CUSTOMER INFORMATION SHEET

UNIVERSAL INKPRO
MFG. CORP.

Company Name Date

Tel Number
Address
Fax Number
Trading Name Email Address
Delivery address Zip Code
Date Incorporated Tin Number
Nature of business SEC / DTI no.
Business Type Sole Proprietor Partnership Corporation
Type of Machine
Type of Products
Volume
Authorized Capital
Affiliated / Parent Nationality
Company
FULL NAME AND ADDRESS OF DIRECTORS / PARTNERS / PROPRIETORS
NAME DESIGNATION ADDRESS

BANK REFERENCES (At least 2)

BANK NAME CONTACT PERSON ADDRESS CONTACT NO.

TRADE REFERENCES (SUPPLIER, at least 3)

COMPANY NAME CONTACT PERSON ADDRESS CONTACT NO.

We certify that the information given is true and correct. And we agree to notify UNIVERSAL INKPRO MFG. CORP. for any
changes in the above information.

Name of Authorized
Position
Representative
SIGNATURE OVER PRINTED NAME
FO-UIPSCS-001/Rev.0 Page 1 of 2
PLEASE SUBMIT THE FOLLOWING DOCUMENTS

1. Photocopy of TIN Registration Document

2. Photocopy of SEC or DTI Certification
3. Photocopy of PEZA or BOI Registration Certification,where applicable
4. Articles of Incorporation or By-Laws,where applicable
5. Mayor's Permit
6. Company Profile
7. Others _______________

TO BE FILLED UP BY UNIVERSAL INKPRO MFG. CORP.

ENDORSED BY DATE
ACCOUNT MGR. PC CODE

Approved by :
Top Management Accounting
Date approved :

ADDITIONAL INFORMATION / REMARKS

Received by Finance Date Received by

Disposition

Customer Info. Date Transaction no.

update in the system by Customer code

FO-UIPSCS-001/Rev.0 Page 2 of 2