CLIENT REGISTRATION FORM

PERSONAL DATA
Name
Address
Telephone Number

Fax Number

Mobile Number

E-mail Address

Residential Address
Address (Other Country)
Date of Birth
Civil Status

Citizenship

Gender

Single Married Separated/Divorced Widowed

WORK INFORMATION
Company / Business Name

Number of Children

Designation

Company / Business Address

Nature of Business
Estimated Monthly Income:
P200,001 & above

P150,001 200,000

P100,001 150,000

P 50,000 100,000

P 50,000 and below

PROPERTY INTEREST
Project Name

Unit Type

HOW DID YOU FIRST BECOME INTERESTED IN THE PROPERTY?

REASON FOR BUYING

[
[
[
[
[
[
[
[
[
[
[
[

[
[
[
[
[

] Real Estate Broker

] In-House Seller
] Eton-Affiliated Employee
] Current Eton Unit Owner
] Event
] Sales Booth / Exhibit
] Newspaper / Magazine
] Direct Mailer / Text Blast
] Walk-In
] Internet / Website
] Billboard
] Others

_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

] Primary Home
] Investment (business)
] Vacation Home
] Retirement Home
] Inheritance / Gift to Children

[ ] Others : ________________________________

CLIENT AUTHORIZATION SHEET

I hereby acknowledge that ___________________________, accredited broker of Eton Properties Philippines, Inc., has given me a
comprehensive presentation of project/s identified as ____________________________________________________.
I hereby authorize Mr./Ms. ___________________________ as my seller of choice for a period of thirty (30) calendar days upon
signing of the Client Registration Form. No other seller shall be recognized and/or credited by Eton Properties Philippines Inc. should
I decide to make a reservation deposit for a unit/lot in any of the project/s within the said period.
Finally, I certify that I have paid no commission, fees, or other renumeration to the referror and/or broker and that he/she did not
ask or demand any from me.
Authorized by:
__________________________________
CLIENT

__________________________________
DATE

To be filled up by Property Specialist / Broker Liaison Officer:

Tripping / Briefing Date :
Property Specialist / Broker :
Manager / Broker Liaison Officer :
Sales Director :

________________________________
________________________________
________________________________
________________________________

6/11/15 BN

8F Allied Bank Center, 6754 Ayala Avenue, Makati City, PH 1200

(02) 845-3866 loc. 831

brokers.network@eton.com.ph