A. REPORT INFORMATION
Name of Deputy
*
First Name
Middle Name
Last Name
Deputy ID No.
*
Email Address
*
B. REPORT FOR FILM / MOVIE
Name of Theater / Cinema
Title of Film / Movie
DATE & TIME OF SCREENING
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Month
-
Day
Year
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Hour
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10
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50
Minutes
AM
PM
AM/PM Option
Classification Rating of Movie / Film
G
PG
R-13
R-16
R-18
Checklist for Film / Movie
Permit to Exhibit is posted at a conspicuous place at the ticket booth.
YES
NO
N/A
A 4’x3’standee prominently displays the film classification rating at the entrance lobby of the theater.
YES
NO
N/A
Theater owner/theater porter or attendant accepts only movie patrons within the age bracket of the film classification rating.
YES
NO
N/A
All posters and photos displayed At the theater lobby is General Patronage and is safe for all to see.
YES
NO
N/A
Other Comments
C. REPORT FOR TELEVISION PROGRAMS
Name of Television Network
Name of Television Program
DATE & TIME THE PROGRAM WAS SHOWED
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Month
-
Day
Year
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11
12
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Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Classification Rating of the Program
G
PG
SPG
Other Comments
C. REPORT FOR PUBLIC UTILITY VEHICLES / SEA VESSELS
Name of Transport Company
Plate Number or Body Number
Route of PUVs/Passenger Vessel
Date & Time On Board
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Month
-
Day
Year
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10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Other Comments
Verify that you're human
*
Submit Your Report
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