Customer Information Record

Personal

Personal Details CIF No.

Name

JOLOC Last Name CAESARFirst Name MATIAS Middle Name

Present Address Please insert
1” x 1”
Blk 29 Lot
No. 13 El Pueblo Del Rio Subdivision,
Street Mag-asawang Sapa, Santa Maria
Subdivision / District / Town photo here

Bulacan, Philippines 3022

City / Province Country Zip Code

Permanent Address (if applicable)

Blk 29 Lot
No. 13 El Pueblo Del Rio Subd.,
Street Subdivision Mag-asawang
/ District / Town Sapa,CitySanta
/ Province Maria, Country
Bulacan, Philippines,Zip3022
Code

Date of Birth (mm/dd/yyyy) Place of Birth Civil Status Single ✔ Married

Others______________________
04/19/1976 Manila
Gender Citizenship TIN SSS / GSIS No.
✔ Male Female
Filipino 189-047-934-000 33-2578840-2
Spouse (if applicable)

Joloc Last Name Jennifer First Name Dayrit Middle Name

Date of Birth (mm/dd/yyyy) Place of Birth Occupation No. of Dependents

01/10/1981 Navotas City Call Center 3

Contact Details
Telephone No. Mobile No. E-mail Address

0448127213 09238003656 caesarjoloc@gmail.com

Financial Details
Source of Funds ✔ Employment Pension Occupation
Business Others ___________________________ Accounting Assistant
Employment Status ✔ Employed Retired
Self-employed Student Others _____________________________________________________

Name of Employer (If Employed) Years with Employer

De Los Santos Medical Center 1

Address

201 E. Rodriguez, Sr. Blvd., Kalusugan, Quezon City, 1112

Position / Rank Telephone No.

Accounting Assistant/Rank and File 6328935762

Name of Business (If Self-Employed) Years in Business

Address Telephone No.

Existing Savings Time Account Home Loan Credit Card

BDO Account(s)
Current Personal Loan Auto Loan Others ______________________________________________________

Other banks Savings Time Account Home Loan Credit Card

account(s)
Current Personal Loan Auto Loan ✔ Others ______________________________________________________
Savings Payroll

Indicate name of bank(s) _________________________________________________________________________________________________________________________

China Bank

*If U.S. person, accomplish FATCA Information Sheet.

By signing, I hereby certify that the information given in this application is true and correct to the best of my knowledge and I confirm that I have read the Terms and Conditions of the General and Special Provisions on
Deposits and have fully understood and agreed to be governed by the provisions thereof, as well as the rules and regulations of the Bank, Bangko Sentral ng Pilipinas, Anti-Money Laundering Council, Bankers
Association of the Philippines and the Bureau of Internal Revenue with respect to taxes imposed on interest on deposits and bank commission/charges relative to the establishment of operations of the account/s
opened.

___________________________________________________________________
Signature over Printed Name / Date Signed
Additional Information

Mother’s Full Maiden Name

Matias Last Name Clarita First Name Dela Cruz

Middle Name

Father’s Name
Joloc Last Name Carmelo First Name Jamon Middle Name

Dependents
Alliyah Vivien D. Joloc
Name Daughter
Relationship 08/19/1999
Birthday

Adrianne Niklaus D. Joloc

Name Son
Relationship 07/10/2000
Birthday

Aaron Justin D. Joloc

Name Son
Relationship 05/30/2007
Birthday

Referral(s) if possible, kindly indicate name of relative you can refer to us

Aldy N. Dayrit
Name Brother-in-law
Relationship 9223898810
Contact No. E-mail Address

Name Relationship Contact No. E-mail Address

Name Relationship Contact No. E-mail Address

Credit Card
By signing, I agree that this shall serve as my application for issuance of a BDO Credit Card and I undertake
to submit documents as may be deemed necessary by BDO. I authorize BDO to conduct random verification
with government agencies or third parties to establish authenticity of the information declared and/or
documents submitted and hereby waive confidentiality of the rules and laws as applicable. I understand that
the issuance of a BDO Credit Card shall be subject to credit evaluation and discretion of BDO. ________________________________________
Signature over Printed Name / Date Signed

For Bank’s Use Only

ID Type ID Number Date Issued Place Issued Expiry Date

Resident Code Resident RC N NLDS Verified

Non-Resident H __________________________________________

Referred by
BDO Employee _______________________________________________________ Client __________________________________ Walk-in

Signature verified by Date

Approved by Date

Courtesy Call / Business Visit

Conducted by

Name Signature

Position Date

Results