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    Client Information Form

    Uploaded by

    Gian Carlo Aniceto
    This document is a client information form for an insurance company. It requests information from clients such as name, address, bank details, and a signature for a declaration. It also contains sections for the requestor to provide details of the request type and account information for the client. There is a section marked "For Finance Use Only" to update client details in the company's systems upon form completion.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd

    Client Information Form

    Uploaded by

    Gian Carlo Aniceto
    372 views1 page
    This document is a client information form for an insurance company. It requests information from clients such as name, address, bank details, and a signature for a declaration. It also contains sections for the requestor to provide details of the request type and account information for the client. There is a section marked "For Finance Use Only" to update client details in the company's systems upon form completion.

    Original Description:

    CIF

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    This document is a client information form for an insurance company. It requests information from clients such as name, address, bank details, and a signature for a declaration. It also contains sections for the requestor to provide details of the request type and account information for the client. There is a section marked "For Finance Use Only" to update client details in the company's systems upon form completion.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    372 views1 page

    Client Information Form

    Uploaded by

    Gian Carlo Aniceto
    This document is a client information form for an insurance company. It requests information from clients such as name, address, bank details, and a signature for a declaration. It also contains sections for the requestor to provide details of the request type and account information for the client. There is a section marked "For Finance Use Only" to update client details in the company's systems upon form completion.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    You are on page 1of 1

    INSURANCE COMPANY OF NORTH AMERICA

    A Chubb Company
    24th Floor Zuellig Building, Makati Avenue Corner
    Paseo de Roxas Makati City 1226, Philippines

    CLIENT INFORMATION FORM

    GENERAL INFORMATION INPUT BY REQUESTOR

    Request Type New Update Termination


    Requestor Name
    Department

    ACCOUNT INFORMATION INPUT BY CLIENT

    Client Name
    Address
    City
    Postal Code
    Country
    Telephone/ Mobile Number
    Business Contact Name

    BANK DETAILS: INPUT BY CLIENT


    Bank Country
    Bank Name
    Bank Branch
    Swift Code
    Account Name
    Bank Account Number
    Payment Currency
    Remittance Email address

    CLIENT'S DECLARATION

    Signature Over Printed Name


    Date

    FOR FINANCE USE ONLY

    BIR 2303 /Registration (for New )


    Updated in PeopleSoft
    Business Permit Vendor Masterfile

    SEC (for Corporate), DTI (for Individual) Vendor ID


    Bank Details

    Contract Agreement Reviewed By:

    Other Vendor Information


    Approved By:

    Chubb_Ph_Finance_10.10.2018_G:\Finance\Finance Files\VENDOR MASTER FILE\Vendor Information Form

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