RAEMULAN LANDS, INC

Broker's BIO-DATA/ Information Sheet PLEASE ATTACH

1x1 PHOTO

Fill out this form completely. Print legibly. Please attach your RECENT colored ID picture with white background. Rest assured that all information
here are considered CONFIDENTIAL and will only be used by authorized personnel.
PERSONAL INFORMATION

FULL NAME____________________________________________________________________________
NICKNAME____________________________________
Last First Middle

REALTY GROUP _______________________________________________ No. of years with current Realty group ______________________
CURRENT POSITION ___________________________________________ No. of years in the Real Estate Business _____________________
PRC REGISTRATION NO. / LICENSE NO. __________________________ TIN NO. ______________________________________________
RESIDENCE
ADDRESS__________________________________________________________________________________________________________________________
No./ Street Barangay Town/District
____________________________________________________________________ TELEPHONE NO._______________________________
City/Province Zip Code
OFFICE
ADDRESS__________________________________________________________________________________________________________________________
No./ Street Barangay Town/District

____________________________________________________________________ TELEPHONE NO.______________________________

City/Province Zip Code

DATE OF BIRTH________________________________________ AGE______________ PLACE OF BIRTH _____________________________

CELLPHONE NO._______________________________________ EMAIL ADDRESS__________________________________________________

GENDER CIVIL STATUS RELIGION___________________SSS NO._____________________________
Male Single Widowed TIN NO.______________________________
Female Married Separated PHILHEALTH NO._____________________
EDUCATION
SCHOOL/LOCATION YEAR COMPLETED? DEGREE/MAJOR HONOR RECEIVED
If not, no. of units
FROM TO completed
ELEMENTARY
HIGHSCHOOL
COLLEGE
POST GRADUATE
ASSOCIATION POSITION/TITLE YEAR OF PARTICIPATION
AFFILIATED REAL ESTATE
ORGANIZATION
TITLE VENUE/CONDUCTED BY DATE
SPECIAL TRAININGS /
SEMINAR/WORKSHOP
ATTENDED
FAMILY BACKGROUND

SPOUSE NAME__________________________________________ AGE________ OCCUPATION_____________________EMPLOYER__________________

MOTHER'S NAME________________________________________ AGE________ OCCUPATION_____________________EMPLOYER__________________
FATHER'S NAME_________________________________________ AGE________ OCCUPATION_____________________EMPLOYER__________________
CHILDREN (Please attach sheet if necessary)
NAME AGE CIVIL STATUS OCCUPATION SCHOOL/COMPANY

ACCREDITATION HISTORY (Please attach sheet if necessary)

DEVELOPER 1
Broker
Company Name ______________________________________________________________________________________________________
Level/Category _______________________________________

Address ______________________________________________________________________________________________________
Commission Rate _______________________________________
Type of Property
Project Name ______________________________________________________________________________________________________
Sold Socialized Housing
Lower Midle Market (750 - 1.9M)
Midle Midle Market (2.7M - 3.6M)
Upper Midle Market (5.1M - 6.5M)

No. of Units Sold ______________________________________________________________________________________________________

Condo Commercial Lots Lot only
Year and Date of
Ave. Monthly Production ______________________________________________________________________________________________________
Accreditation _______________________________________
Rewards / Recognition / Promo Received: __________________________________________________________ Year: __________________________
__________________________________________________________ Year: __________________________
DEVELOPER 2

Broker
Company Name ______________________________________________________________________________________________________
Level/Category _______________________________________

Address ______________________________________________________________________________________________________
Commission Rate _______________________________________
Type of Property
Project Name ______________________________________________________________________________________________________
Sold Socialized Housing
Lower Midle Market (750 - 1.9M)
Midle Midle Market (2.7M - 3.6M)
Upper Midle Market (5.1M - 6.5M)

No. of Units Sold ______________________________________________________________________________________________________

Condo Commercial Lots Lot only
Year and Date of
Ave. Monthly Production ______________________________________________________________________________________________________
Accreditation _______________________________________
Rewards / Recognition / Promo Received: __________________________________________________________ Year: __________________________
__________________________________________________________ Year: __________________________
DEVELOPER 3

Broker
Company Name ______________________________________________________________________________________________________
Level/Category _______________________________________

Address ______________________________________________________________________________________________________
Commission Rate _______________________________________
Type of Property
Project Name ______________________________________________________________________________________________________
Sold Socialized Housing
Lower Midle Market (750 - 1.9M)
Midle Midle Market (2.7M - 3.6M)
Upper Midle Market (5.1M - 6.5M)

No. of Units Sold ______________________________________________________________________________________________________

Condo Commercial Lots Lot only
Year and Date of
Ave. Monthly Production ______________________________________________________________________________________________________
Accreditation _______________________________________
Rewards / Recognition / Promo Received: __________________________________________________________ Year: __________________________
__________________________________________________________ Year: __________________________

Broker Signature Over Printed Name Date

FATIMA A. CAMBE
SMO Signature Over Printed Name Date

AVIGAIL D. BORROMEO
SMD Signature Over Printed Name Date

REMARKS / RECOMMENDATION: