@COCOLIFE a COCOGEN LUNTED COCONUT PLANTERS LIFE ASSURANCE CORPORATION {2 One Carport Cantar, Datu Vargas Averue (COCOLIFE Bulg, 07 Ayan Averve, Matas Cry S228 Sune Moraes Avon, Orpat Cert, Pang ty Tal No B10-7880 Fax No 88129059 TIN 00080%-736-200 NV. Wibee: wince com ‘eno bart i708 eteucticd Mora oa eae one Oe cy om Om OMe PLN: — USTHANE reste MooLE MAE PALIPRNE ACRES om sus Cl sncie =< wanned—~—=D Seware> ~~ Woon ~ | | care oF a ~Tpaceor eae rs ‘OCCUPATION: = is "NATURE OF WORK CAST WN aaa NE POORESS: PASSPORT HOMER TSE [sex ‘BENEFICIAL OWNER, fran rata prean wh nay ows eco cuse, soon whose eho Yaaasion er ays bag onvetd oat lina ntl On algal puro of rangemae | nln ia il ey eal Ouers we nsw eg char hs 0% rw tbe nga sha 9 Doyoutan aBetce ome? ChyEs_ OHO IVES, pote aol Bu Cot Brat Omer am, DESTRATION COUNT ‘CONTACT FER SOURCE OF FINDS Cisaby Pots Fes! Comion Caine Cuesta Pen eh Dare ce BR cas FuLNaMe EGER) maccorsnm | sex | aeuanonsne | Sia [rns cogent) T 7 + ‘aver de nt yt Baler = r (Corton) Natonaty ‘Address Contact Detals (Mobile andor Ema) 1 2 = . ae 3 s eae 4 oe _ 6 NOTE bea ees a ceunod Pinar” snd “Reece res nad trie evans Prterzhos apunt ans cat 3) amotio 18 joss rd hae od yest op 3) pes snd ath ar an apr rel cept nyo ee er aye ri y, 9} etn eto erect ay yan cr an ly hen on Be pa craeceretrhn ey per hapalan g ate EXCEPTIONS 0 THE ABOVE: ark, wien mean as NONE) q \ wy ape nth ve tn nano tl be cone fv fal mat sur. speao rsync | Ny deca al he feaoen see nd aie a ‘onl, fe an core te oly Iodine Perea ll ue be ey mere hve ent ral ek nd Cazes Ue fer Copa {COGOLFE) ea owe ero ard eh Rect ad oe "DSCLOSURE in rarino wh be eave Cen Cd er 21654, yo enc nemaon lewd Mec oan Dts scene ie cara be Pup fee ak asset andre au. Ore cde ale aca capes ae css yr bin We grb ta cy oss wh oe yo Cae No 2165 yb ene aD son Crm west awe oh CCOCULIFE ups an nda data privacy rights are asauos that al your persona fora, snave personal inkrmaten ena pvieged ifomalon (alec, "Poronl Dain), colecied ad to be coleciea, are processed In complarcs athe Data Privacy Act of 20¥2 (RA No 10473 an timoemertng Rules and Requatons (FR), ‘Toanabio uso pro our processes ead wth your aplcatin fre and cine vous product, iti knprtan st COCOLIFE collect, ves and soos your parson data. Thu, we are using yourifomaton fo: (1) Aan your ole, with any parson oerganzaton who hes frat sb! yo, suing our employer ser Gos Acrouni ahorced inate, Investgave agers, Inara and relsurer, 2 Proven Money Laurdang x Terar-Fanch acles, and (3) Peo any Oh acon a8 a Deneoessary implant heirs an conden of aur cone. \inen yu provi information ther than youre, you cert that you bined the consent io dose a proces thse ifoaton f your parents, spouse, cite, dependet orabottenober person ike secitaaes, deci ofiars ard emp \We may share your personal cata onto fe extent thats reasonabe and necessary o our opayees anoles handing your ordre an rues ou uberis, fils arto, jin verse & oferta parca, employer under Group Aesurs fo eid purpose