CUSTOMER’S BANK ACCOUNT INQUIRY

BANK BRANCH DATE

CURRENT ACCOUNT NUMBER SAVINGS ACCOUNT NUMBER

Sir/ Madam:

In connection with my/ our Credit Application and Check Acceptance with Century
World Marketing. I/ We hereby authorize you to provide them necessary information
specified below.

Very truly yours,

___________________ ____________________
Authorized Printed Signature Authorized Printed Signature

(To be filled up by the bank)

Account Name

Address

Date Current Account Opened Date Savings Account Opened

Depositor maintains COMBINED Average Daily Balance (ADB) of (in Pesos)

Low 4 Digits Low 4 Digits Low 4 Digits

Middle 4 Digits Middle 4 Digits Middle 4 Digits
High 4 Digits High 4 Digits High 4 Digits

Status of this account/ depositor can best be in identified as: (Please check all that applies)

Regular Account/ Client Account is inactive

One of our Valued Client Poorly managed account
One of our Top Ten Client Account is Closed

Has this depositor dishonoring check (s) Number of Times

Yes No
Reasons for Dishonoring Check (s)

Information Supplied by (Printed Name & Signature) Position

Noted By (Printed Name & Signature of an Officer of the Bank) Position