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GCash KYC Form v2.0

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peterpaulpantilla
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431 views

GCash KYC Form v2.0

Uploaded by

peterpaulpantilla
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Know Your Customer

For Business
Form

Partner Name: SOFAREE DIGITAL MARKETING SERVICES

Authorized Signatory Details

1. Full Name (Last Name, First Name, Middle Name) PANTILLA PETER LINTAG

2. Address (Street #/ Building Name, Barangay, 355 PANTUA STREET TIMUGAN


Municipality / Town, City / Province) LOS BANOS LAGUNA
3. Date of Birth (Month/Day/Year) 12/17/1969

4. Place of Birth MANILA

5. Nature of Work BUSINESSMAN

6. Source of Funds (Example: Salary from INCOME FROM BUSINESS


Employment, Income from Business, Income from
Investments, Regular Remittance, etc.)

7. Position / Designation Level (Example: CEO, FOUNDER / OWNER


COO, CFO, CIO, CSO, President, Partner, Chairman, VP, GM,
Director, Supervisor)

8. Contact Details (Email Address / Mobile Number) 09499899460

9. Citizenship / Nationality FILIPINO

10. Specimen Signature

Customer Declaration

I certify that all information I have provided in this form is true and correct. I hereby authorize GXI to
verify all information provided herein. I agree to promptly notify GXI of any change in the information
which I have provided after the date of this declaration. I fully understand that any misinterpretation
of failure to disclose information on my part as required herein, may result in the disapproval of my
application for GXI products and services, and that GXI is not under any obligation to share with me
the reason/s or rationale for such disapproval.
11/14/2024
PETER PANTILLA
Signature Above Printed Name Date

V2.0 (March 6, 2023)

W GLOBAL CENTER www.GCash.com


[email protected]
30th Street corner
GCashOfficial
9th Avenue, BGC, The Fort, Taguig City
2882

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