Documente Academic
Documente Profesional
Documente Cultură
INSTRUCTION: Please provide the following required information according to your client type by filling out
tablecells or ticking off appropriate boxes in the 2nd column. Mandatory fields are written in bold type and
markedwith asterisks ( * ). Items in the 2nd column with asterisks ( * ) and not in bold type are the optional but
become mandatory when one of them in the same optional group is being filled out. Figures in parenthesis
indicate the exact/maximum number of characters allowed for the corresponding field.
1. CLIENT TYPE *
Importer
2. NATURE OF BUSINESS *
Other Wholesaling
3. BUSINESS ENTITY *
Corporation
5. CITIZENSHIP * (17)
PHILIPPINES
6. BUSINESS ADDRESS
ADDRESS * (70)
CITY * (20)
LILOAN, CEBU
6002
COUNTRY * (2)
PHILIPPINES
PHONE * (7-15)
0324241019
7. CONTACT INFORMATION *
ALTERNATE
PHONE (7-15)
FAX (7-15)
MOBILE PHONE *
(10-15)
EMAIL * (88)
bandallemarine_corporation@yahoo.com
WEBSITE/URL(100)
8. WAREHOUSE/TRANSIT CODE *
9. TAX IDENTIFICATION NO. * (12)
467135624000
VA0000000078
CS201533345
5,000,000.00
500,000.00
RELATED COMPANY
(100)
COMPANY TYPE
BROKER 1
PLANT ADDRESS
TIN * (12)
936227663000
CCN * (12)
BR0000717193
ADDRESS * (35)
CITY * (25)
LILOAN, CEBU
6002
COUNTRY * (2)
PHILIPPINES
CLIENT PROFILE REGISTRATION FORM (IMPORTER) - BANDALLE MARINE SUPPLY & SERVICES
MAJOR STOCKHOLDER
MAJOR
STOCKHOLDER
BRIAN
MIDDLE NAME *
ROMO
LAST NAME *
BANDOJA
CITIZENSHIP *
PHILIPPINES
256141262000
ADDRESS * (35)
CITY * (25)
DANAO CITY
6004
COUNTRY * (2)
PHILIPPINES
PHONE * (7-15)
09177194483
brian.bandoja@gmail.com
SIGNATURE
PRINCIPAL OFFICER
FELIXBERTO JR
MIDDLE NAME *
OLIMBA
ABALLE
POSITION * (35)
VICE PRESIDENT
TIN/ PASSPORT
NO./ or ACR NO.
139691333000
ADDRESS * (35)
BAJADA POBLACION
CITY * (25)
SAN REMEGIO
6011
COUNTRY * (2)
PHILIPPINES
PHONE * (7-15)
0324359115
ALTERNATE
PHONE (7-15)
MOBILE (10-15)
FAX (7-15)
EMAIL * (88)
aballejun@hotmail.com
SIGNATURE
CLIENT PROFILE REGISTRATION FORM (IMPORTER) - BANDALLE MARINE SUPPLY & SERVICES
RESPONSIBLE OFFICER
LENGIE
MIDDLE NAME *
VILLAMOR
LAST NAME *
BANDOJA
POSITION * (35)
OFFICE HEAD
261353035000
AREA OF
RESPONSIBILITY * (35)
ADMINISTRATION FINANCE
ADDRESS * (35)
CITY * (25)
DANAO CITY
6004
COUNTRY * (2)
PHILIPPINES
PHONE * (7-15)
0324241019
levie_0712@yahoo.com
SIGNATURE
MAJOR SUPPLIER
000000000000
NAME * (35)
ADDRESS *
CITY * (25)
325604
COUNTRY * (2)
CN
PHONE * (7-15)
86057762739265
IMPORTABLE COMMODITY
zjhaiji@163.com
COMMODITY CODE
ITEM NAME
COMMODITY
DESCRIPTION
CLIENT PROFILE REGISTRATION FORM (IMPORTER) - BANDALLE MARINE SUPPLY & SERVICES
CERTIFICATION
I certify that the foregoing information are true and correct to the best of my knowledge.
Date Signed:
CLIENT PROFILE REGISTRATION FORM (IMPORTER) - BANDALLE MARINE SUPPLY & SERVICES
NAME
DATE/PLACE ISSUED
known to me to be the same persons who executed the foregoing instrument and they acknowledged to
me that the same are their free and voluntary acts and deeds.
This client profile registration form consisting of 5
pages, including the page on which this
acknowledgement is written and the Nature of Business attachment of _____ pages, has been signed
on the left margin each and every page and at the bottom of this instrument the parties and their
respective witnessess.
WITNESS MY HAND AND NOTARIAL SEAL ON THE DAY, YEAR AND PLACE ABOVE-WRITTEN
Doc. No._______________;
Page No.______________;
Book No.______________;
Series of 2015