9F Estancia Offices, North Wing, Capitol Commons, Pasig City, 1605, Metro Manila

Mobile: 0945 275 5151 | Email: oclpbrokers@sales-ortigas.com.ph

LOCAL BROKER ACCREDITATION FORM

TYPE OF ACCREDITATION
Please check: o BROKER INDIVIDUAL o BROKER CORPORATION
FOR INDIVIDUAL
LAST NAME FIRST NAME MIDDLE NAME NICKNAME

DATE OF BIRTH (MM/DD/YYYY) GENDER MARITAL STATUS CITIZENSHIP

PERMANENT/MAILING ADDRESS

EMAIL ADDRESS MOBILE NUMBER OTHER CONTACT NUMBERS

PRC BROKER'S LICENSE NUMBER VALID TO VALID FROM TAX IDENTIFICATION (TIN) NUMBER o VAT
o NON-VAT
BROKER ORGANIZATION AFFILIATION

FOR CORPORATION
NAME OF CORPORATION CONTACT NUMBER OF CORPORATION EMAIL ADDRESS OF CORPORATION

ADDRESS OF CORPORATION

NAME OF LEAD BROKER OF CORPORATION CONTACT NUMBER OF LEAD BROKER

PRC BROKER'S LICENSE NUMBER OF LEAD BROKER VALID TO VALID FROM TAX IDENTIFICATION (TIN) NUMBER OF CORPORATION

o VAT SEC REGISTRATION NUMBER BROKER ORGANIZATION AFFILIATION

o NON-VAT
OTHER DEVELOPER(S) ACCREDITED/AFFILIATED WITH
REAL ESTATE COMPANY POSITION INCLUSIVE DATES STATUS (Active/Inactive)

SIGNATURE OVER PRINTED NAME DATE FIELD FOR ORTIGAS & COMPANY: DATE
ACCREDITED BY:

By signing this form, I hereby authorize Ortigas and Company, Limited Partnership, its subsidiaries, affiliates, partners, successors and/or assigns (the “Ortigas Group”) to collect, process, store, and use any and all
information that I furnish the Ortigas Group for the purpose of providing me with product and promotional information, services, feedback and/or surveys on the Ortigas Group’s products and services. I hereby
expressly and knowingly waive any and all statutory or regulatory provisions governing the confidentiality of such information, if applicable.

ORTIGAS & COMPANY ACCREDITATION REQUIREMENTS CHECKLIST

Submit a hard copy or email soft copy to oclpbrokers@sales-ortigas.com.ph
FOR INDIVIDUAL BROKERS FOR BROKER CORPORATION
o Filled-out Broker Accreditation Form o Filled-out Broker Accreditation Form
o Photocopy of PRC Brokers License ID o Photocopy of PRC Brokers License ID of Lead Broker
o Certificate of Registration (BIR Form 2303) o Certificate of Registration (BIR Form 2303)
o Copy of Official Receipt o Copy of Official Receipt of Corporation
o HLURB ID/Certificate o Secretary Certificate/Board Resolution of Corporation
o 1x1 Picture o HLURB ID/Certificate of Lead Broker
o BIR Form 2307 o 1x1 Picture of Lead Broker
o BIR Form 2307
v08062018