1721 I. Limkakeng Street Happy Valley, Cebu City 6000 Tel. Nos. 253.9100, 512.0989 and 0999.832.2048 Bank Type of Financing: Pag-‐Ibig Spot Cash Deferred Cash Others _____________ CLIENT INFORMATION SHEET CLIENT PERSONAL DATA Last Name First Name Home Address Own Middle Name Rent Living with Parents/Others Postal Code Gender Male Civil Status Female Single Married Separated/Divorced Widowed Citizenship Date of Birth Place of Birth Religion Home No. Fax No. Mobile Nos. CTC No. Date of Issue Place of Issue Passport No. Date of Issue Place of Issue TIN No. Email Address Filipino American Others: ___________ Company Name/Employer's Name No. of Years in Business/Employed Position Office Address Office No. Nature of Business Monthly Household Income: No. of People Living With You Below P10,000 P30,000 -‐ P49,999 P120,000 -‐ P150,000 P10,000 -‐ P19,999 P50,000 -‐ P80,000 P150,001 -‐ P180,000 P20,000 -‐ P29,999 P80,001 -‐ P120,000 P180,001 and above Including Helpers/Yayas No. of Vehicles Owned: Make and Model Color Year Plate No. 1. 2. 3. SPOUSE'S INFORMATION, IF MARRIED: Last Name First Name Date of Birth Place of Birth Mobile Nos. Religion Email Address Citizenship Filipino American Others: Middle Name ___________ TIN No. CTC No. Date of Issue Passport No. Date of Issue Place of Issue Place of Issue Company Name/Employer's Name No. of Years in Business/Employed Position Office Address Office No. Nature of Business Monthly Household Income: Below P10,000 P30,000 -‐ P49,999 P120,000 -‐ P150,000 P10,000 -‐ P19,999 P50,000 -‐ P80,000 P150,001 -‐ P180,000 P20,000 -‐ P29,999 P80,001 -‐ P120,000 P180,001 and above No. of Dependents: Name Age Birthdate School Attended 1. 2. 3. 4. 5. BANK REFERENCES Bank Name & Branch Account No. Contact Person Contact No. Credit Limit Expiry Date Address Contact No. CREDIT REFERENCES Credit Card(s) Credit Card No. CHARACTER REFERENCES Name Relationship REASON FOR BUYING SOURCE OF AWARENESS Primary Home Site Walk-‐in Internet Investment Others Billboards Broker / Agent Vacation Home _________________________ Flyers/Brochure Agent's Website Retirement Home Newspaper Ads Referral Inheritance/Gift to Children Questland Website Others ___________ TOWNHOUSE UNIT Unit __________ Corner Regular No. of Bedrooms: ________ Ground Floor ________ Second Floor No. of Toilet & Baths: ________ Ground Floor ________ Second Floor NOTES A. B. C. D. E. F. G. H. I. I acknowledge that __________________________________________________, accredited broker of Questland Builders and Developers with PRC License Number ________________, has given me a comprehensive presentation of NORTH8. I hereby authorize him/her as my broker of choice. No other broker should be recognized and/or credited by Questland Builders and Developers, should I decide to make a reservation deposit for said project from the signing of this Customer Information Sheet. I/We hereby certify that the above information are true and correct. Should there be any changes in the above information, I/We will be responsible to inform Questland Builders and Developers in writing of such changes. Accomplished by: Conforme: BUYER QUESTLAND BUILDERS AND DEVELOPERS Signature over Printed Name / Date BUILDER BY: BUYER Signature over Printed Name / Date ATTY. ERNESTO D. LIMKAKENG ERNST LESTER S. LIMKAKENG LOT OWNER OWNER/PROPRIETOR 6000 .2048
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