FORM NO.

018

CLIENT CONTACT / TRIPPING REPORT

Date:_____________

This is to certify that on _____________, 20___ at _______ A.M./P.M.

Mr./Mrs/.Ms. _________________________ with Real Estate Broker’s License Number
________________;

( ) Contacted and furnished me with data and documents on the property

described as follows:

Location:________________________________________________________
Lot Area _______________________ Floor Area:_______________________
TCT No. _______________________CCT No. _________________________
Description:_____________________________________________________
______________________________________________________
______________________________________________________

( ) Showed me the property described above

This certification DOES NOT NECESSARILY BIND me to purchase the above-

mentioned property. However, should I decide to purchase the above property, I hereby
agree to transact through ______________________, the above-mentioned broker.

____________________
Client’s Signature

Address: ____________
____________________
____________________

Tel. No: _____________

Fax. No: _____________
Cell No. _____________
E-mail : _____________