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
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
BIR Certificate of Registration 2303
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
DTI / SEC
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Valid ID
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Photos of Store (Including Signage)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Other Branches
Rows
Store Name
Address
Landline Number
Mobile Number
Email
1
2
3
4
5
Online Store
Rows
Store Name
Web Address / URL
Platform (e.g Lazada, Shopee)
1
2
3
4
5
Contact Persons
*
Rows
Full Name
Email Address
Contact Number
Owner
Purchaser
Accounting
Other Suppliers
*
Rows
Company Name
Terms
Discount
Credit Limit
1
2
3
4
Signature
*
Submit
Should be Empty: