CUSTOMER INFORMATION SHEET
Registered Company Name
*
Store Name
*
Business Address
*
Delivery Address
*
TIN #
*
Email Address
*
example@example.com
Landline Number
*
Please enter a valid phone number.
Mobile Number
*
Please enter a valid phone number.
Website
*
Write N/A if none
Facebook
*
Write N/A if none
Instagram
*
Write N/A if none
Forwarder / Trucking
Required for provincial deliveries
Forwarder / Trucking Address
Required for provincial deliveries
Forwarder Contact Number
Required for provincial deliveries
Declared Value (in %)
Required for provincial deliveries
Business Permit
*
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of
BIR Certificate of Registration 2303
*
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DTI / SEC
*
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Valid ID
*
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of
Photos of Store (Including Signage)
*
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Other Branches
Store Name
Address
Landline Number
Mobile Number
Email
1
2
3
4
5
Online Store
Store Name
Web Address / URL
Platform (e.g Lazada, Shopee)
1
2
3
4
5
Contact Persons
*
Full Name
Email Address
Contact Number
Owner
Purchaser
Accounting
Other Suppliers
*
Company Name
Terms
Discount
Credit Limit
1
2
3
4
Signature
*
Submit
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