PROSPECTIVE CLIENT‘S DAT A SHEET

(PLEASE COMPLETE ALL SECTIONS AND PRINT LEGIBLY ON BOTH SIDES. THANK YOU.)

A. FIRST NAME MIDDLE NAME LAST NAME NICKNAME

CIVIL STATUS SEX BIRTHDATE CITIZENSHIP T.I.N. _________________________
 SINGLE  WIDOWED  MALE ✔ FILIPINO
 PASSPORT NO. ________________
 MARRIED  FEMALE  OTHERS ____________________ IF ALIEN, ACR NO. ______________
T

HOME ADDRESS: ___________________________________________________________________________________________________________ SINCE _____________

N

RESIDENCE(S) FOR THE PAST 5 YEARS (INCLUDE DATES) __________________________________________________________________________________________

A

______________________________________________________________________________________________________________________________________________
C

______________________________________________________________________________________________________________________________________________

TEL. NO. MOBILE PHONE NO. E-MAIL ADDRESS:

I

 EMPLOYED COMPANY NAME _________________________________________ DEPT./POSITION _____________________ YRS. OF EMPLOYMENT ______

L

 SELF-EMPLOYED NATURE OF BUSINESS ___________________________________________________________________________________________________

P

COMPANY BUSINESS ADDRESS TEL. NO.

B. EST. MONTHLY INCOME: OWN SPOUSE INCOME FROM OTHER SOURCES ____________
P

SOURCE OF INCOME: LOCAL EMPLOYMENT ________________ LOCAL EMPLOYMENT ________________

OVERSEAS EMPLOYMENT ____________ OVERSEAS EMPLOYMENT ____________ TOTAL MONTHLY EARNINGS ________________
A

EST. MONTHLY EXPENDITURES _____________

LIVING ACCOMMODATION: DO YOU RENT? __________ PAY MORTGAGE? __________ OWN A HOUSE? __________ OTHERS? (SPECIFY) _______________________

IF RENTING, LESSOR'S NAME __________________________________________________________________________ TEL. NO. ________________________________

LESSOR'S ADDRESS

C. SPOUSE: FIRST NAME MIDDLE NAME LAST NAME NICKNAME

Y

BIRTHDATE CITIZENSHIP T.I.N. __________________________________________

 FILIPINO PASSPORT NO. _________________________________
L

 OTHERS _____________________________ IF ALIEN, ACR NO. _______________________________

I

TEL. NO. MOBILE PHONE NO. E-MAIL ADDRESS:

M

 EMPLOYED COMPANY NAME ________________________________________________ DEPT./POSITION _______________ YRS. OF EMPLOYMENT ______

 SELF-EMPLOYED NATURE OF BUSINESS _____________________________________________________________________________________________________
A

COMPANY BUSINESS ADDRESS ___________________________________________________________________________ TEL. NO. _____________________________

F

D. NO. OF DEPENDENT/S: ________________________________ WORKING __________________________ STUDYING: ELEM./HIGH SCHOOL ____________________

COLLEGE
E. BANK (SIGNATORY OF BANK ACCOUNT(S) BELOW TO SIGN BANK AUTHORIZATION LETTER PLEASE)
NAME OF BANK BRANCH/ADDRESS TYPE OF ACCOUNT ACCOUNT NUMBER ACCOUNT HOLDER
S

1. __________________________________ ________________________________________ __________________ _____________________ __________________

2. __________________________________ ________________________________________ __________________ _____________________ __________________
E

3. __________________________________ ________________________________________ __________________ _____________________ __________________

C

F. LOAN (PAST/PRESENT FINANCIAL OBLIGATION)

FINANCING COMPANY BRANCH/ADDRESS LOAN ACCT. # ACCT. HOLDER DATE OF LOAN AMOUNT
N

1. _____________________________________ ______________________ _________________ _________________ _________________ ___________________

2. _____________________________________ ______________________ _________________ _________________ _________________ ___________________
E

3. _____________________________________ ______________________ _________________ _________________ _________________ ___________________

R

G. TRADE (NAME 3 COMPANIES/SUPPLIERS/PERSONS HAVING THE MOST BUSINESS WITH YOU)

NAME ADDRESS TELEPHONE NUMBER
E

1. ___________________________________________ ______________________________________________________________________ ______________________

2. ___________________________________________ ______________________________________________________________________ ______________________
F

3. ___________________________________________ ______________________________________________________________________ ______________________

E

H. PERSONAL (NAME 3 PERSONS LIVING IN METRO MANILA WITH PHONE NUMBERS. DO NOT INCLUDE RELATIVES)
NAME ADDRESS TELEPHONE NUMBER
R

1. ___________________________________________ ______________________________________________________________________ ______________________

