CDS-SEU-FR-003
Revision No. 5
Effectivity Date: February 7, 2017

COOPERATIVE DEVELOPMENT AUTHORITY

Cooperative Annual Progress Report (CAPR)

As of December 31,


INSTRUCTIONS TO COOPERATIVES

  1. All blanks shall be filled-up with appropriate information.
  2. The submission of the duly accomplished Cooperative Annual Progress Report (CAPR) Form shall be done ANNUALLY within One Hundred Twenty (120) days after the end of the calendar year.
  3. Submission to CDA shall be done electronically through www.cda.gov.ph in accordance with MC No. 2014-05. Likewise, the cooperative shall submit to the Authority, through the Extension Office, one (1) copy of the encoded CAPR Form within five (5) days from the electronic submission duly signed by the Accountable Officer.
    Failure of the cooperative to furnish the Authority with a printed copy shall be considered as if no report has been filed, hence the cooperative shall be considered in delat in the submission. Likewise, any material alterations or tampering, which made the electronic documents different from the original shall be coonsidered as if no report has been filed and the electronic documents have never been received. (Revised IRR of R.A. 9520)
  4. The Authorized Representative of the Cooperative shall encode all the data required in the CAPR Form.
  5. The Chairman and General Manager shall certify to the truthfulness and correctness of the information contained herein.
  6. Do not leave blank. Write 0 for none and NA for Not Applicable.

GENERAL INFORMATION


A. Cooperative Identification Number (CIN):
B. Name of the Cooperative as of latest amendment: *
C. Present Address of Cooperative:
          Region: *
          Province: *
          District: *
          City/Municipality: *
          Street Address: *




D. Registration Number (under RA 9520): *
E. Date Registered:
          Original Registration Date under RA 6938:
          Registration Date under RA 9520: *
Note: The date should be the latest Registration Date prior to RA 9520
Date Format: yyyy-mm-dd

F. Business Permit 		 
          Business Permit No.:
          Date Issued:
          Amount Paid:
G. Category of Cooperative: *
H. Type of Cooperative: *
I. Asset Size of the Cooperative: *
Note: Land should be excluded from the Total Asset as per CDA MC 2007-07 dated June 5, 2007.
J. Common Bond of Memberhip: *
K. Date of General Assembly: *
L. Quorum Requirement [%]: *
M. Fiscal Year: * Note: From Month To Month e.g. January - December, July - June
N. Area of Operation: * Others, pls. specify
O. Business Activities:  
     O1. Annual Volume of Business: (select only business activities undertaken (maybe more than one) and indicate total amount per business activity)
 
  Business Activity Bases of Volume of Business Amount
 
Provision of Services (please choose below)

     O2. Products/Commodities:
 
Major Products Use drop down to choose Specific Products Check either products are raw or processed
Crops
Aqua Marine
Livestocks
Metal/Minerals
Other Products & Commodities
     O3. Other Financial Services:
 
Money Transfers Foreign Exchange Trading Bills Payment
Remittances ATM Operations Other, pls. specify
     O4. Importation Activities, if any, identify: *
 
Import Items:
Volume of Importation:
P. Information on Number of Employees *

  Current Year
Male Female
Number of Personnel Receiving Salaries
Number of Personnel receiving Honoraria only







Note: Honoraria - number of officers/employees receiving honoraria.
Note: In case of Workers Cooperative, all workers are considered direct employees of the cooperative.

Q. Contact Person (at the time of submission) *
a. Name:
b. Designation:
c. Phone Number:
d. Fax Number:
e. Email Address:
R. Information on Membership *
Particulars Other Juridical Persons
No. of Regular Members:
No. of Associate Members:
     R1. Membership Composition (Please select composition and indicate number of members in each composition):
 
 CompositionNumber
     R2. Age Group of Members: *
 
Age BracketNumber
      R3. List of Officers - Officers as of the Reporting Period (Indicate name and address):
 
R3.a. Board of Directors
PositionNameAddress


R3.b. Other Officers
PositionNameAddress


R3.c. Committees of the Cooperative

A. AUDIT COMMITTEE
PositionNameAddress


B. ELECTION COMMITTEE
PositionNameAddress


C. MEDIATION AND CONCILIATION COMMITTEE
PositionNameAddress


D. ETHICS COMMITTEE
PositionNameAddress


E. EDUCATION AND TRAINING COMMITTEE
PositionNameAddress


F. OTHER COMMITTEE: Enter total number of officers for Other Committee:
S. Information on Cooperative Branches/Satellites *
No. of Branches:
No. of Satellites:
      S1. Details of Cooperative Branches *
 
      S2. Details of Cooperative Satellites *
 
T. Laboratory Cooperative
Name and Address
of the
Laboratory Cooperative		 Number of Members Recognition Number Date Issued
Male Female
Student Non-Student Student Non-Student


     T1. Activities of Laboratory Cooperative:
 
Activities/Services
     T2. Information on Deposit Liabilities of Laboratory Cooperative:
 
Type of Deposits No. of Members with
deposit accounts		 No. of Accounts Total Amount
Savings deposits
Time deposits
Other types of deposits, please specify:
U. Information on Number of Units Owned/Managed by Transport Cooperatives *
Units/Vehicles Units Owned by
the Transport Coop.		 Units Owned by
Members & Managed
by Cooperative
Number of Units


V. Information on Transactions to Members/Non-Members *
Gross Sales/Receipts Members Non-Members
Amount of Gross Sales/Receipts


W. Certificate of Compliance (COC) *
COC No. Date of Issue Valid Until

X. Certificate of Tax Exemption/Ruling *
CTE No.
Validity
T.I.N.
Y. Information on Deposit Liabilities *
Type of DepositsRegular MembersAssociate Members
No. of Members with
deposit accounts		 No. of Accounts Total Amount No. of Members with
deposit accounts		 No. of Accounts Total Amount
Savings deposits
Time deposits
Other Types of deposits,
please specify:
Z. Information on Actual Taxes Withheld/Remitted to BIR (Total for the whole year) *
 Total Amount
Taxes withheld and remitted for Employees Salary/Compensation
Taxes withheld and remitted for Honorarium
Expanded Withholding Taxes
VAT Payments / Percentage Taxes
Income Taxes Paid
Other taxes, pls. specify


AA. Affiliations *
Name of Federations/Unions Address


     AA1. Information on the Utilization of CETF - LOCAL:
 
Name of Activity/ies Date of Activity Number of Members Benefitted Amount Utilized


     AA2. Information on the Remittances of CETF to Federations/Unions:
 
Name of Federation/Union Amount Remitted


     AA3. Information on the Utilization of Community Development Fund:
 
Name of Activity/ies No. of Beneficiaries Date of Activity Amount Utilized


     AA4. Information on the Utilization of Optional Fund:
 
Name of Project/Activity Date of Project/
Activity		 Amount Utilized


AB. Risk Pooling Activities (activities that cover protection against death, injury and illness, loss of property, and other contingent events.:
 
Name of Program Partner/Insurance Provider No. of Member
Beneficiary		 Amount Disbursed




Prepared by: *

Position: *




Certified true and correct:



General Manager *

       

Chairperson *