A printable customer information form is an important document to have on hand for your business. This form allows you to collect the necessary information from customers, such as name, address, and contact information. Having this information in a central location makes it easy to keep track of your customers and stay in touch with them. You can also use this form to record any transactions that take place between you and the customer. For example, if you are providing services or selling products to the customer, you can note those details on the form. having a printable customer informationform is a great way to make sure that your business runs smoothly and efficiently. You can find free templates for printable customer information forms online.
This quick guide will let you determine how much time it will take you to complete printable customer information form, how many pages it's got, and a few other specific specifics of the form.
Question | Answer |
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Form Name | Printable Customer Information Form |
Form Length | 3 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 45 sec |
Other names | number fill in, pdf filler contact, FormsPal com phone number, FormsPal customer service phone number |
CITISECONLINE.COM, INC.
Exchange Road, Ortigas Center, Pasig City, 1605 Philippines
Customer Service Hotline (632)
Fax Number (632)
CUSTOMER ACCOUNT INFORMATION FORM
(Form must be completely filled up) |
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ACCOUNT NUMBER: |
_________________ |
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√ Affix your signature where required |
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(to be filled by CitisecOnline) |
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PLEASE WRITE CLEARLY IN BLOCK CHARACTERS |
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Individual |
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Joint Or |
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Joint And |
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Others |
__________________________ |
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INFORMATION ABOUT THE PRIMARY ACCOUNT HOLDER |
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Name |
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Last |
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First |
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Middle |
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Gender |
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Civil Status |
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Male |
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Female |
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Single |
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Married |
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Widowed |
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Separated |
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Name of Spouse (if applicable) |
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Number of Dependents (if applicable) |
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Date of Birth (month/day/year) |
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Place of Birth (town/province/city) |
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Citizenship |
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Filipino |
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Other ______________________ |
Tel No/ Mobile No (including country code and area code) |
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Email Address |
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Facsimile No (Including country and area code) |
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Residential Address (no, street, town/district, city/province, postal/zip code, country) |
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Educational Background |
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Employment Status |
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Primary |
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Secondary |
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Tertiary |
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Employed |
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Unemployed |
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Post Graduate |
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Other _________________ |
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Retired |
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Other _________________ |
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Tax Identification Number |
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SSS or GSIS Identification Number |
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Name of Employer/Name of Business (if Owned) |
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Nature of Business |
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Office Tel No/Fax No (+ country code and area code) |
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Years with employer/Years of Business (if Owned) |
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Employer Address / Business Address (no, street, building,town/district, city/province, postal/zip code, country) |
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page 1 of 3 |
FINANCIAL AND INVESTMENT PROFILE
Liquid Net Worth (in Php) |
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Total Net Worth (in Php) |
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Annual Income (in Php) |
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< 500,000 |
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< 1 Million |
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< 500,000 |
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< 1 Million |
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< 250,000 |
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< 500,000 |
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< 5 Million |
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< 10 Million |
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< 5 Million |
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< 10 Million |
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< 750,000 |
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< 1 Million |
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Over 10 Million |
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Over 10 Million |
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Over 1 Million |
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Primary Source of Income |
Approximate Amount of Capital Available for |
Risk Tolerance |
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Salary |
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Retirement |
Investment (in Php) |
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Aggressive |
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Investment |
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Others |
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Moderate |
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Business |
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Conservative |
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Investment Objectives |
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Investment Experience |
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Investment Knowledge |
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List 1 to 4 in order of priority |
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Capital Preservation |
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None |
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None |
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Long Term Investment |
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Limited |
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Limited |
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Growth |
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Good |
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Good |
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Speculation |
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Extensive |
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Extensive |
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DISCLOSURES |
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Are you a corporate officer or director, or do you own 10% or more of a PSE listed or publicly held Company? |
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No |
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Yes (specify name) ________________________________________ |
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Are you an officer or employee of another Borker/Dealer? |
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No |
