1721 I. Limkakeng Street Happy Valley, Cebu City 6000
Tel. Nos. 253.9100, 512.0989 and 0999.832.2048
Bank
Type of Financing:
Pag-‐Ibig
Spot Cash
Deferred Cash
Others _____________
CLIENT INFORMATION SHEET
CLIENT PERSONAL DATA
Last Name
First Name
Home Address
Own
Middle Name
Rent
Living with Parents/Others
Postal Code
Gender
Male
Civil Status
Female
Single
Married
Separated/Divorced
Widowed
Citizenship
Date of Birth
Place of Birth
Religion
Home No.
Fax No.
Mobile Nos.
CTC No.
Date of Issue
Place of Issue
Passport No.
Date of Issue
Place of Issue
TIN No.
Email Address
Filipino
American
Others:
___________
Company Name/Employer's Name
No. of Years in Business/Employed
Position
Office Address
Office No.
Nature of Business
Monthly Household Income: No. of People Living With You
Below P10,000
P30,000 -‐ P49,999
P120,000 -‐ P150,000
P10,000 -‐ P19,999
P50,000 -‐ P80,000
P150,001 -‐ P180,000
P20,000 -‐ P29,999
P80,001 -‐ P120,000
P180,001 and above
Including Helpers/Yayas
No. of Vehicles Owned:
Make and Model
Color
Year
Plate No.
1.
2.
3.
SPOUSE'S INFORMATION, IF MARRIED:
Last Name
First Name
Date of Birth
Place of Birth
Mobile Nos.
Religion
Email Address
Citizenship
Filipino
American
Others:
Middle Name
___________ TIN No.
CTC No.
Date of Issue
Passport No.
Date of Issue
Place of Issue
Place of Issue
Company Name/Employer's Name
No. of Years in Business/Employed
Position
Office Address
Office No.
Nature of Business
Monthly Household Income: Below P10,000
P30,000 -‐ P49,999
P120,000 -‐ P150,000
P10,000 -‐ P19,999
P50,000 -‐ P80,000
P150,001 -‐ P180,000
P20,000 -‐ P29,999
P80,001 -‐ P120,000
P180,001 and above
No. of Dependents: Name
Age
Birthdate
School Attended
1.
2.
3.
4.
5.
BANK REFERENCES
Bank Name & Branch
Account No.
Contact Person
Contact No.
Credit Limit
Expiry Date
Address
Contact No.
CREDIT REFERENCES
Credit Card(s)
Credit Card No.
CHARACTER REFERENCES
Name
Relationship
REASON FOR BUYING
SOURCE OF AWARENESS
Primary Home
Site Walk-‐in
Internet
Investment
Others
Billboards
Broker / Agent
Vacation Home
_________________________
Flyers/Brochure
Agent's Website
Retirement Home
Newspaper Ads
Referral
Inheritance/Gift to Children
Questland Website
Others ___________
TOWNHOUSE UNIT
Unit
__________
Corner
Regular
No. of Bedrooms: ________
Ground Floor
________
Second Floor
No. of Toilet & Baths: ________
Ground Floor
________
Second Floor
NOTES
A.
B.
C.
D.
E.
F.
G.
H.
I.
I acknowledge that __________________________________________________, accredited broker of Questland Builders and
Developers with PRC License Number ________________, has given me a comprehensive presentation of NORTH8. I hereby
authorize him/her as my broker of choice. No other broker should be recognized and/or credited by Questland Builders and
Developers, should I decide to make a reservation deposit for said project from the signing of this Customer Information Sheet.
I/We hereby certify that the above information are true and correct. Should there be any changes in the above information, I/We
will be responsible to inform Questland Builders and Developers in writing of such changes.
Accomplished by:
Conforme:
BUYER
QUESTLAND BUILDERS AND DEVELOPERS
Signature over Printed Name / Date
BUILDER
BY:
BUYER
Signature over Printed Name / Date
ATTY. ERNESTO D. LIMKAKENG
ERNST LESTER S. LIMKAKENG
LOT OWNER
OWNER/PROPRIETOR
6000
.2048