provided inthis ply. irc-pary seo rover peroing franca Sinisatve, eccal ance anclary services, ard person rely Dat we caclilyertered wh, fat ensure ha condentaly sanded we glean nd ares ‘eine PA CCOCOLIFE ahi ensure that personal dala under its csloy ae prcecnd against any accidental er unlawful dostucte, aeraten an unlawl desu I ielemarte sopoptaie sean measures sting calected penal data Peraonl data ilbe safely Garoyed hough secre means ae the ape te eanton pig proved by ‘horas Geemined by COCOLIFE ‘nly browse hough cur Pvcy Ply Staten in ur company webs o Know more about a portance ol your iohis undo the DPA You may al Sed in your orcas ‘COCOLIFE Duta Proiectn Once at COCOLIFE Bulsng 8807 Ajala Avenue, Makati of oral adress epogpeattie. sm * elo you seknowedge and agree win te foregoing and cert tat you ex consent oe colecton processing, sharing song of your persona and sense aw stermation by COCOLIFE fr purposes decoed mus Deta Privacy Pally Insure I Youastnowiedge tht you area Unted Stats CUS.) Porson! unde U.S. Laws 1 Youacknowledge that you sre NOT US, Perton under US. - Butyounave atleast ne ofthe fotowng US. Indes a ‘Ad you nave no U.S. etn "You agre to advise us as 000 a8 possible of any change nthe Information that you proved tows" "US. Paton means: } U.S ize nccing dal lizan) U.S, permanent resident (roe card hose; Indiv athave ied fora subtanlnumber of ay in ‘he US. e. More than 31 days dung the caret year ora ltl of 189 days cura he 2-year orod hal ces the carter year nd hs 2 yrs erate batore hat US. corporafons,parnerstip, and Eusts cesod under US. aw, or) Foreign (nov. egsered) erste ar sustaralycunedby& U.S. Parson (rere an 10% of ‘hot by ve value) + 6) US, Pace of Binh) US, mating or eidence address (nein & US, pot tice bw «US ehone ru: A tending Instruction o banter nds oan account IRabaainedin the Unted Stats) Acre ative pove! ower 2 signal eth ganas a person witha US, mre: Ansar Ohad mal sess Iratis your slo eres. Dung the eect of he contact, Lage othe flowing: (1) incase the Corgan is unable to comely wih relevant customer de ligence (COD) measures, s8 equted ‘er the AteMorey Laundeig Ad amend ad reorar’suences, ue ote father. te Company ray) oe menses est ba tras avalabie "wehibt ay turer waneacoos on ts convacpatcy unl tl and propec COO measures have Boon succestly conducts and 2) n ene he forgongeunducces «=: “yany may eats buns relaionship. The oxo ofthe Company of hs meesure shal ol ere De chen cstrerorcave he urns prt pam ‘nwa vate, any, whichever appleate, and (2) Be tent by obigaons stout elovant Usted Naons Securty Courel Reacion aang ote prevention tnd wupresson of poferaton trancing of weepans of mass deacon, nc the ean an unonsng soon ae wel pronntens rm ondungFansachon ‘esgnaas partons anc non | ihe understned hereby cet hat | expty and unarbguouly consent othe colecton, process, sharing, sonng of my persona nd snsve persona nraion by ‘GOGOUFE or purposes desctbed in te Data Privacy PolcyandPATCA I hereby cart at cael untae ana omgraend