AJAT PHILIPPINES, INC.

Lot 3&5 Salangsang Subd., Guinto St., Brgy. San Isidro, General Santos City, 9500 Philippines
Tel. Nos. (083) 552-9021 / (083) 301-6255 / (083) 302-3308 Email: info@ajatphilippinesinc.com

CUSTOMERS INFORMATION SHEET

Please fill up information about you and your company. Your assistance by the way of completing data as soonest
possible time will be greatly appreciated.

Date: __August 13, 2019

OUTLET INFORMATION
Owner’s Name ALMERA MACABANDO
Company Name DCM CONSTRUCTION
Complete Address BRGY. SAN ROQUE, LAMBAGOHON, SAN ROQUE, ILIGAN CITY
Delivery Address BRGY. SAN ROQUE, LAMBAGOHON, SAN ROQUE, ILIGAN CITY
Owners Birthday SEPT. 9, 1985
Company’s Anniversary JANUARY 18TH
Tin Number 941-608-529-000 VAT Number
SEC Reg. No. DTI Number
ACCOUNT CONTACT
Contact Person YASMIN AVA SHARA Office Phone
AMAIKURUT
Email Home Phone
Mobile No. 09567805814 Fax No.
COLLECTION CONTACT
Contact Person YASMIN AVA SHARA Office Phone
AMAIKURUT
Email Avashara15@gmail.com Home Phone
Mobile No. 09567805814 Fax No.
Follow-up Schedule Collection Day
SUPPLIER REFERENCE (Please list three major suppliers)
Name of Supplier Contact Person Contact No. Terms

BANK REFERENCE (please list three major banks)

Name of Bank and Account Number Contact Person Contact Number
Branch
LBPI –MARAWI CITY 1262003740 YASMIN AMAIKURUT 09567805814

Submitted by: Received and Verified by:

YASMIN AVA SHARA W. AMAIKURUT

Accounting
Signature Over Printed Name Signature Over Printed Name
Noted and Approved by:
Note:
Please attach photocopy of: JOSE F. TO-ONG, JR.
>Latest Business Permit President
>BIR Form 2303(Certificate of Registration)
>SEC Registration(if corporation)
>Latest DTI Permit