Accessories & Supplies 110 Labo St., Brgy.

Salvacion 1114 Quezon City

Tel Nos. 559-4795.559-4941.559-4944.559-4959

Depot, Inc.
Telefax 4154727.4156678
Website: http://www.asdi.ph /Email:sales@asdi.ph

CUSTOMER INFORMATION

Company Information:

Registered Business Name : __________

Company Address : __ _
Telephone Number/s : _______________________________
Facsimile Number/s : ______________________________________________
Branches (If Any) : ______________________________________________
BRANCH ADDRESS TEL. NO.
____________________ ____________________ ____________________
____________________ ____________________ ____________________
____________________ ____________________ ____________________

Type of Organization:

 Single Proprietorship  Partnership

 Corporation  Government Agency
  Others _____________________________________________________________

Name of Business: __________________________________________________________

Nature of Business: __________________________________________________________

Number of Years in Business: __________ Total No. Of Employees: __________________

Office Premises: ( ) Owned ( ) Rented Monthly Rental: __________________
SEC Reg No: _________________ Business Reg. No. (DTI): ______________________
Taxpayer’s Identification Number (TIN): _________________________________________
Total Amount of Subscription: ________________________________________________
Total Amount Paid-up: ______________________________________________________
Total Capitalization: _______________________________________________________

Accessories & Supplies 110 Labo St., Brgy. Salvacion 1114 Quezon City
Tel Nos. 559-4795.559-4941.559-4944.559-4959

Depot, Inc.
Telefax 4154727.4156678
Website: http://www.asdi.ph /Email:sales@asdi.ph

Company Officers:
NAME POSITION TEL # ADDRESS
_____________ _____________ _____________ _____________
_____________ _____________ _____________ _____________
_____________ _____________ _____________ _____________
_____________ _____________ _____________ _____________
Person Authorized to Issue PO/Order Signature
_________________________________ _________________________________
_________________________________ _________________________________

Financial Information

Name of Bank/ Account No. Address /Branch/Tel. Nos.

_________________________________ _________________________________
_________________________________ _________________________________
_________________________________ _________________________________
_________________________________ _________________________________
 Credit References (Suppliers):

Company Name Contact Person Tel. No. Credit Limit Terms

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

________________________
Authorized Officer
(Print Name and Sign)

Position : __________________
Date : __________________

CUSTOMER’S BANK ACCOUNT INQUIRY

Bank Branch Date

Savings Account Number Current Account Number

Gentlemen:

In connection with my / our Credit Application and Check Acceptance with Accessories &
Supplies Depot, Inc. I / We hereby authorize you to provide them the necessary information
specified below.

Very truly yours,

___________________________ _________________________

Authorized Signature Authorized Signature

(To be filled up by the bank)

Account Name

Address

Date Savings Account Opened Date Current Account Opened

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

⃝ Low 4 Digits ⃝ Low 5 Digits ⃝ Low 6 Digits

⃝ Middle 4 Digits ⃝ Middle 5 Digits ⃝ Middle 6 Digits
⃝ High 4 Digits ⃝ High 5 Digits ⃝ High 6 Digits or more
Status of this account / depositor can best be identified as: (please check all that applies)

⃝ One of our valued account / depositor ⃝ Account is inactive

⃝ Well-managed borrowing account ⃝ Poorly managed account
⃝ Well-managed non-borrowing account ⃝ Account is Closed
Has this depositor dishonoured his check(s) Number of Times
⃝ Yes ⃝ No
Reasons for Dishonouring check(s)

Information Supplied by : (Printed Name & Signature) Position

Noted by : (Printed name & Signature of an Officer of Position

the Bank)