CUSTOMER'S GENERAL INFORMATION SHEET

( ) NEW CUSTOMER ( ) CREDIT APPLICATION ( ) CHANGE NAME PREVIOUS COMPANY NAME: ______________________

( Note: Please don't leave any item blank. Write N/ A if information requested is not applicable to your company. Thanks. )

COMPANY PROFILE

COMPANY NAME:

HEAD OFFICE ADDRESS:

DELIVERY ADDRESS:

BRANCH/ ES / or OUTLET/ S ADDRESS/ ES:

1 _____________________________________________________ 4. _________________________________________________

2. _____________________________________________________ 5. _________________________________________________

3. _____________________________________________________ 6. _________________________________________________

CONTACT NO.: ___________________________ ___________________________ ________________________ _________________________

FAX NO. : CP. NO. :

E-MAIL ADDRESS: WEBSITE:

Pls. Check Type of Organizations: ( ) Sole Proprietorship ( ) Partnership ( ) Corporation ( ) Others: __________________________

BASIC REQUIREMENTS

( ) BUSINESS PERMIT ( ) SKETCH OF DELIVERY ADDRESS

( ) SEC REGISTRATION CERTIFICATE ( ) AUTHORIZED RECEIVING PERSONNEL WITH 2 SIGNATURE SPECIMEN

NOTE: Pls attach a photocopy of the basic requirements listed above

OWNER/S BOARD OF DIRECTOR / TRUSTEES

Name Position in Co. Profession Nationality Address

Year Business Start : Total No. of Employees :

CATEGORY

( ) WAREHOUSE SUB CHANNEL: ________ ( ) FOOD SERVICE SUB CHANNEL:__________ ( )MODERN TRADE SUB CHANNEL: _________

KEY CITY: _____________________ REGION: __________________

FINANCIAL REFERENCES

BANK/S BRANCH / ES SA / CA ACCOUNT NO CONTACT PERSON/ S ADDRESS

Note: Pls fill up at least two ( 2 ) Commercial Bank Accounts

SUPPLIER / S CONTACT PERSON / S CONTACT TEL. NOS. ADDRESS

Accomplished by: _____________________________ ________________________________ __________________________

Signature Over Printed Name Position in the Company Date

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To be filled out by Global Pacific Distribution Network Corporation

Recommending Credit Limit: Php ____________________ Terms: ___________ days Remarks:__________________________________________

Prepared by: _________________________________________(HRI SPECIALIST)

Endorsed by: ____________________________ ( ASS/ASM )

Noted by: ____________________________ ( RSOM )

APPROVED CREDIT LIMIT: ____________________ APPROVED CREDIT TERM: ______________________

FINAL APPROVA: APRIL WYNNIE MORALES

Finance Manager