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Mitra Architectural Studio

8906-C Sampaloc Avenue, San Antonio Village, Makati City, 1203
Office Landline: (02) 5198520; Email: architect_mitra@yahoo.com

CLIENT INFORMATION SHEET
Note: All personal information is held securely in accordance with the appropriate legislation, is confidential and
treated appropriately.

MR./MRS./MS./ ________________
___________

_________

_____________________

(LAST NAME)

(FIRST NAME)

(MIDDLE INITIAL)

MARITAL STATUS: ____________________________
__________________

CITIZENSHIP:

DATE OF BIRTH:
_______________________________________________________________
REGISTERED HOME ADDRESS:
____________________________________________________
_____________________________________________________________________________
BUSINESS ADDRESS:
____________________________________________________________
_____________________________________________________________________________
PROJECT ADDRESS (LOCATION OF PROJECT):
________________________________________
_____________________________________________________________________________
TAXPAYER IDENTIFICATION NUMBER (Business)
_____________________________________
TAXPAYER IDENTIFICATION NUMBER (Individual)
____________________________________
CONTACT DETAILS:
TELEPHONE: __________________
_____________________

EMAIL:

Makati City. San Antonio Village.com FAX : ________________________ CELL NO.: ___________________ PREFERRED CONTACT MODE(S): __________________________________________ _________________________________ SIGNATURE OVER PRINTED NAME DATE: ____________________________ . Email: architect_mitra@yahoo.Mitra Architectural Studio 8906-C Sampaloc Avenue. 1203 Office Landline: (02) 5198520.