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Business Customer Information Form

This document contains a business customer information form for F.A.L Marine Products Trading. It provides their business address in Barangay Tabu-an Estancia Iloilo 5017 and contact information for the owner and authorized signatory Faith Anne B. Luena. The form also provides organizational details like the date of registration, number of employees, and discloses that Faith Anne Luena is authorizing PLDT to obtain her personal information for purposes of evaluating her application and account.

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Faith Anne Luena
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249 views

Business Customer Information Form

This document contains a business customer information form for F.A.L Marine Products Trading. It provides their business address in Barangay Tabu-an Estancia Iloilo 5017 and contact information for the owner and authorized signatory Faith Anne B. Luena. The form also provides organizational details like the date of registration, number of employees, and discloses that Faith Anne Luena is authorizing PLDT to obtain her personal information for purposes of evaluating her application and account.

Uploaded by

Faith Anne Luena
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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New Customer

BUSINESS CUSTOMER INFORMATION FORM


To be filled out by the Customer

BASIC CUSTOMER INFORMATION


Registered Business Name: F.A.L MARINE PRODUCTS TRADING

Store/Shop/Outlet Name/Trade Name: F.A.L MARINE PRODUCTS TRADING


Business Address: BARANGAY TABU-AN ESTANCIA ILOILO 5017
Billing Address (if different from Business Address): BARANGAY TABU-AN ESTANCIA ILOILO 5017

Names of Bill Recipients 1 FAITH ANNE B, LUENA


Contact numbers of Bill Recipients 091907422681
Email Address of Bill Recipients 1 falmarineproductstrading@yahoo.com
Finance Officer : FAITH ANNE B, LUENA Finance Officer Contact Number: 09190742268
Business Ownership:
Tax Class:

Industry Type : RETAIL Please Specify: MARINE PRODUCTS BUY & SELL
Name of Authorized Signatory : Position and E-mail Address:
OWNER / falmarineproductstrading@yahoo.com
FAITH ANNE B, LUENA
ID Presented:

ORGANIZATION DATA
Type of Business (Check only one)
Date of Registration: 29 MAY 2019 No. of Employee(s)/Staff: 4
FOR CORPORATION
Key Officers (indicate the name and position/designation) Contact No.

FOR PARTNERSHIP - Name of Partners


Name and Position/Designation Contact No.

1
2.
3.

FOR SOLE PROPRIETORSHIP


Name of Owner : FAITH ANNE B, LUENA
SSS No.: 309-886-762
Personal TIN No.:
Home Address: PRK 2 BARANGAY TABU-AN ESTANCIA ILOILO 5017
FAX No.: Mobile No. 09190742268 / 033-500-2949
SOLE PROPRIETOR DISCLOSURE
My signature below signifies that

1. I hereby authorize PLDT INC. and/or any person authorized by PLDT to obtain relevant and pertinent personal information about myself and credit information from the PLDT
banks, credit card companies, and other financial institutions in the course of evaluating my application, and I authorize the release of such information by these companies from wh
information are requested. I also consent to PLDT's disclosure of information concerning myself or my subscription to these companies. I acknowledge that a complete list of the enti
accessed by myself on the PLDT website [ http://www.pldt.com/privacy-policy ]

2. I also hereby authorize PLDT to use and disclose to the PLDT Group and Its subsidiaries and its authorized business partners all information contained in this application including
as well as all information in connection with my subscription, my network/service usage and connections including data about the device/e I use to connect to your service, my paym
to my subscription, and all information about myself from your advertisers and business partners, for purposes of (a) facilitating my application for services which they offer; (b) prod
being offered to me by PLDT Group and its subsidiaries and its authorized business partners; (c)advertising new products and services being offered by PLDT Group and its subsidiari
partners; (d) credit investigation and establishing my credit worthiness; and(e) improving customer experience.

I hereby declare that all the above information are true and correct to my own knowledge. I hereby authorize PLDT/SM
of the above given information from whatever source it may consider appropriate. Any misrepresentation on the above inform
just cause for the rejection of my application or the termination of my contract with the Company.

FAITH ANNE B, LUENA OWNER


Authorized Signatory/Signature above Position
Printed Name
Customer Records Update (for existing SMART customers)

NFORMATION FORM
Date Accomplished/Signed: MARCH 10,2020
NFORMATION
Main Telephone No./Trunkline:
Fax No.:
Customer's E-mail Address: falmarineproductstrading@yahoo.com
Website:

A ILOILO 5017

2 JESSICA VILLASIS
2. 09190735349
2 . falmarineproductstrading@yahoo.com
Finance Officer's Email Address: falmarineproductstrading@yahoo.com

Company TIN: 309-886-762

BUY & SELL


Contact No.[Landline No. & Mobile No.]

09190742268 / 033-500-2949

UMID CRN-01117540317-5
N DATA

Years in Operation: 1 YEAR


RATION
Email Address

ame of Partners
Email Address

IETORSHIP
Date of Birth: 1991/02/03
Telephone No.:

Email Address: falmarineproductstrading@yahoo.com


DISCLOSURE

information about myself and credit information from the PLDT Group, it's subsididaries, affiliate
thorize the release of such information by these companies from which my personal data and credit
on to these companies. I acknowledge that a complete list of the entities under the PLDT Group can be

ness partners all information contained in this application including supporting documents submitted,
ng data about the device/e I use to connect to your service, my payment history/behavior with respect
of (a) facilitating my application for services which they offer; (b) product and service improvement
products and services being offered by PLDT Group and its subsidiaries and its authorized business

y own knowledge. I hereby authorize PLDT/SMART/SUN to verify any


ate. Any misrepresentation on the above information shall constitute a
with the Company.

10/3/2020
Date

BCIF_ver7 with DPA_02052018

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