Republic of the Philippines

GOVERNMENT SERVICE INSURANCE SYSTEM

GSIS Building, Financial Center, Roxas Boulevard, Pasay City 1308
Attach here
REAL ESTATE ASSET DISPOSITION AND MANAGEMENT OFFICE 2 x 2 ID photo
REAL PROPERTY ACCOUNTS MANAGEMENT DEPARTMENT of bidder

PERSONAL PROFILE

NAME OF BUYER ____________________________________________________________________________________________

LAST NAME FIRST NAME MIDDLE NAME

DATE OF BIRTH (dd/mm/yyyy) ___________________ CIVIL STATUS ___________ GENDER ______ CITIZENSHIP _________
BUYERS INFORMATION

CONTACT NOS. HOME _____________________ MOBILE _______________________ TIN NO.__________________

PERMANENT HOME ADDRESS __________________________________________________________________________________

__________________________________________________________________________________

PRESENT HOME ADDRESS __________________________________________________________________________________

__________________________________________________________________________________

COMPANY/EMPLOYER BUSINESS NAME & ADDRESS ______________________________________________________________

__________________________________________________________________________________________________________

BUSINESS TELEPHONE NO. _________________________; ___________________________

PREFERRED MAILING ADDRESS ______________________________________________________________

______________________________________________________________

NAME OF SPOUSE ___________________________________________________________________________________________

SPOUSE PERSONAL

LAST NAME FIRST NAME MIDDLE NAME

DATE OF BIRTH (dd/mm/yyyy) _________________________________ GENDER ______________________

CITIZENSHIP ______________ TIN NO. ______________ MOBILE NO ____________________

DATA

PERMANENT HOME ADDRESS _________________________________________________________________

_________________________________________________________________

COMPANY/EMPLOYER BUSINESS NAME ____________________________________________________

COMPANY/EMPLOYER BUSINESS ADDRESS ____________________________________________________

____________________________________________________
DOCUMENTS
ATTACHED

GOVERNMENT ISSUED IDS _________________________ OTHER IDS __________________________________

2 PCS OF 2 x 2 ID PICTURES

OTHER DOCUMENTS __________________________________________________________

I/We certify that the foregoing information/statements are to the best of my/our knowledge, true, correct and complete.

________________________________ _______________________________
Signature of the Applicant/Date Signed Signature of the Spouse/Date Signed
FOR GSIS USE ONLY
Signature of GSIS Representative Printed Name/ Position Date Received:

Received by:
THIS FORM CAN BE REPRODUCED, NOT FOR SALE