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CLIENT INFORMATION FORM

IFUBENG CONST ENTERPRISE & CONSTRUCTION SUPPLY


Company Name: _________________________________________________________________________
Lot 8 Blk2 Sunflower Home Alno, La Trinidad, Benguet,2601
Address: ________________________________________________________________________________
927 - 928 – 661 - 000
_____________________________________________________ TIN#: ___________________________
ifubengconstepf@gmail.com
Email: ________________________________________________ Website: ________________________
09171322018
Phone #: ______________________________________________ Fax #: ___________________________
Marcial F. Madeo Marketing Manager
Contact person: ________________________________________ Position: _________________________
BLK.03 CLOVERLEAFE ST., ADDAS GREENFIELDS, MAMBOG
Branch/Warehouse address: _________________________________________________________________IV, BACOOR CITY, CAVITE
Sole Proprietor
Type of ownership: _____________________________________ 2018
Start of business Operation (year): ____
MOISES H. TAYABAN
Owner/s name: ___________________________________________________________________________
Lot 8 Blk2 Sunflower Home Alno, La Trinidad, Benguet,2601
Owner/s Address:__________________________________________________________________________
President/Owner
Owner/s Position:__________________________________________________________________________
927 - 928 – 661 - 000
Owner/s TIN No:___________________________________________________________________________
Construction
Nature of business: ________________________________________________________________________

Company Assets:
1.) Komatsu Backhoe PC150
2.) Toyota Hilux 2021, BAE 8104
3.) ISUZU Forward Dumptruck,1990, WMM776

If Car Please specify the Make, Model, Year and Plate No.
If Real-estate Property please specify the Location and Lot Area.

Bank References:

Bank 1 Bank 2
Bank Name Land Bank of the Philippines
Branch Lagawe branch
Account Number
Contact Person & Designation
Contact Number
Member Since

Bank 3 Bank 4
Bank Name
Branch
Account Number
Contact Person & Designation
Contact Number
Member Since
Supplier References:

Supplier 1: ____________________________________________________________________________

Address: ______________________________________________________________________________

Contact person: ________________________________ Contact #: _____________________________

Items purchased: _______________________________________________________________________

Supplier since (year): ____________________________ Average monthly purchase: _______________

Terms of payment: ______________________________ Terms availed since(year): ________________

__________________________________________________________________________________________

Supplier 2: ____________________________________________________________________________

Address: ______________________________________________________________________________

Contact person: ________________________________ Contact #: _____________________________

Items purchased: _______________________________________________________________________

Supplier since (year): ____________________________ Average monthly purchase: _______________

Terms of payment: ______________________________ Terms availed since(year): ________________

Supplier 3: ____________________________________________________________________________

Address: ______________________________________________________________________________

Contact person: ________________________________ Contact #: _____________________________

Items purchased: _______________________________________________________________________

Supplier since (year): ____________________________ Average monthly purchase: _______________

Terms of payment: ______________________________ Terms availed since(year): ________________

__________________________________________________________________________________________

Supplier 4: ____________________________________________________________________________

Address: ______________________________________________________________________________

Contact person: ________________________________ Contact #: _____________________________

Items purchased: _______________________________________________________________________

Supplier since (year): ____________________________ Average monthly purchase: _______________

Terms of payment: ______________________________ Terms availed since(year): ________________


Supplier 5: ____________________________________________________________________________

Address: ______________________________________________________________________________

Contact person: ________________________________ Contact #: _____________________________

Items purchased: _______________________________________________________________________

Supplier since (year): ____________________________ Average monthly purchase: _______________

Terms of payment: ______________________________ Terms availed since(year): ________________

__________________________________________________________________________________________

Supplier 6: ____________________________________________________________________________

Address: ______________________________________________________________________________

Contact person: ________________________________ Contact #: _____________________________

Items purchased: _______________________________________________________________________

Supplier since (year): ____________________________ Average monthly purchase: _______________

Terms of payment: ______________________________ Terms availed since(year): ________________

Please provide the following Documents:

Mayor’s Permit for current year


Barangay Permit for current year
Certificate of Incorporation from S.E.C
General Information Sheet from S.E.C
Certificate of Registration of business name from D.T.I
Certificate of Registration from B.I.R form 2303
Latest ITR

Other Info / Comments:


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