_____ and
the related Income Statement for the year then ended, together with supporting schedules, as set fort
in this Annual Report to be filed with MARITIME INDUSTRY AUTHORITY pursuant to section 17 (h)
of Commonwealth Act No. 146, as amended. My/ Our Examination was made in accordance with the
generally accepted auditing standards, accordingly included such test of the accounting records and
such auditing procedures as I/ We considered necessary in the circumstances.

In my/ our opinion, the said Balance Sheet and Income Statement present fairly the financial
position at December 31, 20 ______ and the results of the operation for the year and ended of
_______________ in conformity with the generally accepted accounting principles applied on basis
consistent with that of the proceeding year.

_________________________

Certified Public Accountant

__________________
Date

(17 – C)
 __________________
Place

OATH BY CHIEF OPERATING OFFICER

REPUBLIC OF THE PHILIPPINES

Province of ________________________
Municipality City of __________________

I, ________________________ of ____________________________________
hereby made oath and say that u am the __________ of _______________ that I have
carefully examined the foregoing report, that I believe that all the statement of facts
contained in the said report are true and that the said report is a correct and complete
statement of the business and affairs of the above-named proprietor during the period from
January 1, 20 ____ to December 31, 20_____.

_________________
Signature of
Affiant

Subscribed and sworn to before me this __________ day of ________ Affiant

exhibited to me his/ her Residence Certificate No. _________ issued at ___________ on
_____________.

(18 – C)
 _________________
Notary Public

(19 – C)