Customer Account Information Form

Last Name
First Name
Middle Name
Gender
Date of Birth (Month/Day/Year)
Place of Birth (Town/City/Province)
Citizenship
Tel. No. / Mobile No.
Facsimile No.
TIN or SSS / GSIS No.
Name of Employer / Business
Employment Status
Office Tel. No.
Office Address
r Male r Female
r Employed r Retired r Unemployed
r Self-employed r Others ______________
TIN SSS / GSIS No.
Are you a corporate officer or
director of a PSE-listed
company?
Are you an officer or employee
of another Broker / Dealer?
Other Brokers where you have
an account.
1.
2.
CitisecOnline.com, Inc.
2401-B East Tower, Philippine Stock Exchange Centre
Exchange Road, Ortigas Center, Pasig City, 1605 Philippines
Customer Service Hotline (632) 6-333-777 Fax No. (632) 6-363-512
Email Address: helpdesk@citiseconline.com
r Filipino r Resident Foreigner
r Non Resident Foreigner __________________
r Yes r No
If yes, specify company name ___________________________
r Yes r No
If yes, specify company name and provide a consent letter from
employer. ___________________________________________
r Male r Female
r Employed r Retired r Unemployed
r Self-employed r Others ______________
TIN SSS / GSIS No.
1.
2.
r Yes r No
If yes, specify company name ___________________________
r Yes r No
If yes, specify company name and provide a consent letter from
employer. ___________________________________________
COL FINANCIAL GROUP, INC.
2401-B East Tower, Philippine Stock Exchange Centre
Exchange Road, Ortigas Center, Pasig City, 1605 Philippines
Customer Service Hotline +632 651 5888 Fax No. +632 636 3512
Email Address: helpdesk@colfinancial.com
PERSONAL INFORMATION PRIMARY ACCOUNT HOLDER SECONDARY ACCOUNT HOLDER
ADDITIONAL INFORMATION PRIMARY ACCOUNT HOLDER SECONDARY ACCOUNT HOLDER
DISCLOSURES PRIMARY ACCOUNT HOLDER SECONDARY ACCOUNT HOLDER
Email Address
Civil Status
Residential Address
r Single r Separated
r Married r Widowed
r Single r Separated
r Married r Widowed
Name of Spouse (if applicable)
(SPECIFY NATIONALITY)
r Filipino r Resident Foreigner
r Non Resident Foreigner __________________
(SPECIFY NATIONALITY)
Please fill up clearly in BLOCK LETTERS and affix signature(s).
(Please select one)
INDIVIDUAL JOINT OR OTHERS_____________________
ACCOUNT NO. ____________________
CASH MARGIN
Do you have an existing COL
account? If yes, please
indicate account number.
1.
2.
1.
2.
PSE Trading Participant; SIPF and SCCP Member
On February 1, 2007, the Securities and Exchange Commission granted COL Financial Group, Inc. (formerly CitisecOnline.com, Inc.)
(COL) exemptive relief from SRC Rule 30.2-2 and SRC Rule 52.1-8. Hence, all confirmation invoices, monthly statement of account
and all other communications shall be sent via electronic mail to customers email address.
CUSTOMER BANK ACCOUNT DETAILS
Bank Account Name
Bank Name
Bank Account Number
Bank Address
APPLICATION REQUIREMENTS
FOR COLS USE ONLY
Processed By: Approved By:
I/We confirm that all the information given in this CAIF are true and correct. COL is hereby authorized to verify the same from
whatever sources it may consider appropriate. Any misrepresentation made on the submitted documents is sufficient ground for
legal action against me/us and the rejection of this application. Should this application be denied, COL has no obligation on its part
to furnish the reason for such rejection.
Signature(s)
Primary Account Holder Date

Secondary Account Holder Date

Assets
Net Worth
Annual Income
Source(s) of Income
Investment Experience
A. BASIC REQUIREMENTS:
1. Minimum cash/check deposit payable to COL Financial Group, Inc. for opening of the following accounts:
COL Starter Account - Php 5,000; and
COL Plus Account - Php 25,000;
2. Photocopy of one (1) identity document issued by the Philippine Government e.g. passport, drivers license, SSS/GSIS ID,
Professional Regulation Commission (PRC) ID, and Comelec Voters ID. (Please present original for verification);
3. Two (2) copies of Specimen Signature Cards; and
4. Online Securities Trading Agreement duly signed.
B. ADDITIONAL REQUIREMENTS FOR THE FOLLOWING:
1. Without face-to-face opening of account - a latest copy of any of the following documents must be submitted:
Public Utility Bill, Credit Card Statement or Bank Statement.
2 Resident Foreigners - include a photocopy of:
a. Alien certificate of registration (ACR) issued by the Bureau of Immigration; OR
b. A Certification to engage in business or working permit issued by the Department of Labor & Employment (DOLE).
3. Non-Resident Foreigners - include the following:
a. Proof of Income certified by Employer; AND
b. Identity Documents authenticated by Philippine Embassy or Consulate.
Salesman/Referred By: Date Opened:
r <500,000 r <1 Million r <5 Million
r <10 Million r Over 10 Million
r <500,000 r <1 Million r <5 Million
r <10 Million r Over 10 Million
r <500,000 r <1 Million r Over 1 Million
r Salary r Business r Investments
r Retirement r Others _________________
_______
Capital Preservation
_______
Long-term Investment
_______
Growth
_______
Speculation
r None r Limited r Good r Extensive
Investment Objectives
(List 1-4 in order of priority)
r <500,000 r <1 Million r <5 Million
r <10 Million r Over 10 Million
r <500,000 r <1 Million r <5 Million
r <10 Million r Over 10 Million
r Salary r Business r Investments
r Retirement r Others _________________
_______
Capital Preservation
_______
Long-term Investment
_______
Growth
_______
Speculation
ACCOUNT TYPE (Please select one)
r COL STARTER r COL PLUS r COL PREMIUM r PCG r OTHERS_______________________
r <500,000 r <1 Million r Over 1 Million
FINANCIAL &
INVESTMENT PROFILE
PRIMARY ACCOUNT HOLDER SECONDARY ACCOUNT HOLDER
MAILING OF INVOICES, MONTHLY STATEMENT OF ACCOUNT AND OTHER COMMUNICATIONS
r None r Limited r Good r Extensive
PSE Trading Participant; SIPF and SCCP Member