thst above tare Qxng My cone ‘Sioatue of Aopen ate Sones essed by Date Sones aman RaeeT SIO cworreras Po 22180 Form Code FM-POEA-02-GP.07 (01) Copy T= POEA, REPUBLIC OF THE PHILIPPINES DEPARTMENT OF LABOR AND EMPLOYMENT PHILIPPINE OVERSEAS EMPLOYMENT ADMINISTRATION (OVERSEAS WORKERS WELFARE ADMINISTRATION OFW INFORMATION SHEET DO NOT WRITE ON THIS SPACE (Cor POEA snd OWWA Use Only) ‘ype or eter Type of Empiorens Land Based CD Name ire Ciseo-ased Baik Wanggera Avery Endorses | cone SEM iF SEC No Rene: | PERSONALDATA i ote Nae ian ne Bi de CO Chie C Feoe cigs CD Siege serene TaD AT Claas Cl Witenes ies TO) rte TeANo: ‘Passpon No; Mother Maiden Nee’ Niet Eden Aten” = Dace For Sete ay SID No SRCND: ‘CONTACT PARTICULARS Nene ofPrincbetCunpanyiagiye: soba Ait ‘ese ste) Ena ates cs fig, ont to: Monty Sy — Depa aa ame ofAgmy ft) LIFELINKS INTERNATIONAL RESOURCES, INC BENEFICIARY DATA fetietp eeciry owe xo Fenton Vein sec ae. Aiton Fear Tien — nee Pexmanent Tel Noe MEDICARE DEPENDENTS DATA (for OWWA-MEDICARE ener ol) Nave pe cae cccetne orsany see RHA goo TAL) satonty — ‘Name of Children “eben ‘Sane ‘Explored Cenvuy asae PST NAME NUDDLE TAL) MDB ey gape tens eee Zz ootvo o8 Z 00 0-5 De os oooao ag ia fo 8 8 oe RST NAME Sele Dinie es Le Ane Nate ot asin bees e Name ob vavents i bee easy ine SRST ove TITALY AUTBRny Heaths tptetteie Pa ‘NUTHORIZED Mone este ManasMEMBERSHIP REGISTRATION FORM (MRF) Pros aa es rae accoetinne vents bta | EBISTEATION TRRCRING o> Foon MOF wa ere wen Resta js ey nanting ety cos MOE memaeaone carecony [> CoveSEns LPN WORRERIOFWD Gearamos UST NAME RST NAME RANEEXTERSTON——yiop.enawe _, ROMDOLE NAME ReaISTRANT fi ore Ion toed 3 DATE OF RTH aan enc ara "TARPAYERS DENTIFCRTION No (7) ECO) | Sue" [Binge in ames | LO ws Gremie |B vores 6 Lagaysemiias Sestasis ne PRESENT ROME ADDRESS } Cot Po Bois Nae rot No. kN, Phe Me HN we Se Ne bolas a ns ——— paid ese SEA Saisie) PREFERRED MAILING ADDRESS (HEREBY CERTIFY THAT THE INFORMATION GIVEN a epee cats moos, ee TH FOR WAY BE REPRODUGED NOT FOR SRE ae MEMBERSHIP REGISTRATION FORM (MRF) fee aaa eee 5 oN Taare LAST NAME FIRST NAME a ‘MIDOLE NAME Ph eer rape ese = om a ore ee ans [eR SoS CLM CCT) [Bite | Bee, 2 De | le [tort oar uti Rare oI se ‘PREFERRED WAILING ADORESS SEN DPrsertome Atos DE HEREIN ARE TRUE remanentOP-LLIR-A1/ Rev.00 Litetinks Resources. Inc. E-SUBMIT FORM feuinks | WORKER DATA Last Name Middle Name Firset Name Birthday Passport No. Gender SSS No. Civil Stas ADDRESS Province Municipatity Street Email Address Cellphone Number In case of emergency,please contact Relationship Name Address Contact Number Related Persons Information. Please indi Relationship CoPependent Last Name Beneficiary First Name ‘Middle Name Birthday Province Municipality Street e if dependent or beneficiar Relationship Last Name First Name Middle Name Birthday Province (Dependent (ZoBeneficiary Relationship Last Name First Name Middle Name (Dependent (7 Beneficiary Municipality Street any This ts in eccordance with SOP-LLIR-O4