BLITZ PROCESSING & BUSINESS CONSULTANCY SERVICES

Email: admin@blitzprocessing.com
Mobile: 0968-857-0367
Tel.#: 088-565-0204
Website: www.blitzprocessing.com

CLIENT INFORMATION SHEET

Full name as it appears on your PRC ID: ______________
Full maiden name (for married only): _____________________________
Complete address (This will be the shipping address of your id): _________________________
Mobile #: _____________
Email: _______________
Sex:
Birthdate (month/date/year): _____________________
Birthplace: __________________________________
Name of Father: _______________________________
Citizenship: __________________________________
Name of Mother: _______________________________
Citizenship: ___________________________________
Civil status:____________________________________
If yes, Name of Spouse:____________________________
Citizenship: ___________________________________
School/University Name: __________________________
Address: ______________________________________
Course:_______________________________________
Date of graduation (month/date/year): _________________
Practicing profession: Y __ or N ___
If yes, where if No, Occupation? _____

For client with existing PRC account:

Username: _______________
Password: _______________
If you forgot, don’t have or didn’t validate your PRC account, leave blank.

You can change your password after the slot appointment.

Privacy Statement
We are committed to protecting your privacy. Authorized employees within the company on a
need to know basis only use any information collected from individual customers for account
creation purposes only.

Confidentiality
Client records are regarded as confidential and therefore will not be divulged to any third party,
client, and or supplier/s.

I hereby certify that the above information are true and correct to the best of my
knowledge.

Conforme:
___________________
Name & Signature