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Reseller Form
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CUSTOMER’S INFORMATION SHEET
PERSONAL INFORMATION
Name
Birthdate
Applied Date
Residence Address
Telephone Number
Mobile Number
Email Address
COMPANY INFORMATION
Business Name
Address
Telephone Number
Contact Person
Position
Authorized P.O. Signatory
Branches
(if any)
Address
BANK INFORMATION
Bank
Account No.
Authorized Signatory
Name
Position
NOTE:
You will receive an excel copy of the accomplished form that you have submitted. Kindly resend to us together with the required signatures and the following documents:
SEC or DTI
Certification of Registration
Mayor’s Permit
Company Profile
Clear
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