BBG CIR Personal 09 06 2017 PDF

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Customer Information Record
Personal
Personal Details
NameCIF No.
Contact Details
Last NameNo.StreetSubdivision / District / TownNo.StreetSubdivision / District / TownCity / ProvinceCountryZip Code
Present AddressPermanent Address
(if applicable)City / ProvinceCountryZip Code
GenderDate of Birth
(mm/dd/yyyy)
Place of BirthCivil StatusDate of Birth
(mm/dd/yyyy)
Place of BirthOccupationNo. of DependentsTINCitizenshipSSS / GSIS No.Telephone No.Mobile No.E-mail Address
Financial Details
Employment StatusSource of FundsOccupationName of Employer
(If Employed)
Years with EmployerAddressPosition / RankTelephone No.Name of Business
(If Self-Employed)
Years in BusinessAddressTelephone No.
First NameMiddle Name
Spouse
(if applicable)Last NameFirst NameMiddle Name
MaleFemaleSingleOthers  ______________________ MarriedEmployedSelf-employedStudentRetiredOthers _____________________________________________________ EmploymentBusinessPensionOthers ___________________________ ExistingBDO Account(s)SavingsCurrentHome LoanAuto LoanOthers ______________________________________________________ Credit Card
Please insert1” x 1”photo here
Time AccountPersonal LoanOther banksaccount(s)SavingsCurrentHome LoanAuto LoanOthers ______________________________________________________ Credit CardTime AccountPersonal Loan
By signing, I hereby certify that the information given in this application is true and correct to the best of my knowledge and I confirm that I have read the Terms and Conditions of the General and Special Provisions on Deposits and have fully understood and agreed to be governed by the provisions thereof, as well as the rules and regulations of the Bank, Bangko Sentral ng Pilipinas, Anti-Money Laundering Council, Bankers Association of the Philippines and the Bureau of Internal Revenue with respect to taxes imposed on interest on deposits and bank commission/charges relative to the establishment of operations of the account/s opened.
 ___________________________________________________________________ Signature over Printed Name / Date Signed
*If U.S. person, accomplish FATCA Information Sheet.
Indicate name of bank(s) _________________________________________________________________________________________________________________________ 
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Credit Card
Name
 
RelationshipBirthday
Additional Information
By signing, I agree that this shall serve as my application for issuance of a BDO Credit Card and I undertake to submit documents as may be deemed necessary by BDO. I authorize BDO to conduct random verification with government agencies or third parties to establish authenticity of the information declared and/or documents submitted and hereby waive confidentiality of the rules and laws as applicable. I understand that the issuance of a BDO Credit Card shall be subject to credit evaluation and discretion of BDO.
For Bank’s Use Only
ID TypeID NumberDate IssuedPlace Issued Expiry Date
Courtesy Call / Business Visit
Conducted by
Name Signature
Results 
PositionDate
Resident CodeResidentNon-ResidentRCNNLDS VeriedH __________________________________________ Signature verified byApproved byDateDateClient __________________________________ Referred byBDO Employee _______________________________________________________ Walk-in
DependentsMother’s Full Maiden Name
 
Referral(s)
if possible, kindly indicate name of relative you can refer to usLast NameFirst NameMiddle Name
Father’s Name
Last NameFirst NameMiddle Name
 ________________________________________ Signature over Printed Name / Date Signed
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