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  • CIS Your Full Name 4

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    This document is a client information sheet requesting personal details from Edmundo P. Cervantes including his name, nationality, driver's license/passport information, date of birth, addresses, contact information, and digital wallet address. It also requests a copy of his passport or driver's license be attached. Edmundo signs at the bottom to confirm the provided information is correct.

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    This document is a client information sheet requesting personal details from Edmundo P. Cervantes including his name, nationality, driver's license/passport information, date of birth, addresses, contact information, and digital wallet address. It also requests a copy of his passport or driver's license be attached. Edmundo signs at the bottom to confirm the provided information is correct.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    34 views2 pages

    CIS Your Full Name 4

    Uploaded by

    Image Prints
    This document is a client information sheet requesting personal details from Edmundo P. Cervantes including his name, nationality, driver's license/passport information, date of birth, addresses, contact information, and digital wallet address. It also requests a copy of his passport or driver's license be attached. Edmundo signs at the bottom to confirm the provided information is correct.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    CIS

    Client Information Sheet

    Required information

    Please attach:

    - Copy of passport/Driver’s License


    - Corporate certificate in case of company

    Client Information

    Client name EDMUNDO P. CERVANTES


    Nationality/ies FILIPINO
    Driver’s License no(s)/Passport A02-94-046970
    Issued Date 05/08/2023
    Expiration date 05/10/2028
    Social security no N/A
    Date of birth MAY 10, 1968
    Place of birth MANAOAG, PANGASINAN
    Present Address 186 SORIANO ST. POBLACION MANAOAG, PANGASINAN
    Mobile no 63-956-611-1288
    Email address edmundo68cervantes@gmail.com
    Legal Address / Country 186 SORIANO ST. POBLACION MANAOAG, PANGASINAN,
    PHILIPPINES
    TRUEHN wallet address 0xc534733063151AF114c5d418a1082693172C83e2

    I the undersigned confirm that the information is right and correct and in best willing and understanding.
    Confirmed by

    EDMUNDO P. CERVANTES

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