Customer Information Sheet

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YAL RESTAURNAT

CUSTOMER INFORMATION SHEET (CIS)


COMPANY PROFILE
Company Name:
current business address:
Number Of Years in Current Address: Owned Rental Mortgaged
Previous Address:
Number Of Years In Previous Address: Owned Rental Mortgaged
Contact Detail: Tax Identification No: Nature of Business:
Telephone No/s Tax Identification No: Nature of Business:

Fax No. Number of years in business: No Of Years In Current Ownership, if different:


E-mail Address:
Type Of Organisation :
Corporation General Partnership Limited Partnership Sole Proprietorship
Financial information about your company Have you or your officers or affiliates ever filed a petition for bankruptcy?
Assets Are you subject to any litigation if so, describe here:
Liabilities
Annual Net Income Are you current in meeting your other financial obligations?
BANK REFERENCES
Bank Name Branch Account Name Account No. Bank Tel. No

COMPANY CREDIT REFERENCES


Company Name Nature of business Length of relationship Contact person Telephone No.

LIST OF OWNERS & DECISION MAKERS


Name Position Home address Telephone No. % of Ownership

CUSTOMER`S AUTHORIZED REPRESENTATIVES


Name Signature

LIST OF DOCUMENTS SUBMITTED


SEC Registration (securities & Exchange Commission) financial Statements:
DTI Registration (Department of Trade and Industry) Balance Sheet
Current Mayor`s Permit & licenses (city Permits & licenses) Income Statement
TIN ID (tax Identification Card) Cast Flow Statement
Bank Statement (3 months) Others
CERTIFICATION
I hereby certify that the above information is true, correct and complete to the best of my knowledge and belief. The information is given to induce the
company to extend credit. We authorize the Company to make such credit investigations as the Company sees fit, including contacting the above trade
references and banks and obtaining credit reports. We authorize all trade reference and banks to disclose to the company any and all information concerning
the financial and credit history to the company and myself.
Customer`s Full Name Signature Date
FOR DSS GROUP`S ONLY
RECOMMENDED APPROVED
Credit Limit Credit Terms Credit Limit Credit Terms

Recommended by / date: Verified & Recommended by / Date Reviewed by / Date: Approved by / Date
Full Name and Signature Sales manager Finance Manager Chief Op Officer / Chief Exec Officer

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