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Yes (specify broker and present consent letter by employer) ______________________ |
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Do you have an account(s) with other stockbrokerage firms or mutual fund companies? |
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No |
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Yes (specify name) ________________________________________ |
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INFORMATION ABOUT THE SECOND ACCOUNT HOLDER |
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Name |
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Last |
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First |
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Middle |
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Gender |
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Civil Status |
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Male |
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Female |
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Single |
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Married |
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Widowed |
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Separated |
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Name of Spouse (if applicable) |
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Number of Dependents (if applicable) |
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Date of Birth (month/day/year) |
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Place of Birth (town/province/city) |
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Citizenship |
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Filipino |
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Other __________________ |
Tel No/ Mobile No (+ country code and area code) |
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Email Address |
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Facsimile No |
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Residential Address (no, street, town/district, city/province, postal/zip code, country) |
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Educational Background |
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Employment Status |
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Primary |
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Secondary |
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Tertiary |
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Employed |
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Unemployed |
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Post Graduate |
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Other _____________ |
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Retired |
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Other _________________ |
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Tax Identification Number |
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SSS or GSIS Identification Number |
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Name of Employer/Name of Business (If Owned) |
Nature of Business |
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Office Tel No/Fax No (+ country code and area code) |
Years with Employer /Years of Business (If Owned) |
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Employer Address/ Business Address (no, street, building,town/district, city/province, postal/zip code, country)
page 2 of 3
FINANCIAL AND INVESTMENT PROFILE
Liquid Net Worth (in Php) |
Total Net Worth (in Php) |
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Annual Income (in Php) |
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< 500,000 |
< 1 Million |
< 500,000 |
< 1 Million |
< 250,000 |
< 500,000 |
< 5 Million |
< 10 Million |
< 5 Million |
< 10 Million |
< 750,000 |
< 1 Million |
Over 10 Million |
Over 10 Million |
Over 1 Million |
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Primary Source of Income |
Approximate Amount of Capital Available for |
Risk Tolerance |
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Salary |
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Retirement |
Investment (in Php) |
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Aggressive |
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Investment |
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Others |
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Moderate |
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Business |
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Conservative |
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Investment Objectives |
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Investment Experience |
Investment Knowledge |
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List 1 to 4 in order of priority |
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Capital Preservation |
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None |
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None |
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Long Term Investment |
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Limited |
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Limited |
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Growth |
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Good |
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Good |
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Speculation |
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Extensive |
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Extensive |
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DISCLOSURES |
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Are you a corporate officer or director, or do you own 10% or more of a PSE listed or publicly held Company? |
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No |
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Yes (specify name) ________________________________________ |
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Are you an officer or employee of another Borker/Dealer? |
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No |
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Yes (specify broker and present consent letter by employer) ______________________ |
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Do you have an account(s) with other stockbrokerage firms or mutual fund companies? |
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No |
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Yes (specify name) ________________________________________ |
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MAILING AND COMMUNICATION INSTRUCTIONS |
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Confirmation of invoices and other notices will be sent thru Email/Electronic Delivery |
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Email Address |
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Facsimile No (+country and area code) |
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CUSTOMER BANK ACCOUNT DETAILS |
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Bank Account Name |
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Bank Account Number |
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Bank Name and Branch Address (pls indicate complete name and address) |
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APPLICATIONREQUIREMENTS AND INSTRUCTIONS
* Minimum cash/check deposit of P25,000 made payable to CitisecOnline.com Inc.
* Photocopy of at least two (2) acceptable indentification (please present original for verification)
- Passport, Phil. Drivers Liscence, SSS ID, Credit Card (w/Pic), Birth Certificate, Company ID (w/Pic) or other government accepted IDs
For
- Public Utility Bill, Credit Card Statement or Bank Statement
* Specimen Signature Cards (2)
* Online Securities Trading Agreement (OSTA) * Additional Requirements for non Residents:
- Proof of Income Duly Certified by Employer
- Identification Documents authenticated by Philippine Embassy or Consulate
I / we confirm that the information given by me/us is true and correct. I/we authorize CitisecOnline to verify the same from whatever sources it may consider appropriate. I/we understand that any misrepresentation I/we make on the submitted documents is sufficient grounds for legal action against me/us and the rejection or my/our application. I/we understand that should my/our application be denied, CitisecOnline has no obligation on its part to furnish the reason for such rejection.
Signature(s)
√
Primary Account Holder |
Date |
Secondary Account Holder |
Date |
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(For CITISECONLINE'S use only) |
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Referror/Salesman |
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Processed by |
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Approved by |
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