2. ___________________________________________ ______________________________________________________________________ ______________________
3. ___________________________________________ ______________________________________________________________________ ______________________

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OTHER INFORMATION
I. DO YOU OWN A VEHICLE?  YES  NO IF YES, HOW MANY? __________
CAR MAKE MORTGAGE (Mortgator, Amount Mortgaged, Remaining Term) YEAR ACQUIRED

J. DO YOU OWN A REAL ESTATE PROPERTY?  YES  NO IF YES, HOW MANY? __________
KIND (lot, h/l, condo., etc.) LOCATION MORTGAGE (Mortgator, Amount Mortgaged, Remaining Term)

K. HAVE YOU PURCHASED REAL ESTATE PROPERTY FROM CITYLAND BEFORE?  YES  NO

L. COURT CASES: ARE/WERE YOU OR YOUR COMPANY INVOLVED IN ANY CASE EITHER AS PLAINTIFF OR DEFENDANT? __________
CASE # COMPLAINT FILED DATE FILED PLAINTIFF VS. DEFENDANT

M. DO YOU HAVE ANY RELATIVE OR FRIEND WHO WORKED OR IS WORKING IN CITYLAND OR ITS AFFILIATES? __________
IF YES, PLEASE STATE:
NAME RELATIONSHIP POSITION DEPT.

N. EMERGENCY CONTACTS (ONE IMMEDIATE RELATIVE, ONE CLOSE FRIEND)

NAME HOME or BUSINESS ADDRESS TEL. NO. RELATIONSHIP
1.

2.

O. I AM BUYING THIS LOT/UNIT FOR: (PLEASE CHECK ONLY ONE)

 OCCUPANCY  RESALE  TO RENT OUT  INVESTMENT

P. I CAME TO KNOW CITYLAND THROUGH: (PLEASE CHECK ONLY ONE)

NEWSPAPER MANILA BULLETIN PHIL. DAILY INQUIRER PHIL. STAR OTHER (SPECIFY _____________________)

BOX ADS

PRESS RELEASE

 BILLBOARD (LOCATION ______________________________________________________________________________)

 BROKER (NAME ________________________________________________________________________ TEL. NO. ______________________________________)

 REFERRED BY FRIEND / RELATIVE (NAME ________________________________________________________________ TEL. NO. _______________________)

 WEBSITE ___________________________________

 WINDOW AD  MASS PRESENTATION

 SALES STAFF / COLD CALLS

 ADDITIONAL PURCHASE

 WALK-IN _____ OFFICE _____ ONP _____ NRT _____TMR2 _____ PPT _____ TGR _____ GCR _____ BOOTH

 OTHERS ___________________________________

Q. I HAPPEN TO LIKE THE UNIT/LOT IN THIS PARTICULAR CONDO / SUBDIVISION BECAUSE OF: (PLEASE CHECK ONLY ONE)

 PRICE  AMENITIES  TERMS OF PAYMENT  UNIT LAY-OUT

 LOCATION  BUILDING FACADE  UNIT SIZE / AREA  OTHER (SPECIFY ____________________)
R. WHAT OTHER LOCATION/S WOULD YOU LIKE CITYLAND TO BUILD/DEVELOP? (PLEASE BE SPECIFIC)
________________________________________________________________________________________________________________________________________

PROJECT _____________________________________ DOWNPAYMENT P ____________________________________

LOT/UNIT NO. _____________________________________ DP DUE DATE ______________________________________

CASH PRICE P____________________________________ MA AMOUNT P ____________________________________

NET PRICE P____________________________________ NO. OF MONTHS ______________________________________

I / WE CERTIFY THAT THE ABOVE INFORMATION/DATA IS TRUE AND CORRECT. I/WE HEREBY AUTHORIZE CITYLAND GROUP OF COMPANIES AND ITS
EMPLOYEES/REPRESENTATIVES TO OBTAIN AND PROCESS MY/OUR/ANY INFORMATION/DATA NECESSARY FOR EVALUATING MY/OUR APPLICATION RELATIVE TO
MY/OUR PURCHASE OF PROPERTY AND OTHER RELATED SERVICES. I/WE AGREE THAT ANY MATERIAL MISTAKE OR CONCEALMENT OF ANY INFORMATION OR
THE WITHDRAWAL OF CONSENT TO SECURE/PROCESS SUCH SHALL BE GROUNDS FOR CANCELLATION OF THE APPLICATION OR ANY CONTRACT WITH CITYLAND.

____________________________________________ ___________________________________
PROSPECTIVE BUYER/LESSEE DATE
(SIGNATURE OVER PRINTED NAME)
NOTED BY:

__________________________________
SALES STAFF revisedG2018/leslie-d/msword/datashet.
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