FORM#7_012019

CEBUANA LHUILLIER REGISTRATION FORM

Customer Code: ____________________Customer/Store Name:__________________________________________

Owner’s Name: _________________________________________________________________________________
SEC/DTI Registered Name:________________________________________________________________________
Business Address: _______________________________________________________________________________
Home Address: _________________________________________________________________________________
Phone Number: __________________________________ Mobile Number: _________________________________

(Each Customer, whether a natural person, a single proprietorship, partnership or corporation, hereinafter referred to as
“Company”)

Representative authorized to pick up merchandise in all modes of payment (individually “Representative” collectively
“Representatives”)

1. _____________________________ 2. ______________________________3. _____________________________

Terms and Conditions:

1. By signing this form and executing this document, you hereby confirm that:
a. Each of the Representative is duly authorized to represent and transact with Suy Sing Commercial Corporation in behalf of
the Company;
b. Any change to the authorized Representatives of the Company shall be communicated to the TREASURY DEPARTMENT,
addressed to the CREDIT & COLLECTION OFFICER of Suy Sing, in writing. Unless otherwise rejected by Suy Sing, any
change shall be effective 24 hours after such notice is actually received by the CREDIT & COLLECTION OFFICER;
c. Any items, products, merchandize picked-up or received by any Representative shall be deemed received by the Company;
d. Suy Sing shall not be responsible for any loss, damage, injury, non-delivery of the product, items, or merchandize received by
the Representative, including for causes arising from theft, misappropriation, or fraud of any such Representative.
2. For the protection of both parties, Suy Sing requires the customer's authorized representative (s) to present their identific ation
papers, a valid company ID, or a government issued ID, both containing at least the name, picture and signature of the authorized
representative for proper identification. The policy of NO ID, NO PICK UP shall be strictly observed. Customer shall give Suy Sing
prior written notice of any changes made on this application form.
3. Suy Sing sales person is not allowed to collect and receive any payments for all transactions either pick up or delivery from the
company. Suy Sing will not be held liable for losses due to non-compliance.
4. Suy Sing Commercial Corporation Treasury Office will call the customer to facilitate the approval of this application. The customer
should answer correctly the security questions as required by Suy Sing Treasury Office for verification.
5. Completely signed application forms that are faxed back to Suy Sing or digitally captured and sent via email, Viber or other forms
of electronic communication, shall also constitute agreement and compliance by the Company to all the terms and conditions
stated herein.
6. I/we certify that the information given by me/us is true and correct. I/we authorize Suy Sing Commercial Corporation Treasury
Office to verify the information provided by me/us from whatever sources it may consider appropriate. I/we understand that
falsifying any of the information on the enclosed documents is sufficient ground for legal action and the rejection of my/our
application.

By signing this form, I agree and consent that Suy Sing may collect, use, share, store, dispose my personal data obtained from
this form for any purpose as stated under the Terms and Conditions, and that I acknowledge that I have read and agreed to the above Terms
and Conditions.

____________________________________________ ___________________
CUSTOMER SIGNATURE OVER PRINTED NAME DATE

To be filled out by Suy Sing Commercial Corporation

Processed by (AO): Checked by (TM):

SIGNATURE OVER PRINTED NAME / DATE SIGNATURE OVER PRINTED NAME / DATE